The government decided on Dec. 21 to raise fees for medical services by 0.004 percent and those for nursing care services for elderly people by 1.2 percent in fiscal 2012. Medical fees are revised every second year and nursing care fees every third year. The government hopes that the fee raises will lead to wage raises for medical professionals and nursing care workers. Although the decision will entail raising health and nursing care insurance premiums, it is hoped that it will help improve the working conditions at medical institutions and nursing care facilities, thus leading to improvement of the services.

In 2009, the Democratic Party of Japan government raised medical service fees for fiscal 2010 — the first raise in 10 years — to prevent the collapse of medical services, especially in the countryside, due to the earlier policy of holding down social welfare spending. Rewards for emergency medicine, obstetric and pediatric services were raised more than for other medical services. This has resulted in improvement of financial conditions at hospitals. The decision this time, which defied the Finance Ministry’s call for lowering the fees by about 2.3 percent, deserves praise.

The 0.004 percent raise of fees for medical services breaks down into a 1.379 percent raise of fees mainly for doctors’ treatment skills and a 1.375 percent fall of fees for drugs and medical supplies. The details of the fee revisions will be worked out later. It will be important to give more rewards to hospital doctors for emergency medicine and perinatal medical treatment — areas where doctors are in shortage.

The rewards for nursing care services do not directly go to nursing care workers. They go to operators of nursing care facilities. Although the government decided to raise the fees by 1.2 percent, the system of giving a monthly subsidy of ¥15,000 to each nursing care worker ends at the end of fiscal 2011. The government must strongly persuade operators of nursing care facilities to give a large part of the increased rewards to their employees.

The wages of nursing care workers are low — about 70 percent of the average wages of workers in all industries. The government must remember that the DPJ’s manifesto for the 2009 Lower House election called for raising nursing care workers’ monthly pay by ¥40,000.

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