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Revised extra-charge system must better suit pregnant women’s needs

The Yomiuri ShimbunWhat kind of system is suitable for realizing sufficient medical services for pregnant women? Thorough discussions are called for.

Regarding the extra fee added to the medical bills of pregnant women when they see a doctor at a medical institution, a panel of experts for the Health, Labor and Welfare Ministry has compiled a proposal seeking the resumption of the system after a revision.

The extra-charge system was introduced in fiscal 2018. As out-of-pocket payments subsequently increased for expectant mothers, the system faced mounting criticism for “bullying pregnant women.” That led to the extra fee being frozen in January this year.

The original purpose of the extra fee was to urge medical institutions to provide particularly careful services for pregnant women such as when examining them and administering drugs, in consideration of the safety of expectant mothers and fetuses.

The system is also aimed at encouraging departments other than obstetrics, which tend to shy away from treating pregnant women to avoid trouble, to accept them more willingly by receiving the extra fee.

It is reasonable that the panel of experts regarded the system’s purpose highly, saying, “Pursuing high quality medical services for pregnant women is necessary.”

The extra charge had to be suspended partly because the system’s purpose was not widely understood by the public. If the health ministry aims to resume it, it is imperative to step up efforts to win public understanding of the system’s necessity.

Set specific application rules

Meanwhile, the panel has pointed out defects in the current system. It has called for an overhaul, citing such reasons as, “It is not appropriate to add the medical fee simply for providing medical care to pregnant women.”

Under the current system, the extra fee can be charged even when expectant mothers are getting contact lenses. This is because specific rules, such as what sort of medical services are subject to the extra charge, have not been set. It cannot be helped if the system is criticized for its sloppy design.

A future task is to create a scheme in which medical fees will be added appropriately according to the types of services that pregnant women receive. The health ministry will proceed with considering the revision of medical fees for fiscal 2020. It is hoped that medical services necessary for pregnant women will be properly discerned.

As for the resumption of the extra-charge system, how to reduce the financial burden on pregnant women is also a point of contention.

One member of the panel of experts said, “Consideration must be made for a measure that will prevent those who want to have children from hesitating to do so due to the increase in out-of-pocket payments.”

Some local governments have implemented their own programs to subsidize medical costs for pregnant women as part of efforts to counter the falling birthrate. Calm discussions are needed to determine who will shoulder the fees for substantial medical services and how it will be done.

(From The Yomiuri Shimbun, June 8, 2019)Speech



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