The Liberal Democratic Party would like to get doctors and medical organizations, in principle, to prescribe generic drugs, instead of proprietary drugs, to people on welfare with their consent. Behind the idea is the hope of curbing the rising costs of livelihood assistance, known as seikatsu hogo, provided to low-income people. But as people receiving livelihood assistance could view the LDP’s policy as a form of discrimination, utmost care should be taken in pushing this policy forward.
The number of people receiving livelihood assistance has been rising due to the nation’s sluggish economy. In September, a record 2,133,905 people in 1,557,546 households were on welfare. The number of people has increased for five straight months, with a record reported each month. For the initial fiscal 2012 budget, some ¥3.7 trillion is to be spent on livelihood assistance. The cost for medical assistance accounts for about half the budget.
At present, welfare recipients are not required to pay for medical treatment. This places a financial burden on both the central and local governments. The central government shoulders half the cost for livelihood assistance, the prefectural governments assume a quarter and municipal governments the remaining amount.
In view of the fact that the nation’s total medical spending is increasing by about ¥1 trillion every year, the central government’s goal is to increase the share of generic drugs to 30 percent or more of all drugs prescribed in the nation by the end of fiscal 2012. It hopes that increased use of generic drugs will help slow the growth of total spending on national health care and livelihood assistance.
Generic drugs have the same ingredients as proprietary drugs whose patent has expired. Because generic drugs require little spending for research and development, and for marketing, their standard prices in Japan’s public medical insurance system is 20 percent to 70 percent lower than proprietary drugs.
Results of a Kyodo News survey released Nov. 22 show that among the heads of 49 major municipalities — prefectural capitals and ordinance-designated cities — 28 of them (57 percent) favor requiring people on welfare pay part of their medical costs, and 31 (63 percent) support use of generic drugs, in principle, for welfare recipients. The LDP is of the same opinion.
Yet, such a policy could dissuade some welfare recipients from seeking medical care. To forestall this possibility, the health and welfare ministry has hit upon the notion of prescribing generic drugs at first, and then switching to proprietary drugs later, when treating people on welfare. The LDP is considering having generic drugs prescribed all the time with the consent of welfare recipients. Although generic drugs must pass the same government standards as their proprietary counterparts, some doctors harbor doubts and prefer to prescribe the latter. Welfare recipients should be fully informed about generic drugs to be used in treatment, and the judgment on whether to use them should be left entirely to them.
Options for generic drug prescriptions must be drastically increased for all. No doubt many people would welcome the opportunity to reduce their medical costs, and such a move would also benefit the government — and ultimately the taxpayer.
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