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Medical reform package endorsed
The Asahi Shimbun, February 25, 2002
A medical reform package to take effect in April will raise patients' hospital bills by as much as 50,000 yen($375) a month for those hospitalized more than six months, according to a draft unveiled Wednesday.
Health minister Chikara Sakaguchi received an official endorsement of the draft of the fiscal 2002 medical reform package from the Central Social Insurance Medical Council, an advisory panel, on Wednesday.
Government sources said the majority of the reforms will take effect in April.
The package, which will cut reimbursement payments to medical service providers, is intended in part to discourage hospital overstays.
In October, the government will begin cutting reimbursements for patients who have been hospitalized for more than 180 days without a compelling reason.
In the initial phase, reimbursement payments will take into account only 95 percent of a person's hospitalization fees. That amount will drop to 90 percent in fiscal 2003 before falling to 85 percent in 2004.
The Ministry of Health, Labor and Welfare estimates a total of 50,000 patients will be affected by the measure. Their bills are expected to increase by 40,000($300) yen to 50,000($375) yen per month.
The ministry hopes to shave 1.3 percent from the total of insurance reimbursements to lessen the load on a medical insurance system increasingly burdened by an aging society.
This is the first time that medical insurance reimbursements will be lowered.
Payments for medical tests will see the largest cuts, with the package aiming to slice 100 billion yen annually from such reimbursements.
The government also hopes to save 50 billion yen by reducing expenditures on prescriptions. An additional 25 billion yen is expected to be saved by reducing its coverage of the cost of repeat hospital visits.
Savings on payments to cover basic hospitalization fees will amount to 25 billion yen annually.
The package is the first to emerge from Prime Minister Junichiro Koizumi's drive to force patients and doctors to shoulder a larger share of swelling medical expenses.
Although the drastic, broad-based reform is being hailed as an achievement, sources say the lion's share of the burden falls on patients rather than medical services providers.
However, it will create a new fee structure that will lower the fees levied on patients each time they seek treatment, which will affect hospitals' income.
The package also aims to improve pediatric care, which requires a large hospital staff and is less profitable than other specialties, by boosting by 25 billion yen the amount available for insurance reimbursements.
Yielding to pressure from the powerful Japan Medical Association, however, the package has failed to narrow the gap between the amounts charged by large hospitals and small clinics for repeat visits.
Consequently, outpatients will be charged only 700 yen-an amount that includes fees for simple tests-at hospitals with 200 or more beds, while those who seek treatment at smaller clinics will be charged 740 yen and must pay extra for tests.
According to sources close to the Central Social Insurance Medical Council, officials from the National Federation of Health Insurance Societies, which represents the health insurance system, argued the gap should be closed because it favors private practitioners.
However, the argument was rejected due to protests by the Japan Medical Association.
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