JAPAN: Seniors to Pay More for Medical Services

TOKYO (The Japan Times), December 1, 2005: The government and Liberal Democratic Party-New Komeito ruling coalition agreed Wednesday to raise medical costs for the elderly in two stages, starting in 2006. The plan to slow down snowballing health-care costs includes an already scheduled 10 percent increase in medical bills for people 70 years and older with annual incomes of 6.21 million yen or more. Those people will see an increase to 30 percent from 20 percent in their medical costs beginning next October. That income bracket will change in 2008 to 5.20 million yen and over. Wednesday's proposal goes further, stating that people aged 70 to 74 who have incomes of 5.20 million yen and under would see a rise to 20 percent from 10 percent in their medical bills beginning in fiscal 2008. "These measures are necessary for sustainable public health care in an aging society," LDP lawmaker Jinen Nagase said. "We believe we will be able to gain public understanding. It's for the future." People aged 7 to 69 will continue to be charged 30 percent of their medical costs, while those 75 and over will still pay 10 percent. While 20 percent of medical costs for children aged up to 6 will continue to be charged to their families, the plan says the government will consider lessening the 30 percent for older children. The plan is a compromise as the hikes for the largest group, the 70- to 74-year-olds in the 5.20 million yen and over bracket, will not be felt until fiscal 2008. The ruling bloc had initially sought to flatten the out-of-pocket costs for people between 65 and 74 years of age at 20 percent. However, the proposal met resistance from the Finance Ministry over the reduction of payouts by people in the 65-69 age bracket. It also said it would be impossible to cap new government bond issues at Prime Minister Junichiro Koizumi's goal of "as close to 30 trillion yen as possible" without asking the elderly to foot more of their medical bills. The ministry also wanted all hospital patients to pay for their meals and their share of utility costs. Wednesday's package does not include this idea, but it does say the government will re-examine hospitalization costs for the elderly, and strengthen ties between hospitals and nursing-care service providers to shorten hospital stays. The average hospital stay in Japan is by far the longest among member nations in the Organization for Economic Cooperation and Development. The average stay here is 41.9 days, while the average of all OECD nations is 11.7 days. Experts have said that asking the elderly to pay bigger medical bills will not be effective unless the government also succeeds in the other half of its medical reform program -- cutting payments to hospitals, clinics and pharmacies. The largest cut made so far has been an overall reduction of 2.7 percent. Senior Finance Ministry officials have said each percentage point of reductions in medical fees represents a huge battle won. The government aims to submit several bills to implement the seniors' medical-cost hikes during the Diet's next regular session for implementation in fiscal 2006 through fiscal 2008. The health ministry has proposed trimming 7 trillion yen from projected medical expenditures by fiscal 2025. By MAYUMI NEGISHI The Japan Times All rights reserved