For the first time, Japan is trying to hold down the number of bedridden elderly people kept alive, sometimes for years, by feeding tubes.

The government is planning to cut payouts on insertions in new patients and encourage home care. About 260,000 elderly live on feeding tubes nationwide. Faced with a heavy public debt burden, the government is trying to curtail growth of a ¥38.5 trillion annual health bill by releasing patients from hospitals sooner.

The Health, Labor and Welfare Ministry also plans to boost reimbursements to institutions that check swallowing ability and encourage rehabilitation to help the bedridden eat naturally. The changes, effective April 1, mark the first time Japan has cut government reimbursements for the practice.