Encouraging My Number Insurance Cards Use with Scripts and Lump Sum Rewards Raises Concerns

“The patient bears 30% of the increase, while the remaining 70% is covered by health insurance. If the balance of health insurance revenues and expenditures is disrupted, it may lead to discussions about increasing insurance premiums or raising consumption tax.”

At medical institutions that have raised initial and follow-up consultation fees after raising the wages of nurses and other staff, patients receiving medical care might understandably rebel, asking, ‘Why should patients bear this burden?’

“There’s also discomfort among those providing medical care about whether this should be covered by insurance points. Among doctors at the frontline, there’s a growing sense of crisis that they might incur the public’s wrath.

The increase in initial and follow-up consultation fees due to revision of medical fees also aims to improve revenue for medical institutions in response to inflation. However, patients won’t find it convincing if hospital and dental fees increase just like other goods due to inflation. If it’s said that this is a price increase related to promoting the use of minor insurance cards and base-ups, patients might find it even more unacceptable.”

“In essence, it’s a story where medical institutions that listen to the government’s instructions will increase their medical fees.”

In this revision of medical fees, a new addition called the ‘Medical DX Promotion System Development Bonus’ has been introduced. Medical institutions that meet the government’s requirements for promoting medical DX, such as online qualification confirmation and billing with My Number insurance cards, as well as introducing electronic prescriptions, can add 8 points to initial consultation fees (6 points for dental and 4 points for pharmacies). Whether patients use the My Number insurance card or the current insurance card, the initial consultation fee will increase by 80 yen, resulting in a 24 yen increase for patients covering 30% of the cost.

By the way, displaying posters to promote the use of My Number insurance cards is also one of the requirements.

“The conditions for implementing the government’s medical DX bonus in medical institutions are all facility standards aimed at utilizing My Number insurance cards in medical practice. Institutions that align their systems and structures according to government directives are evaluated and receive higher scores through the medical DX bonus.

In essence, it’s a story where medical institutions that follow the government’s instructions will increase their medical fees. For instance, although prescription fees have been reduced this time, the government seems to think, ‘It’s okay if we increase initial and follow-up consultation fees as long as we cooperate in expanding the use of My Number insurance cards.’ Medical professionals on the frontline feel dismayed by such carrot-and-stick methods.”

Furthermore, Nakata points out the government’s eagerness to accelerate the use of My Number insurance cards in medical settings.

In order for medical institutions to calculate the medical DX bonus, they need to submit facility standards notifications to the local health bureau. To make it easier to obtain medical fees by lowering the application threshold, the Ministry of Health, Labour and Welfare has included transitional measures in the facility standards.

“The facility standards for the medical DX bonus include transitional measures for electronic prescriptions and electronic medical record information sharing services, allowing calculation even if these are not yet implemented by now and have a grace period until next year. Electronic prescriptions have not been widely adopted in medical institutions, and the electronic medical record information sharing service systems aren’t operational yet, but applications are still accepted.

It seems the Ministry of Health, Labour and Welfare is out of touch with reality. It feels like they are floundering. One might say, ‘Take a step back and reconsider.'”

Even if medical institutions haven’t set up systems for issuing electronic prescriptions or utilizing electronic medical record information sharing services, patients will bear increased initial consultation fees as long as they meet other facility standards for the medical DX bonus. From the medical field, there’s confusion about how to explain this to patients when asked about the medical DX bonus.

“Whether it’s flat-rate tax cuts or other measures, I believe the government keeps burdening the frontline excessively. It’s about time they reconsider their approach. We need to put an end to policies that increase the workload on the frontline, dragging us down, even under the Kishida administration.”

Tomoyuki Nakata, DDS, Periodontist. Born in 1984 in Saitama Prefecture. He also works as a healthcare administration writer.