Revision of Medical Service Fees: Change Compensation to Match Professional Responsibilities

Editorial

15:17 JST, November 21, 2025

Amid prolonged high prices, the improvement of pay for medical service workers based on government-set prices has been delayed compared with such efforts by companies in general.

Doctors, nurses and other medical personnel bear heavy responsibility as they are entrusted with other people’s lives. It is crucial to revise their compensation to match the responsibilities of their work.

Discussions within the government are fully underway about the revision of medical service fees for fiscal 2026. The fees, a source of income for medical institutions, are revised every two years. This year is when the government will decide on the revision.

Medical service fees are broadly divided into two parts: the core portion, which covers labor and other costs for doctors, nurses, pharmacists and other medical personnel, and another portion for the prices of medicines.

Revisions in recent years have repeatedly lowered drug prices to create a funding source to help raise the core portion. In the previous revision, drug prices were cut by 1% while the core portion was raised by 0.88%. Overall, medical service fees saw a 0.12% reduction.

However, lowering drug prices has squeezed the business of generic drug manufacturers, whose drug prices already have been low. As a result, manufacturers have been shying away from producing drugs with low profit margins, causing shortages of items such as cough medicine.

Isn’t it unreasonable to further reduce drug prices?

It is hard to say that medical service workers enjoy generous compensation. According to a survey by the government, the average monthly salary for nurses, pharmacists and other medical personnel in 2024 was about ¥340,000, about ¥20,000 below the average for all industries.

Medical institutions normally increase wages using funds such as fees for initial visits and for second or subsequent visits, which have no restrictions on how they are spent. However, even if the government raises fees, such as those for initial visits, there are said to be cases in which medical institutions use the increase in the fees at their discretion for facility improvements or other purposes.

The government should investigate whether the increased fees actually lead to higher wages for medical service workers.

It is also important to pay attention to the differing financial situations between hospitals and clinics.

According to a survey by the government, hospitals with 20 or more inpatient beds had an average operating profit margin of 0.1% in fiscal 2024. In contrast, clinics without inpatient beds achieved a margin of 6.4%. It is said that hospitals above a certain scale face significant costs for improving and maintaining facilities.

It is necessary to take measures to enable financially struggling hospitals to receive more medical service fees.

Meanwhile, if medical service fees were raised by 1%, medical costs would increase by ¥500 billion annually. This increase would be covered by means such as insurance premiums and patients’ copayments.

If medical service fees are to be raised, the government must thoroughly explain this to the public and seek understanding for the increased burden. At the same time, it is crucial to continue reforms aimed at curbing social security expenditures.

(From The Yomiuri Shimbun, Nov. 21, 2025)