Revising Medical, Nursing Care Fees Should Make services More Efficient
Efforts should be made to establish an effective and efficient system by strengthening coordination between the medical and nursing care services. It is vital to speed up work to create a system suited to a super-aged society.
The government has decided to cut overall medical fees, which comprise service fees and drug prices paid to medical institutions and pharmacies, by 1.19 percent in its fiscal 2018 revision. Fees for nursing care services are to be raised by 0.54 percent — a revision that coincides with a medical fees revision for the first time in six years.
Medical fees, which are government-set prices for health care, are revised biennially. The fees were reduced by 0.84 percent in the previous revision. The latest revision will see the fees effectively cut for the third time in a row.
The “main body” of medical fees, used to cover medical personnel costs and other expenses, is poised to increase by 0.55 percent. The “drug price” part of the fees, mainly comprising pharmaceutical prices, is to be cut by 1.74 percent in accordance with actual market prices.
From the standpoint of achieving fiscal soundness, the Finance Ministry called for a revision that drastically reduces medical fees with an eye on cutting into the main body of them. The Japan Medical Association strongly sought to increase the fees in the revision, citing the government’s request to industries to raise wages.
Hospital management has been on a downward trend in recent years. A shortage of doctors in regional areas and excessive workloads of hospital staff doctors are also major challenges. Increasing the range of reductions for medical fees overall while ensuring there is a slight increase in the main body of the fees is reasonable for paying consideration to the fiscal soundness and stability of the medical care system.
Shift to home care needed
Discussions on setting the fees for individual medical treatments will be held after the turn of the year.
The currently excessive number of beds for accepting seriously ill or injured patients will be streamlined, with stricter requirements put in place. Arrangements will be made to increase fees for beds for recovering patients, for whom importance is placed on helping them leave hospitals, while fees for home medical care will be raised. Efforts are required to turn the current medical service system into one suited to a super-aged society.
The nursing care fees paid to service providers are revised triennially. The previous revision saw the fees lowered 2.27 percent. The latest fees revision will be the first increase in six years.
Nursing care providers have gone out of business one after another since the previous revision. Considering the current serious labor shortage, it is essential to drastically improve working conditions.
Increasing nursing care fees can be seen as a necessary measure for attaining the government’s goal of reducing to zero the number of people who quit their jobs to care for family members.
Reviewing services for people requiring light degrees of nursing care should be done when setting fees for individual medical services. To make effective use of limited financial and personnel resources, focusing on benefiting people who need high levels of nursing care is inevitable.
Limiting the use of “living support services” by those who need light care — in which visiting caregivers conduct cooking and cleaning — should be considered, as well as a lowering of relevant nursing care fees. Measures to promote self-support among those in need of nursing care and prevent their conditions from worsening should also be taken.
Curbing rising medical and nursing care costs is the key to realizing sustainable social security. But if the provision of necessary services is at risk, people are unlikely to have a sense of security. It is crucial to set medical fees while prioritizing areas that are in line with a shift from dependence on hospital treatment toward home care.
