Ministries joust over whether to up medical fees

The issue is one of the focal points in the compilation of the fiscal 2010 budget. If the government decides to raise the amount of medical remuneration in fiscal 2010, it will be the first such increase since fiscal 2000.

“To restore the nation’s ailing health care system, we need to consider increasing government expenses for health care. We can’t reduce the medical remuneration [paid to doctors and medical facilities],” Shinya Adachi, parliamentary secretary of the Health, Labor and Welfare Ministry, said at a press conference last week.

Medical treatment fees are the payments doctors or recognized medical facilities receive from the national health insurance system for rendering medical services to insured patients. A certain number of points are allocated to each category of medical service, with each point worth 10 yen. Every two years, the Cabinet decides whether the fees should increase or decrease, and then the Central Social Insurance Medical Council, an advisory body of the health, labor and welfare minister, decides how many points to credit for each medical service.

If medical remuneration is reduced by 1 percent, the government could cut health care expenses–which totaled about 34 trillion yen paid by the government in fiscal 2008–by 340 billion yen. Such a cut also would reduce the amount of money citizens must pay after receiving services at medical institutions.

Considering the Finance Ministry’s stance, Nagatsuma implied the possibility of a slight increase in the medical service fee, or of increasing the government subsidy to the health insurance system along with raising the medical remuneration by a large margin. “We need to consider a way [to raise medical remuneration] that won’t increase the expenses paid by the citizens at medical institutions or hike the health insurance premium,” Nagatsuma said.