• Yomiuri Editorial

Medical, Nursing Care Fees: Can Revisions Lead to Higher Wages for Frontline Staff?

In order for the public to receive medical and elderly care services with peace of mind, it is necessary to improve the treatment of frontline workers. The revision of medical and elderly care fees must be linked to steady increases in wages.

The government has decided to revise the rates for medical service and nursing care fees starting in fiscal 2024. Regarding medical service fees, the government has decided to raise the core part, which covers personnel costs, by 0.88%, while lowering the prices of medicines by 1%, resulting in an overall decrease of 0.12%. Nursing care fees will be raised by 1.59%.

Medical service fees and nursing care fees will be revised simultaneously for the first time in six years. The focus was on how to achieve wage increases in the medical and nursing care fields.

The Finance Ministry has argued that medical institutions should raise wages through their own management efforts, claiming that their business is steady. In contrast, the Liberal Democratic Party and medical associations have called for a substantial increase in the core part of the medical service fee framework.

Prices for medical services are determined under the medical fee framework. Medical institutions cannot collect the cost of wage increases from patients. Increasing medical care fees to secure funds to raise the wages of medical workers is an understandable idea.

In the nursing care industry, there has been a noticeable outflow of human resources to other industries due to the low wages paid for the heavy responsibility of caring for the elderly. To secure stable human resources in this field, it is essential to raise wages for people working on the front lines of nursing care.

The government expects to be able to achieve a 4.5% increase in the pay scale over the next two years for both medical and nursing care workers as a result of these revisions.

It should ascertain whether medical institutions and nursing care facilities are in fact steadily raising wages.

In recent revisions of medical service fees, drug prices have been lowered in line with market prices, and the core part of the fees has been adjusted to increase within the range of the reduction in drug prices.

As the use of medicines has been increasing with the graying of the population, drug prices will inevitably be reduced to a certain extent.

Meanwhile, a shortage of generic drugs has emerged as a problem.

Many of the pharmaceutical companies involved in the generic drug business are small and midsize companies that are new entrants to the market. It has been argued that the repeated reductions in drug prices have weakened their financial condition, making it impossible for them to maintain an adequate production system.

As the government tries to curb medical costs, is it not putting an excessive emphasis on measures related solely to drug prices? The government may have to consider providing support for pharmaceutical companies to ensure a stable supply of medicines.

Efforts should also be continued to reduce medical costs. Due to the aging of the population and the advancement of medical care technology, medical costs have been increasing by about ¥1 trillion annually, reaching ¥46 trillion last fiscal year. It is important for hospitals and clinics to make constant reforms, such as distinguishing their roles to eliminate unnecessary tests and medications.

(From The Yomiuri Shimbun, Dec. 24, 2023)