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2013年9月20日 (金)

医療・介護費 5兆円抑制を「画餅」とするな

The Yomiuri Shimbun September 20, 2013
Ministry must make ¥5 tril. cut in medical costs real to save social security
医療・介護費 5兆円抑制を「画餅」とするな(9月19日付・読売社説)

The Health, Labor and Welfare Ministry has set a new goal of curbing the expected increase in the nation’s medical and nursing care expenses.

Medical and nursing care costs of Japanese are estimated to rise by ¥35 trillion in fiscal 2025 from the current ¥48 trillion due to the rapidly aging population. The ministry plans to reduce the estimated increase by ¥5 trillion.

The envisaged restriction of medical and nursing care expenditures must become real if the nation’s social security system is to be maintained.

Health insurance societies, to which corporate employees belong, have been in the red for five straight years due to the massive amount of contributions to the medical care system necessary for elderly people. As a result, the finances of health insurance societies have been driven to the verge of bankruptcy.

Bringing medical expenses under control is an urgent task for the government. As part of its effort to achieve this goal, the health ministry has set up a task force to promote public health. In the past, however, the ministry came up with measures to restrict medical and nursing care expenses but failed to produce sufficient results. We expect the ministry to reflect on past mistakes and to carry out effective measures this time around.

As a pillar of the cost-cutting plan, the ministry is focusing on the prevention of lifestyle-related diseases among adults by improving the percentage of people actually taking metabolic syndrome exams. The ministry expects this measure to have the effect of reducing medical expenses by ¥2.4 trillion. However, it is unclear how much can actually be reduced. We wonder if the reduction will be as high as projected.

Practical cost-cutting

Meanwhile, the prevention of pneumonia is expected to be a more practical measure. Pneumonia is the third-leading cause of death among elderly people, following cancer and heart disease. It can also cause elderly people to become bedridden.

It is believed that pneumonia vaccinations can lower the incidence of the condition by about two-thirds. By promoting the vaccinations, the ministry estimates that costs for treatment of the disease could be reduced by about ¥600 billion.

Expenses for pneumonia vaccinations are currently paid out of pocket. However, if it is covered by public funds, prevention of the disease could be more effective.

An increase in the number of people with diabetes is also a problem. Preventive measures should be considered to reduce the number of patients that require dialysis, an expensive treatment, due to kidney failure caused by severe diabetes.

Wasteful spending on medical services must be investigated as well. Japanese see doctors more often than people in other developed countries. Senior citizens with more than one condition tend to go from one doctor to another.

The municipal government of Kure, Hiroshima Prefecture, scrutinized statements of medical expense claims by hospitals and clinics, and identified senior citizens who saw doctors 15 times or more in a month. Public health workers then visited them to offer advice. As a result, duplicate visits to multiple doctors and an overlap in drug administration were curbed, leading to a decrease in medical care costs.

The health ministry should introduce such initiatives to other local governments around the country.

The use of information technology such as digitizing statements of medical expenses will be essential to improving the efficiency of medical services. Taking advantage of the My Number system to be introduced in 2016, it is also important to make use of patients’ medical information to reduce the number of redundant visits to doctors.

(From The Yomiuri Shimbun, Sept. 19, 2013)
(2013年9月19日01時32分  読売新聞)


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