Design medical service fee revisions to better deal with infectious disease

The revisions of medical service fees for fiscal 2022 are characterized by the aim of building medical services that can weather the effects of infectious diseases, including the novel coronavirus.

The aim is to improve the ability to deal with such diseases at all medical institutions, including clinics in local communities, through the revisions of medical service fees that hospitals and other medical institutions receive. The central and prefectural governments need to take the initiative in implementing effective measures for that purpose.

The prolonged coronavirus pandemic has highlighted weaknesses in Japan’s medical system. The capacity of PCR testing was inferior to that of other countries, and the supply of hospital beds for coronavirus patients quickly became strained. It has also become clear that a system in which public health centers play a central role in conducting tests and health observation cannot cope with an explosive spread of infections.

There is a need to take prompt action to solve these structural problems.

The main pillar of the revisions is to newly establish a system to provide additional medical service fees for clinics to treat outpatients with a fever. The goal is to increase the number of facilities that take measures such as establishing separate routes for feverish outpatients to move through the facilities, keeping them apart from ordinary patients.

Preparedness in ordinary times is essential to prevent hospital-acquired infections. It is hoped that the revisions will encourage as many clinics as possible to cooperate so that they can take charge of testing and medical examinations when infections spread nationwide.

According to the Health, Labor and Welfare Ministry, only 35,000 of 110,000 medical facilities nationwide have been designated as facilities to treat outpatients with a fever.

Many medical institutions that have this designation are said to have refrained from announcing it, partly because they want to avoid being flooded with patients. It is reasonable to make public a notice of the designation on their websites a condition for receiving the additional fees.

It is hard to understand why many medical institutions are still reluctant to examine patients with a fever. The central and prefectural governments should publicize their support measures and strongly encourage practitioners and others to participate in examining such patients.

For patients, it is reassuring to know that there is a medical institution nearby that they can visit when they have a fever. How a medical institution responds to infectious diseases may also be a factor in choosing their family doctors.

The revisions also call for raising the amount paid by patients for a first visit to a major hospital without a referral from the current ¥5,000 to ¥7,000. The number of major hospitals eligible for the system will be expanded.

It is appropriate to create an environment in which large hospitals can engage in advanced treatment. It is necessary to have the public understand the division of roles between clinics and major hospitals.

It has also been decided that fertility treatment will be covered by the public medical insurance program. The out-of-pocket expenses for patients receiving treatment will drop to 30% of the cost of treatment, reducing the financial burden on couples who want to have children. It can be appreciated that the content of the treatment, which has varied among medical institutions, will be standardized.

However, there are restrictions, such as on the age of women covered by the public medical insurance program. It will be vital to make efforts to give young people correct knowledge about pregnancy and childbirth.

— The original Japanese article appeared in The Yomiuri Shimbun on Feb. 10, 2022.