December 24, 1999

Kiyoshi SASAMORI
General Secretary
Japanese Trade Union Confederation (JTUC-RENGO)

The government decided at its cabinet meeting on 24 December to increase the medical treatment fees and a policy which will increase the burden on patients. This is to be included in the next year's budget. In order to respond to it, RENGO announced the following comment on the same day. "The government is trying to put a burden on workers and their families who have been already suffering from the high unemployment and depreciation of wages. The government also failed to indicate a proper procedure for a complete reform of the medical scheme. Therefore, RENGO will not accept the decision."

Chuikyo (The Central Social Insurance Medical Council) which was discussing the reform of medical treatment fee was closed on 17 December. It failed to conciliate the two parties, the practitioners who demanded a considerable raise such as Nihon-Ishi-Kai (the Japan Doctors' Association) and the payers who claimed a reform to reduce the burden on patients such as, RENGO, Kenporen (the Health Insurance Federation), Nikkeiren and others. Thus, the decision to reform the medical treatment fees was transferred into the political arena.

The Japan Doctors' Association submitted its demand to raise medical treatment fees to the Central Social Insurance Medical Council on November 26. The Japan Doctors' Association had no hesitation in stating to the payers representatives that it would deal this issue outside of the Central Social Insurance Medical Council. The Japan Doctors' Association lobbied the Liberal Democratic Party. On 18 December, the Liberal Democratic Party discussed with the practitioners and the payers separately. This discussion was the extension of discussions between the LDP and the Japan Doctors' Association. They ignored the Central Social Insurance Medical Council which is the forum for the public consultation. Moreover, the LDP excluded Rengo from the negotiation, which is the representative of workers who pay health insurance premium every month. Without Rengo's participation, it was decided to raise medical treatment fees and to place the burden on the patients. This increase will offset the gain which is created by reducing profit of medicine costs. The LDP's decision totally ignores workers and their families who pay the half of the health Insurance premium. Therefore, we will not accept this decision.

Under the current economic circumstances, there are no rational grounds to raise medical treatment fees. On the contrary, it is right to reduce treatment fees based on the test calculation two years ago when medical treatment fees were reformed last time. The gain from the reduced profit level of medicine costs should be distributed among people. We believe that the gain about 500 billion Japanese Yen should be used to pay part of the total medical costs. However, all the gain is to be used to cover increased medical treatment fees. An average monthly income for a doctor who works at a clinic is 2,350,000 Japanese Yen and it has increased by 360,000 Japanese Yen over the last two years. The reform merely raises medical treatment fees and does not include any measures to deal with the natural increase of medical costs, which are about 4%. The reform also imposes a burden on patients.

RENGO expresses its rage against the government and the LDP who are trying to put an additional burden on workers and their families. They are breaking their promise to have a complete reform of the medical system in year 2000.

The government's proposed budget for 2000 will be submitted to the ordinary diet session next year. The proposed reform of medical treatment fees and health insurance will be discussed next year at the related councils. At the council, RENGO will work closely with concerned organisations such as the Health Insurance Federation and Nikkeiren. RENGO will also strengthen its lobbing activities at the diet together with the opposition parties, including the Democratic Party for a complete reform of medical system in 2000, a reform to reduce the medical treatment fees and against health insurance reforms which increase the burden on patients.