and YOKO HANI
The Liberal Democratic Party and its two smaller non-Cabinet allies formally agreed upon a reform plan August 29 that is hoped will save the nation’s financially troubled health insurance system. However, the reform plan is merely a blueprint and will need more detailed guidelines for a complete reorganization of the health insurance system, which can only be drafted after expected opposition from those with vested interests is rejected, they said.
Naohiro Yashiro, a professor of economics at Sophia University in Tokyo, says the set of proposals is expected to reduce both demand and supply of medical treatment. “But the plan marks only the first step toward drastic structural reform of the nation’s debt-generating health insurance system,” Yashiro says.
Hirokuni Beppu, vice director of the Fuchu Medical Center for the Severely Disabled, agrees. “It is expected that those who have benefited from the current system will oppose the reform. Such opposition is highly likely to hinder a detailed reform plan from being mapped out.”
The Health and Welfare Ministry is expected to soon set up a panel to discuss the details of the reform plan, which have not yet been addressed by politicians. The ministry hopes to submit related bills one by one to the next regular Diet session, which convenes in January.
The formal agreement on the plan by the top policymakers from the LDP, the Social Democratic Party and New Party Sakigake came after a panel of the three parties reached a consensus on the proposal the previous day. The plan includes three main areas:
1) The creation of a new health insurance scheme solely for people aged 70 or older;
2) The scrapping of the current government-mandated pricing system for prescription drugs. It will be replaced with a new system designed to have patients pay any additional cost for drugs beyond a certain set price;
3) The expansion of the fixed-sum payment system to cover common chronic diseases.
Besides the proposals, the reform plan also calls for the need to change medicine from the standpoint of the patients. It urges the thorough implementation of “informed consent” at hospitals, in which patients decide what treatment they will receive after a complete explanation from doctors about their own condition and treatment options.
Doctors commonly decide what treatment is given without consulting with patient. They assume this power is within the scope of a doctor’s discretion.
The agreement, likely to lead to the most radical changes to Japan’s health insurance system since it was launched in 1961, came after long and heated debate among the three parties.