The Central Social Insurance Medical Council of the health and welfare ministry has determined the amount of rewards to be paid to medical institutions beginning in April. It should be praised for making efforts to improve the working conditions of hospital doctors.

Still, there is room for improvement in rewarding medical institutions that provide medical services to patients staying at home, as the government is pushing a policy of increasing the weight of medical services given to such patients.

As part of this policy, providing nursing-care services any time of day for elderly people at home has been introduced. This approach is makes sense as hospitals cannot deliver all the services needed by the growing population of elderly people. A concealed aim is to cut costs by increasing home-based medical and nursing-care services.

In the biennial revision of rewards for medical services, the government raised rewards by 0.004 percent in December 2010. By lowering fees for drugs and medical supplies, the council increased rewards for medical treatments by ¥550 billion. Some ¥120 billion of this will be used to improve working conditions for hospital doctors, especially those treating emergency cases.

The Democratic Party of Japan government’s policy to raise rewards for medical services, which first went into force in fiscal 2010, has helped hospitals to reduce their deficits. But there is a report that money received by hospitals has not been fully used to improve hospital doctors’ working conditions. The government must see that such improvements are forthcoming.

Some ¥150 billion will be used to increase rewards for medical institutions that provide medical services to patients staying at home. Rewards for visits to patients in their homes for an emergency or at night will be increased on the condition that the functions of such medical institutions are strengthened. To receive increased rewards, such institutions must meet certain conditions, including employing three or more full-time doctors. The government should not forget to fairly reward a one-person operation that makes greater efforts to help patients at home.

The government should not hesitate to consider increasing medical and nursing care insurance premiums to improve overall services, while giving due consideration to the financial burdens shouldered by low-income people.

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