Medical institutions and their staff are suffering financial losses after manning the front line in the battle against COVID-19. Many people have reportedly refrained from seeing doctors in recent months out of concern they might be infected during a visit to a hospital or clinic. Institutions that accepted infected people have lost revenue as they were forced to curtail or postpone treatment of other patients while spending extra resources on those hit by the novel coronavirus. Staff at some hospitals are reportedly seeing their summer bonuses cut due to the lost income.
Government support must be extended to prevent the institutions and their staff from hurting because they endeavored to cope with the pandemic. The COVID-19 outbreak, which put the hospitals and their doctors and nurses under heavy strain, is testing the resiliency of Japan's health care system. The nation will be failing the test if the medical institutions and staff have to suffer under financial losses as well.
Monetary losses incurred by 133 university-run hospitals across Japan in April and May — due to the overall decline in the number of patients and the extra cost of treating COVID-19 cases — reached a total of ¥31.3 billion, according to a survey by a conference of the heads of those institutions. In the survey, 84 hospitals said the total number of surgical operations performed in May alone declined by more than 30 percent from a year earlier. The combined revenue of the 133 institutions for the month tumbled 16 percent.
Meanwhile, the hospitals incurred more expenses as they accepted more COVID-19 patients, whose treatment required extra manpower and precautions to prevent secondary infection of the medical staff. These institutions needed to make sure they would have enough beds for COVID-19 patients, but many of the beds went unused when the number of infected patients declined in May, further cutting their revenue.
Recent news reports that hundreds of nurses and other staff at Tokyo Women's Medical University Hospital may be quitting after they were told that they would not be paid a summer bonus (a decision that is reportedly now being reconsidered) is illustrative of the worsening work conditions at medical institutions amid the COVID-19 crisis. According to an organization of labor unions of nurses and other care givers, summer bonus payments were reduced at 35 percent of medical institutions across the country.
The severe financial impact of COVID-19 is not limited to hospitals that have accepted COVID-19 patients. According to the Japan Hospital Association, 66.7 percent of some 1,200 hospitals nationwide incurred losses in April — and although the ratio was higher at 78.2 percent among institutions that took on COVID-19 cases, the figure was still a disturbing 62.3 percent among hospitals that did not.
While the government has extended subsidies to large hospitals capable of dealing with the pandemic and boosted their remunerations for treating patients with serious COVID-19 symptoms, financial problems at smaller institutions and their possible collapse would increase the burden on the larger institutions and put further strains on their staff. This poses an even greater threat in rural areas where local health care systems are more fragile.
The pandemic may complicate the government's push to streamline many money-losing public hospitals. In anticipation of a future decline in the number of hospital beds needed amid the rapidly declining population, the government has singled out some 440 of these institutions across the country for possible reorganization and consolidation.
Meanwhile, about 70 percent of the roughly 900 institutions that have accepted COVID-19 patients are publicly run hospitals as well as those run by the Japanese Red Cross Society. They include about 70 hospitals targeted for streamlining. There are warnings that streamlining those "inefficient" institutions to curb medical expenses may put the medical service system in some regions in peril when the nation is hit by the next public health care crisis.
The financial problems at medical institutions were already worrying enough, but now the number of COVID-19 cases is again growing rapidly — not just in Tokyo, where triple-digit numbers of new infections have been reported almost daily this month, but in other large urban areas.
Prime Minister Shinzo Abe says the health care system is still not under strain, given that the number of seriously ill COVID-19 patients is quite small. However, medical institutions and staff suffering losses as they deal with the pandemic is a problem that raises doubts about the sustainability of the nation's emergency medical service system and must be addressed.
The Japan Times Editorial Board