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Japan's doctors say low fees are driving many to ruin
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     Doctors in Japan have warned that there could be an exodus from the medical profession unless the of health and welfare ministry increases the fixed fees that doctors receive for treating patients.

    The ministry—in Tokyo—sets the sums that doctors and hospitals are reimbursed for consultations, treatment, and operations by the country抯 social security system.

    But the Japanese Medical Association says that hundreds of hospitals and general practice clinics are now facing financial ruin because they are being forced to rely on very low, government fixed prices for their income. The situation has become critical, they say, because the cost of treating patients is soaring while the fees have continued to languish at a low level for decades.

    Moreover, the association says that doctors?representatives are being overruled by the government members of the Central Medical Council on Social Insurance, the advisory body that regularly reviews the level of fees that doctors and hospitals can receive.

    The association—which represents 156 000 doctors (about 60% of all licensed physicians in Japan)—has said that it will continue to lobby the national parliament and health ministry in a bid to improve the pay for doctors.

    The health ministry says that it is obliged to tighten the fees for doctors and hospitals because of the recent prolonged economic downturn in Japan.

    It said the country抯 expenditure on health care has increased rapidly in the past few years梠utpacing the growth rate of the national income—mainly because of the need to care for a progressively ageing population. Japan has experienced one of the largest increases in life expectancy, with the average life expectancy of Japanese women increasing by 22.4 years and of men by 17. 5 years since 1960. Since 2002 the average life expectancy in Japan has been 85.2 years for women and 78.3 years for men.

    However, medical associations in Japan say that doctors should not be forced to bear the brunt of cuts in the healthcare sector while the government continues to treat the pharmaceutical industry relatively generously by allowing lucrative high fixed fees for drugs.

    Under the social insurance system in Japan, the entire population is covered by some form of medical insurance, and people can choose a medical institution to receive medical care at prices set by the government.(Vienna Jane Burgermeister)