The health ministry in principle bans the "mixed" use of medical treatment covered by public health insurance and medical treatment not covered by such insurance. If a patient mixes the two types of care in the course of treating a single illness he or she must pay all the costs of medical treatment — even that which would normally be covered by public health insurance. Based on its interpretation of the Health Insurance Law, the health ministry takes the position that medical care covered by public health insurance and medical care purchased at the patient's own expense form an inseparable treatment, making it necessary for the patient to shoulder all the costs.
In a recent landmark decision, a court ruled for the first time that the ministry's interpretation is wrong. Although the Tokyo District Court is a lower court, its ruling will still impact the ministry's policy. The ministry appealed the court ruling.
The ministry has valid reasons to oppose mixed treatment, especially the fear that such treatment would undermine the the principle of the public health insurance system, as only wealthier people could take advantage of mixed treatment. On the other hand, the desire of patients — especially those suffering from serious illnesses — to receive such treatment is understandable. Public discussions should take place to determine to what extent mixed treatment should be allowed.