Deal between Politics and Medics

Ministry of Finance finished negotiation over the budget of FY 2018 with other Ministries on Monday. While the reward for medical treatment in hospitals, clinics or pharmacies was declined by 1.19% from the previous year, payment for medical doctors or nurses would be increased by 0.55%. It is regarded as a political deal between Shinzo Abe administration and the pressure group of medical doctors in a don’t-ask-don’t-tell manner.

Japan has a universal insurance system, in which the patients pay insurance fee stocked in governmental organization and medical organizations receive the reward for their treatment. The reward is categorized in two, one is for salary of doctors, nurses or pharmacists and another is price of medicines. Although the main body of the reward for salaries was raised for six consecutive years, budget for medicine was declined by 1.74%.

A pressure group of Japan Medical Association, Nichiiren, has been a firm supporter for Liberal Democratic Party. According to a report of Asahi Shimbun, President of Nichiiren, Yoshitake Yokokura, rejected an offer of raising the reward for main body by 0.5%, even though it was higher than 0.49% in the previous year. After Yokokura visited Abe in Official Prime Minister’s Residence in November, Ministry of Finance received pressure to accumulate the reward from Abe side. Then it was concluded in 0.55%.

Nikkei Shimbun described it as Abe’s requital of Yokokura’s favor. Abe and Yokokura have been maintaining a close relationship, since Abe was a young lawmaker interested in medical policy. Even after Abe stepped down as Prime Minister in 2008 and LDP left the administration, Yokokura kept on supporting Abe. One officer in Ministry of Health, Labor and Welfare told Nikkei that the budgetary accumulation was a reward for Yokokura’s unchanged political support.

So, who will pay for the accumulated budget for medical doctors? It’s patients or taxpayers. The reform of reward requires ¥60 billion of national budget. In addition, health insurance fee of ordinary employers and employees and payment of patients at the hospital will increase by ¥160 billion. The argument whether salary of medical doctors, which is already high enough, should be raised any more is left behind the personal connection of Abe and Yokokura. No check-and-balance has worked in the political connection between Prime Minister and the medical boss.