Japanese Patient Payments "Must Rise"

In Japan, a government advisory panel has recommended that patients be made to pay up to 40% of their medicine charges, and that the elderly be billed higher rates for medical treatment.

The proposals are contained in an interim report by the Medical Insurance System Council, an advisory body to Health and Welfare Minister Naoto Kan. In November, the panel is to issue its final report on reform of the health insurance system, which is troubled financially by the aging society and slower economic growth. The reform is also aimed at saving insurance plans now operating in the red.

At present, insurance covers 70%-90% of the cost of medicines, but the Council recommends cutting this to 50%. Also, it suggests that patients carry a heavier burden by raising their share of treatment costs by 10%-20%. But reduction of drug costs is the main target, since they accounted for 29.5% of Japan's total medical spending of $252 billion in fiscal 1995 (to March 31, 1996). Compounding the problem is the fact that Japanese doctors overprescribe because of the reimbursement system. The Ministry of Health and Welfare has imposed some curbs on prescriptions, but they have fallen far short of solving the problem.