More big hospitals in Japan to charge extra fees on patients

November 17, 2017

Tokyo- Japan's health ministry plans to expand the range of hospitals that can impose additional fees on visits by patients with no referral from their regular doctors, as early as fiscal 2018, it was learned Thursday.

Currently, such extra fees of 5,000 yen or more are charged on initial visits to large hospitals with 500 beds or more, totaling 262 nationwide, mainly those affiliated with universities.

Without changing the fees, the ministry will expand the coverage of the system to include hospitals with at least 400 beds, totaling some 150, informed sources said.

The additional fees, which started in fiscal 2016, come on top of the patients' out-of-pocket payments amounting to 10-30 percent in principle of the total medical expenses under public health insurance programs.

The extra fee rule also requires the patients without referrals to pay 2,500 yen or more on their second and later visits.

By broadening the scope of hospitals that can impose the additional fees, the ministry aims to draw a clearer line between big hospitals and smaller ones plus clinics, so the former can focus on specialized medical services for severely ill patients and the latter take care of less serious cases.

The amount of the additional fees will be kept unchanged after many members of the Social Security Council, which advises the health minister, pointed to uncertainty over the effects of a fee hike.

Emergency patients will remain exempt from the extra charges. Jiji Press