Review of High-cost Medical Expense Benefit: Prime Minister’s Haphazard Handling of Issue Is Appalling
15:39 JST, March 14, 2025
It is deplorable that the leader of the governing party is running around in confusion, repeatedly making haphazard responses over social security system reforms.
It is extraordinary that questions are raised from within the Liberal Democratic Party as to whether their leader is capable of running the government.
A meeting of the Budget Committee at the House of Representatives was held mainly to discuss reform of the high-cost medical expense benefit system, which is intended to reduce the burden on patients when their medical expenses become too high.
The initial budget proposal for the next fiscal year, which includes this reform, has already passed the lower house and is being discussed in the House of Councillors. Despite this, in an unusual development, the proposal will be discussed once again at the lower house. This is because Prime Minister Shigeru Ishiba has decided on a policy of totally shelving the reform due to a torrent of objections raised by LDP members in the upper house.
The original reform proposal was to raise the upper limit on patients’ co-payments in stages over a three-year period starting in August this year. But opposition parties and patient organizations all voiced opposition, saying that it would make it impossible to receive medical care with peace of mind.
Therefore, the government first revised the proposal to leave the burden unchanged for patients requiring long-term treatment, and then Ishiba announced that the government would increase the maximum amount in August this year, but would reconsider the co-payment hikes planned for next year and later.
During the debate in the lower house, Ishiba repeatedly stated the necessity of this reform, saying that it was intended to sustain an important safety net. In the end, however, he was forced to shelve even the increase in August.
Ishiba’s policy change forced the budget proposal to be revised in the upper house for the first time. The proposal has already been revised in the lower house regarding free high school tuition. This will be the first time for a budget proposal to be revised in both chambers of the Diet.
It must be said that there was insufficient communication between the Prime Minister’s Office and relevant ministries and agencies, between the Prime Minister’s Office and the LDP, and between lower and upper house lawmakers within the LDP.
At the lower house Budget Committee meeting on the day, Ishiba apologized, saying, “I made a mistake in my judgment that I could gain the understanding of patient groups.”
The review of the system is also aimed at securing ¥3.6 trillion of financial resources for measures against the low birth rate. It can be said that the current confusion was caused in part by the administration of former Prime Minister Fumio Kishida, which foreclosed discussion of tax increases.
Within the government and the LDP, an idea is gaining momentum to postpone submitting to the Diet bills related to pension reform, which focuses on expanding the scope of part-time and other workers required to participate in the employee pension program, until after the upper house election this summer.
Since the bills would impose a burden on part-time workers and the companies that employ them, they apparently judge that submitting the bills to the current Diet session would be disadvantageous for the upper house election.
Last month, the ruling and opposition parties positioned the bills as among the most important ones to be debated in the current Diet session. If the bills remain unsubmitted, what in the world is going on with the LDP’s governance?
(From The Yomiuri Shimbun, March 14, 2025)
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