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Health ministry to freeze extra medical fees for pregnant women after LDP push

Shinjiro Koizumi, head of the Liberal Democratic Party Health, Labor and Welfare Division, talks with Takuya Hirai, minister in charge of science and technology policy, at a House of Representatives plenary session on Nov. 20, 2018. (Mainichi/Masahiro Kawata)

TOKYO -- The Ministry of Health, Labor and Welfare is set to freeze extra medical fees that pregnant women are required to pay when they visit medical institutions for examinations, health minister Takumi Nemoto said on Dec. 14.

The ministry will freeze the additional charges this year at the earliest, and will set up a panel of experts to review medical services for pregnant women.

Under the system, extra charges for pregnant women are added to their medical fees, and they are required to shoulder part of the cost. The extra charge is 750 yen for the first medical examination, while the amount for the second and later visits is 380 yen. Patients who foot 30 percent of their medical fees under insurance are required to pay 225 yen for their first examination and 114 yen for their second and later examinations.

The system is aimed at preventing medical institutions from hesitating to provide treatment to pregnant women because they require special consideration of possible side effects of pharmaceutical products on their fetuses.

Since its introduction in April 2018, however, the system has been criticized as effectively being a "pregnancy tax," as only expecting mothers are required to pay extra. The ministry tried to quell public criticism of the system by urging medical institutions not to demand extra medical charges for examination and treatments that were not related to pregnancy.

However, many legislators present at a meeting of the ruling Liberal Democratic Party (LDP) Health, Labor and Welfare Division on Dec. 13 voiced their opposition to the system, as it still requires pregnant women to bear an additional financial burden.

"It's intolerable to require expecting mothers to shoulder extra costs," Shinjiro Koizumi, head of the division, told reporters after the meeting. "This is our shared opinion."

In response, the health ministry considered using taxpayers' money to cover the extra bill patients are required to foot, which totals about 1 billion yen a year.

However, calls for doing away with the fees have persisted within the ruling bloc. The process to get rid of the system would take a considerable amount of time to go through necessary procedures.

Still, LDP legislators overwhelmed the ministry's objection to review the system. The governing party is apparently taking advantage of the public's opposition to the system in a bid to win support in the summer 2019 House of Councillors election.

There have been a large number of online messages critical of the system since its introduction this past April. An individual close to the LDP Health, Labor and Welfare Division revealed that Koizumi, who took up the post of division head in October, began to call for the abolition of the system precisely because the matter was a hot topic on the internet.

However, the Japan Medical Association (JMA), which is a major organizational supporter of the LDP, has expressed displeasure at the move. The system was originally recommended by the association itself.

"Since the introduction of the system was agreed on at the Central Social Insurance Medical Council, a review of the system should also be discussed there," a person linked to the JMA said.

(Japanese original by Masahiro Sakai, Medical Welfare News Department, and Shinya Hamanaka, Political News Department)

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