Ministry plans to levy fees on people who visit big hospitals without a family doctor’s referral


The health ministry plans to impose bigger additional fees on patients who consult large-scale hospitals without a referral from their own physicians from fiscal 2016, officials said Tuesday.

The extra fees of at least ¥5,000 will be charged at the times of such patients’ initial visits. The costs will come on top of their out-of-pocket payments that amount to 10 to 30 percent of the total expenses for the medical services that the patients receive.

By increasing the special fees, the ministry aims to change the current situation in which many patients use large-scale hospitals even with mild symptoms. The concentration of patients has increased burdens on doctors at such hospitals, including longer working hours.

Some 250 university, public and other hospitals with at least 500 beds nationwide will be covered by the new rule. Patients taken by ambulance to hospitals will be exempt from the charge.

The ministry will submit a draft plan on the special fees later this month at a meeting of the Central Social Insurance Medical Council, which advises the health minister.

At present, hospitals with at least 200 beds are allowed to collect special fees from patients without referral. But the fees are low, at ¥1,000 to ¥4,000, with a limited impact on easing the concentration of patients at major hospitals.

The ministry also plans to impose special fees of ¥1,000 to ¥2,000 on patients without referral on their second and later visits to large-scale hospitals, the officials said.