The spread of the novel coronavirus has exposed structural problems in Japan's medical system. It is an urgent task to build a system that can respond to these issues through appropriate medical treatment fees.
The government has begun to study the revision of medical treatment fees for fiscal 2022. The overall percentage by which they will be altered will be decided by the end of this year, and individual medical treatment fees will be revised soon after the New Year.
Medical treatment fees -- the government-set prices for treatments and medicines -- are revised every two years. They are increased or decreased in accordance with relevant issues at the time, and this is the first revision since the outbreak of the COVID-19 pandemic.
Although Japan has one of the highest numbers of hospital beds per capita among advanced countries, only a limited number of medical institutions can handle COVID-19 patients, and beds for them have been in short supply.
Contributing factors are likely to be structural problems such as the fact that the majority of hospitals are privately run, which weakens the government's authority over them, and the fact that small and midsize hospitals are scattered throughout the country, with few doctors and nurses at each facility.
It is essential to realign hospital beds and consolidate medical personnel at core hospitals. The government needs to encourage hospitals to reorganize and divide up their roles by making calculations more in line with actual conditions, such as strictly assessing how many patients in serious condition have been admitted.
In terms of business, many medical institutions temporarily struggled because more people refrained from going to hospitals due to the pandemic, but their financial situation is now recovering.
According to a government survey, general hospitals as a whole posted a deficit of 6.9% last fiscal year before pandemic-related subsidies were calculated. If these subsidies were included, they posted a surplus of 0.4%.
It is inevitable that medical costs will continue to rise as the population grays, and circumstances do not permit a significant percentage increase in medical treatment fees overall. It is important to proceed with reform in a flexible manner, investing financial resources in necessary areas such as countermeasures against infectious diseases.
The role of neighborhood medical institutions is also a point of discussion regarding the upcoming revisions.
In the early days of the outbreak, many medical institutions refused to treat people with fevers due to concerns about in-house infections and harm to their reputations. In addition, many people died because they were not sufficiently monitored while staying at home and could not undergo examination and treatment.
Many people are likely to have grown anxious about the lack of prompt, appropriate medical care.
The Finance Ministry and health insurance unions are advocating for the establishment of a "family doctor" system in which local doctors regularly check patients and refer them to specialists when necessary. Discussions should be deepened on the specific nature of this system, its role and ways to collaborate with specialists.
An environment must be created in which local medical institutions can be utilized appropriately, including with home and online medical care.
-- The original Japanese article appeared in The Yomiuri Shimbun on Dec. 5, 2021.
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