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The story
On October 28, Japan’s Ministry of Health, Labour and Welfare held an expert panel on medical care for welfare (livelihood protection) recipients. There’s an existing system that charges general patients a special fee for visiting a large hospital without a referral, but welfare recipients have so far been exempt. At this session, the ministry floated a proposal to charge recipients a flat fee too, drawing calls from panel members for fairness with general patients, alongside cautious voices arguing that promoting family doctors should come first. On 5ch, interest centered less on whether the policy change itself is justified, and more on what welfare recipients mean for hospitals financially, and on who actually funds medical assistance benefits.
On the 28th, the Ministry of Health, Labour and Welfare held an expert panel on medical care access for welfare recipients. There’s a system under which general patients must pay a special fee when visiting a large hospital without a referral. The ministry proposed extending a flat fee to recipients, who are currently exempt.
Panel members argued that fairness with general patients should be ensured. At the same time, there was a string of objections to charging recipients out-of-pocket, such as “the priority right now should be thoroughly promoting having a family doctor (at local clinics, etc.).” Discussions will continue.
Recipients currently receive medical care with no out-of-pocket cost, visiting medical institutions selected by the local welfare office.
Source: news.yahoo.co.jp / Original article here
What people said
And this is supposed to be a service cut? Huh?
Anyone who knows how it actually works knows this:
Show up at a big hospital without a referral and you only get seen by some green rookie doctor lol
That's plenty good enough for "namapo" (slang for welfare recipients)
You sure know a lot about this
Say no more
Better to just have them go straight to a big hospital from the start.
They've got nothing but free time, and it's free, so of course they'll rush in for things that aren't even serious.
The government's current plan is to get neighborhood clinics to formally register as "family doctors" (kakaritsuke-i) under the system.
On top of that, they'll consolidate hospitals and concentrate staff doctors to boost efficiency.
It's already locked in that in some major cities, opening a new clinic will be effectively impossible if you refuse to register as a family doctor.
(Once you register as a family doctor, you get penalized if you refuse to see a patient on request — any time, any specialty, even ophthalmology, even in the middle of the night.)
And now some lawmakers are even starting to say cars should be allowed too.
The welfare vested-interest machine is way too big.
This is messed up, isn't it.
Welfare recipients get the right to a guaranteed living, but no luxuries.
Working people get the freedom to live without restriction, but no guaranteed living.
If you want luxuries, you should work.
Things like alcohol, cigarettes, and cars are luxuries you can live without.
"I need a car because I live in the countryside" is still a luxury.
A bike or a bus is enough. You're not working, so there's no need to be in a hurry.
That's right. If anything, welfare recipients are a blessing for hospitals. Since the medical costs are paid out of tax money, there's zero risk of unpaid bills, and they can prescribe huge amounts of medication on top of that.
Hospitals will even run X-rays and CT scans for cases that aren't serious at all, because it's profitable for them.
Hospitals and welfare recipients have a mutually beneficial relationship — some small neighborhood clinics practically stay in business thanks to it. If anything, regular paying customers can be more of a nuisance.
Isn't it the city/municipality that pays, not the national government?
Even at big hospitals, you often just get seen by an intern.
Meanwhile, doctors who become specialists or get a doctorate often go open their own clinic.
Funny kind of article — everyone worships big hospitals, yet politically people back fringe minor parties lol
I mean, neighborhood clinics and big hospitals have different roles.
Colds you just sleep off, minor sprains — anything a local clinic's equipment can handle — get treated there.
Serious illnesses or injuries a local clinic can't handle get referred to a big hospital with proper treatment facilities.
If even minor-symptom patients flood into big hospitals and eat up all the resources, the seriously ill can't get treated.
An old guy I know was exactly that case.
Went from his family doctor to some big-name doctor at a major hospital, and they had no clue what was wrong.
Finally, as a last resort, he tried a private practitioner in the next town over, and they figured it out instantly and cured him right away lol
Apparently quite a few people get medication for free and then resell it.
Here's a little verse:
Welfare benefits —
take-home pay of one-sixty,
a rich man indeed
For a single person, even in Tokyo it's more like 130,000 yen, isn't it?
There's no way a single-person household gets 160,000 yen.
Background and key points of this debate
The system that charges a special fee (“senteiryoyohi”) for visiting a large hospital without a referral exists to stop minor cases from flooding big hospitals, and it has long applied to general patients. Welfare recipients have their medical costs covered through medical assistance benefits, so until now they’ve been exempt from this special fee. The Ministry of Health, Labour and Welfare is considering a change mainly over the question of fairness with general patients — but at the same time, a cautious view that “promoting awareness of having a family doctor should come first” was also raised at the panel, so no conclusion has been reached yet. Opinions on the thread split along two lines: a policy debate over whether recipients should be asked to pay out of pocket, and a more cynical observation about hospital finances — that welfare recipients are customers hospitals can always count on to get paid. Worth noting for readers: even posters on the thread disagreed about how medical assistance funding is actually split between the national government and local municipalities, which is an easy point to get wrong.
*This article is excerpted and summarized from the 5ch (News Speed+) thread “Considering the burden on welfare recipients — visiting large hospitals without a referral.”
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