Hospital Financial Difficulties: Restructuring of Medical Care in Regional Areas Is Inevitable

Editorial

16:41 JST, July 6, 2025

Many hospitals are experiencing financial difficulties, regardless of whether they are national, public or private. They have been unable to respond to recent higher prices and rising labor costs, so their financial woes appear to have grown even more serious.

It is hoped that consideration will be given to rebuilding regional medical care, to prevent a situation in which people become unable to receive necessary medical services.

Six hospital organizations, including the Japan Hospital Association, urgently conducted a survey on the business conditions of hospitals nationwide. More than 60% of the hospitals that responded said they incurred losses in the six months from June last year. Among the 42 national university hospitals across the nation, about 60% suffered deficits last fiscal year.

Medical expenses are determined by medical fees — the government-set prices that are revised every two years. This creates a special situation in which medical expenses cannot be raised at the discretion of medical institutions in accordance with rising costs.

In the revisions last fiscal year, there was only a 0.88% increase in the main portion of medical fees, which mainly covers personnel costs.

In light of the hospitals’ difficult situation, the Health, Labor and Welfare Ministry launched an emergency support program in April this year to provide interest-free funding. Given the importance of regional medical services, hospitals must be provided with public support to overcome the immediate crisis.

Another possible option is to consider allowing the medical fee system to respond to higher prices and wages more appropriately.

However, medical expenses, which have continued to grow, cannot be allowed to swell unnecessarily. It is hoped that hospitals will work harder to improve their management and reduce costs.

Efficiency also should be improved by accelerating efforts to divide roles among hospitals and promote the integration of their functions.

The government aims to formulate a new regional health care plan that will take into account the needs of each region, looking ahead to 2040 when the population of people aged 65 or older is expected to reach its peak.

In areas with a rapidly graying population, there is strong demand for rehabilitation and home medical care services. There are also some areas with a surplus of hospital beds due to population decline. The needs of each regional area must be identified and a system developed to provide medical care in line with specific conditions.

Some regional areas are already moving forward with reorganizations of their hospitals.

The city of Muroran, Hokkaido, has three general hospitals, and acute care services such as surgery are planned to be consolidated at one hospital. The remaining two hospitals plan to handle patients who need chronic care and rehabilitation services. The possibility of eventually integrating the two institutions’ operations and reducing the number of beds is being considered.

It is crucial to spread such initiatives throughout the country.

However, some patients may feel concerned about hospital consolidation and closures. Medical institutions are encouraged to expand home health care and online consultations to prevent patients from being inconvenienced by a lack of hospitals nearby.

It is time for the entire community to seriously consider the future of its medical system, rather than hospitals competing for patients.

(From The Yomiuri Shimbun, July 6, 2025)