Wages of nurses must be raised to level appropriate for the times

It is vital to steadily improve conditions for nurses who play an important role in the medical field and to realize efficient and high-quality medical care services.

The government has decided to lower by 0.94% the overall payments for medical care that hospitals and other medical institutions receive from fiscal 2022.

The costs of medical care services for the nation as a whole have increased by hundreds of billions of yen every year to more than ¥44 trillion a year. It is essential for the government to restrain the increase in public burden by bringing to an appropriate level medical treatment fees — the state-set official prices for treatments and medicines — through their revision once every two years.

The government will raise by 0.43% the main portion of medical treatment fees — which includes fees to cover labor costs for doctors, nurses and other medical personnel — while it will reduce official prices paid for drugs by 1.37% to bring them closer in line with market prices.

Regarding the main portion of medical treatment fees, this will be the eighth consecutive increase since fiscal 2008. The Finance Ministry had insisted on lowering the fees, but Prime Minister Fumio Kishida might have tried to settle the issue in a way that saved face for the Japan Medical Association, which had demanded an increase.

The prime minister has come out with wage increases for nurses and other medical personnel as part of his policy to achieve a “new form of capitalism.” Along with efforts made by former Prime Minister Yoshihide Suga to expand insurance coverage for fertility treatment, wage increases were a major issue in the latest revision.

Signature policies of the current and former cabinets appear to have pushed up medical treatment fees, rather than requests from frontline workers. As the aging of the population is expected to continue, the government should also seriously discuss reforms to curb the expansion of social security costs.

The government intends to increase the wages of nurses involved in the fight against the novel coronavirus pandemic by ¥4,000 per month. The central government’s budget will cover the increase from February to September next year, but from October onwards, the increase will be covered by medical treatment fees.

The average wage of nurses is higher than that of all industries, but it has reportedly become difficult to secure workers mainly due to the high number of night shifts. In addition, many workers have left the profession amid the pandemic. It is understandable that the government aims to raise wages to a level commensurate with working conditions.

However, since medical treatment fees are paid to medical institutions, it is uncertain whether the increase will be reflected in the salaries of nurses working there. The government needs to consider effective measures to ensure that the money reaches nurses on the front line.

If costly fertility treatment, such as in vitro fertilization, is covered by health insurance, the financial burden on couples who want to have children would be reduced. Medical institutions should use the fee revision as an opportunity to improve their treatment performances and actively disclose information in this regard.

A system allowing refills for prescriptions will also be introduced, in which a prescription can be used repeatedly for a certain period of time.

This is expected to reduce medical costs by reducing the number of hospital or clinic visits. It will also save patients the trouble of having to see a doctor just to get medicine. It is hoped that the system will be used appropriately to ensure overdoses do not occur and diseases are not missed.

— The original Japanese article appeared in The Yomiuri Shimbun on Dec. 24, 2021.