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The Japan Medical Association, one of the most powerful supporters of Prime Minister Junichiro Koizumi’s Liberal Democratic Party, has turned against the LDP over its plan to require salaried workers to pay more in outpatient fees and intends to try to topple the government.

“We are not seeking political upheaval, but that could be possible,” Takaaki Ishikawa, vice president of the association, warned at a joint news conference Thursday with leaders of the associations of dentists, pharmacists and nurses.

The medical association has urged the government and the LDP to freeze a planned 50 percent increase in the fees that salaried workers pay for outpatient medical treatment starting in April, fearing there will be a drop in patients.

Political analysts interpreted Ishikawa’s statement as indicating the demand might trigger moves to oust Koizumi and bring about a new administration.

The association, which believes the ruling coalition’s weakness in the upcoming elections is in local assemblies, has already called on 38 prefectural assemblies to adopt resolutions to freeze the increase at between 20 percent and 30 percent.

The association is taking a tough line toward the ruling bloc because it was forced to accept the decision for the 50 percent fee hike two years ago and last April faced a 1.3 percent cut in medical fees, the first in the postwar period.

This time, local-level medical associations, saying medical institutions will collapse like dominoes this autumn with fewer patients after April, are pressuring the executives of the Japan Medical Association not to bow to the coalition.

The association is scheduled to hold a meeting of representatives from local medical associations at the end of March, and its leaders will not be allowed to make an easy compromise with the government, association sources said.

With a sense of crisis spreading among LDP lawmakers that the medical associations, both the national and local-level bodies, will not support LDP candidates in the April local elections, former Prime Minister Ryutaro Hashimoto asked LDP Secretary General Taku Yamasaki on Feb. 13 to sound out opinion in the medical sector.

Yamasaki, a close ally of the prime minister, visited the association and other organizations to inform them that putting off the hike is impossible because it would require that the fiscal 2003 budget be revised.

Reaction was bitter. Keiko Okaya, a top executive of the Japan Nursing Association, reportedly told Yamasaki: “In the current economic situation, the burdens on households have become heavier. We are concerned about possible decreases in the number of outpatients.”

On the same day that Hashimoto made the appeal to Yamasaki, Koizumi met with Hidenao Nakagawa, chairman of the LDP’s Diet Affairs Committee, and confirmed the premium increase will be carried out in April as planned.

“We will seek to establish when and how to settle the problem, but the standoff with the ruling coalition will continue in and after April,” said an executive of the Japan Medical Association.

“The LDP won’t understand the problem unless it suffers a stunning election defeat.”

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