Revision of Medical Fees: Raise Medical Service Workers’ Wages to Improve Quality of Care

Through the COVID-19 pandemic, many people must have realized anew how important it is to protect the medical system. The treatment of medical care workers should be improved to secure human resources and to enhance the quality of medical care.

The contents of the revision of medical service fees for fiscal 2024 have been decided. The main focus is to promote wage increases in the medical care field, which is a public service.

At the end of last year, the government had already decided to raise the core part of medical service fees paid to medical institutions, which mainly covers personnel costs, by 0.88%.

Based on this decision, the government has decided on specific matters such as raising the fee for an initial visit to a medical institution to ¥2,910, an increase of ¥30, and raising the fee for a second or subsequent visit to ¥750, an increase of ¥20. Also, basic hospitalization charges will be raised to ¥1,040 per day, an increase of ¥50, depending on the type of ward.

To raise the wages of doctors, nurses, pharmacists and medical service workers, it is essential that members of the public bear a thin but broad share of the cost. It is important for the government to carefully explain the purpose of this revision to the public.

This is the first time since fiscal 2006 that initial visit fees have been raised, excluding those associated with a consumption tax hike. Many medical institutions will see an increase in revenue, and the government expects to be able to achieve a total wage increase of 4.5% over the next two years.

In addition to increases in initial visit fees, the revision will also establish a “pay scale increase evaluation fee,” an additional fee specifically designed to raise the wages of nurses, pharmacists and others. Medical institutions will be allowed to request this additional fee if they submit a plan for raising wages.

The government should investigate whether wage increases are being properly implemented in the medical service field. If the increased revenue is not being used to raise wages, the government should take strict action, such as demanding the refund of medical service fees paid to medical institutions.

The long working hours of doctors have become an issue in recent years, as evidenced by the recent cases of overwork-related suicides among doctors employed at medical institutions.

In April, “work style reform for doctors” will begin. In principle, physicians will be allowed to work up to 960 hours of overtime per year. Doctors’ workloads should be reduced through such measures as greater use of electronic medical recordkeeping.

In addition, the government has established a new framework of “community comprehensive medical wards” along with the latest revision to deal with the increasing number of elderly patients being transported to emergency rooms.

The majority of elderly emergency patients are suffering from minor or moderate illnesses, but their physical strength declines during hospitalization, which tends to prolong their stay in acute care wards that treat severely ill patients. For this reason, a new type of hospital ward with enhanced rehabilitation and other functions has been established with the aim of clarifying a division of roles.

The medical care system must be steadily reorganized in anticipation of the projected peak of the elderly population around the year 2040.

(From The Yomiuri Shimbun, Feb. 17, 2024)