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🏛 | [Fact check] 5 trillion yen If you want to increase military spending, you have to double the burden of medical expenses at the counter.


[Fact check] If you want to increase military spending by 5 trillion yen, you have to double the burden of medical expenses at the counter.

If you write the contents roughly
Looking at this national medical expenses by system category, the burden on patients, etc. is 5 billion yen (composition ratio: 4540%).

Japan In-depth editorial department [Summary] ・ If the Communist Party chairman increases military spending, the window for medical expenses ... → Continue reading

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    5 billion yen (composition ratio: 4540%)

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      Medical bills

      Medical bills(Health expenditures) means that the people of that country have a year.保健andMedicalTotal cost spent on.Includes both public spending (social security spending) and private spending (own expense)[2].This is accounted for in the country's National Health Accounts (NHAs)[2].


      Medical resource procurement costs

      Medical facilities procure "people, goods, and money," which are medical resources, from the market.Medical resources include "people" such as doctors, dentists, pharmacists, nurses, clinical laboratory engineers, and other medical staff.Medical equipment・ Specimen inspection ・Medicine・ Refers to "things" such as equipment and facilities, working capital, etc.It is based on the idea that it is possible to secure better medical resources and provide better medical care by the market principle, but doctors and nurses can concentrate on medical institutions, clinical departments and cities with good conditions. Since you are free to leave, phenomena such as shortage (and depletion) may occur depending on the clinical department or region.

      At the same time as concentrating medical resources to improve medical efficiency and medical functions, it is also necessary to decentralize medical resources for ease of consultation and equality of medical contents.It is necessary to control the increase in medical expenses while maintaining a balance between the concentration and decentralization of medical resources, which is difficult to steer.

      Doctor fee and hospital fee

      There is an idea to divide medical expenses into expenses required for diagnosis and treatment of illness by doctors (expenses) and other expenses (expenses).Hospital fees include the costs of various medical staff such as nursing and clerical work, as well as the costs of clinical tests, pharmacies and medicines.In the policy of curbing medical expenses, the amount of reduction related to hospital fees is often larger than the amount of reduction in doctor fees.

      The cost of diagnosing and treating a disease by a doctor is literally a doctor feemedical insuranceThere is also the idea that doctors should be paid directly, but in this case, the content of medical services may be affected by medical insurance.

      Medical expenses of each country

      Comparison of countries
      CountryLife expectancyInfant mortality[3]Per 10 population
      Preventable death
      Population XNUMX
      A doctor
      Population XNUMX
      Per nurse
      Per person
      Health spending (US $ PPP)
      In GDP
      Medical expenses expenditure ratio (%)
      In government spending
      Medical expenses (%)
      In medical expenses
      Government burden ratio (%)
      Australian flag Australia81.44.49572.810.13,3538.517.767.5
      Canadian flag Canada81.44.7877[5]2.29.03,84410.016.770.2
      French flag France81.03.34553.37.73,67911.014.278.3
      German flag Germany79.83.48763.510.53,72410.417.676.4
      Italian flag Italy80.53.33604.26.12,7718.714.176.6
      Japanese flag Japan82.62.17612.19.42,7508.216.880.4
      British flag United Kingdom80.14.5832.59.53,0518.415.881.3
      United States flag The United States of America78.15.9962.410.67,43716.018.545.1

      whoAccording to the WHO published by the World Health OrganizationWorld BankAccording to the classification of High Income Countries) in 2010GDPThe average value of the ratio of medical expenses to the total medical expenses is 12.4%, and the average value of the public expenditure ratio to the total medical expenses is 61.8%.[2].

      The United States of America

      According to WHO,The United States of AmericaThen in 2010GDPThe ratio of medical expenses to[2], Public health insurance is for the elderly and disabled (Medicare) And for low-income earnersMedicaid), The state's child health insurance system for children raised by middle-income earners, military personnel, and police officers, so the public expenditure ratio to the total medical expenses of the whole country is 48.2%.[2]..In the United StatesbankruptcyIt is also reported that about half of the people who did this went bankrupt due to payment of medical expenses.[6]..Moreover, many patients or their families who have gone bankruptMiddle classHe was a medical insurance member.These problems have long been recognized and discussed as political problems in the United States. In 2010Medical Insurance Reform ActIs established, and the aim is to reduce medical expenses for low-income earners through the universal health care system.

      United Kingdom

      According to WHO,United KingdomThen in 2010GDPThe ratio of medical expenses to is 9.6%, and the public expenditure ratio to the total medical expenses is 83.2%.[2].National Health ServiceAs long as you receive (NHS), medical treatment is free (no out-of-pocket cost), but if you need medicine, you pay a prescription fee (about 1800 yen).Prescription fees are required for each type of drug, so prescribing multiple drugs can be quite expensive.As a result, prescription fees in the UK alone are often higher than 3% of medical costs in Japan.In addition, dentistry is charged even in the NHS, and the out-of-pocket cost is higher than in Japan. If you receive medical treatment at a private hospital other than the NHS, you will have to pay the full amount, which is considerably higher than the medical expenses in Japan.


      According to WHO,FranceThen in 2010GDPThe ratio of medical expenses to is 11.7%, and the public expenditure ratio to the total medical expenses is 76.9%.[2].Universal healthcareThere is a system, and medical fees are a volume / reimbursement payment system.[7].


      According to WHO, in 2010 in Upper Middle Income CountriesGDPThe average value of the ratio of medical expenses to the total medical expenses is 6.0%, and the average value of the public expenditure ratio to the total medical expenses is 55.5%.[2], 2010 in Lower Middle Income CountriesGDPThe average value of the ratio of medical expenses to the total medical expenses is 4.3%, and the average value of the public expenditure ratio to the total medical expenses is 36.1%.[2], 2010 in Low Income CountriesGDPThe average value of the ratio of medical expenses to the total medical expenses is 5.3%, and the average value of the public expenditure ratio to the total medical expenses is 38.5%.[2]There are no countries with 100% public expenditure, and countries in the 90% range are a few exceptions, and even in the developed countries with the highest public expenditure rate, the countries in the first half to the middle of the 80% range.[2].

      Medical expenses in Japan

      in JapanUniversal healthcare制度が実現され、病気や障害からの回復、病気や障害の進行の遅延、心身の機能維持などの生命や健康の維持に必要な医療は、公的な医療保険が適用される。自己負担として3歳~69歳の患者は医療費の3割、0歳~2歳の小児は2割(自治体で別途公費補助あり)、70歳以上の高齢者は1割(所得によっては3割)を窓口で支払う(2013年10月現在)。それらとは関係ない、美容整形、歯科矯正、人工授精、体外受精、代理出産、性転換手術などの医療は、公的保険対象外のFree medical care(Medical treatment not covered by insurance) and the entire amount will be borne by the individual.

      For the purpose of improving the management of medical institutionsSpecial function hospitalAnd in some private hospitals, from the existing piece-rate payment methodDiagnosis group classification Comprehensive evaluationThe (DPC) method is adopted.


      Lifetime medical expenses per person are 1 million yen for men and 2,600 million yen for women, 2,800% of which occurs at the stage of 50 years old or older (70 estimate).[8].

      Total medical expenses in 2010 was 37 billion yen[9]In addition, medical expenses for the elderly aged 75 and over are 12 billion yen.[9].

      According to WHO, Japan's 2010GDPThe ratio of medical expenses to is 9.2%, and the public expenditure ratio to the total medical expenses is 80.3%.[2], The ratio of medical expenses to GDP is low compared to the average value of developed countries, but the public expenditure ratio to the total medical expenses isDenmark,Sweden,Norway,アイス ランド,United Kingdom,New ZealandAnd so on, it belongs to the highest group[2].. Received from insurance medical institutions from 2006Receipt that shows the contents of medical expensesThe score for each medical content category is described in and the basis for calculating the contribution to be paid at the accounting counter is displayed.

      Senility and medical costs

      When the Nihon Keizai Shimbun surveyed about 20 cities and wards with a population of 130 or more, Kanagawa PrefectureChigasakiThe annual medical expenses were the lowest, which was 14 yen less than the national average.There was no increasing trend in annual long-term care costs, and no correlation like annual medical costs was confirmed.The disparity between the top municipalities and the senile death of Chigasaki City was up to 6.8 times for men and 4.3 times for women.Chigasaki City, where senility, which is the healthiest cause of death, accounted for the largest proportion, had a mortality rate of 100, which was twice the national average.The annual medical expenses per person aged 210.2 and over in the city was 2 yen, which was 75 yen lower than the national average of 79.2 yen.If medical expenses are on par with Chigasaki City nationwide, medical expenses will be increased nationwide.Annual expenditureEvery year2.3 trillion yenBecause it will decreaseSocial security expensesChigasaki City is drawing attention from the perspective of Japan's finances, which spends more than 3%.The Chigasaki Medical Association said, "Multiple occupations of medical care are collaborating, and the system to support the elderly living at home care is well-developed. The number of people who want to reach the end at home is increasing." Explains the large number of people who are welcoming.On the contrary, the lowest rates of senility and death were in Ibaraki City at 30.9, Neyagawa City at 31.9, and Hirakata City and Suita City at 39.7 in Osaka Prefecture.Next were Nagasaki City at 40.9, Kagoshima City at 41.8, Sapporo City at 44.2, and Naha City at 47.4.The annual medical expenses per person over 75 years old in Ibaraki City was 106 yen, although it is not the largest municipality in terms of amount.[10].

      Drug price

      In Japan, insurance-covered drug prices (Drug price) IsOfficial priceIt is a system (Health insurance lawArticles 76-77).

      Medical expenses

      Nari-A cousin-Anma Massage ShiatsuTreatment,Judo reduction teacherThe cost of the procedureMedical expensesAlthough it differs depending on the handling of treatment costs (billing method, calculation method, burden method), it is treated in almost the same way as public medical insurance.

      National medical expenses

      National medical expenses are estimates of expenses required for treatment of injuries and illnesses at medical institutions within a single year. "Publicly funded medical care"Benefits" "Public medical insurance benefits" "Medical care for the elderlyAs a general rule of "benefit", it is estimated by estimating the "partial burden" paid by the patient and the "full self-pay" paid by the patient based on the fixed payment amount for medical treatment, and adding up the above.[11].

      • Medical expenses, dispensing expenses, meal medical expenses at admission, home-visit nursing medical expenses, transportation expenses provided by health insurance, etc. are included in national medical expenses.
      • Medical checkup,vaccination,normal妊娠-childbirth, Prostheses and limbs required for fixed physical disabilities are not included in national medical expenses.
      Japanese national medical expenses[9]
      National medical expenses20 billion yen26 billion yen30 billion yen33 billion yen37 billion yen
      Out of hospital (outpatient)45.7%44.3%41.5%38.8%35.1%

      Excess medical expenses

      The increase in national medical expenses as a result of the increase in patients due to specific illness causes,Excess medical expensesCalled. 2003Japan Research Institute, Inc.Research by Takeshi Shimizu[12]according to,"smoking"Exhaust gas"alcoholThe excess medical expenses due to "abuse" are estimated to be about 1999 billion yen as of 3, and the total excess medical expenses as of 1,898 is estimated to be about 2025 billion yen.

      To curb excess medical costs, the study makes the following suggestions.

      smokingとExhaust gasOn the other hand, the effect of curbing medical expenses when internalized by using taxation and surcharge is estimated to be about 2025 billion yen per year as of 269.also,smoking,Exhaust gas,alcoholIt is estimated that the effect of curbing medical expenses by implementing restraint measures other than internalization against abuse will be approximately 2025 billion yen per year as of 1.

      Breaking news on estimated medical costs

      Approximate medical expenses or medical institution medical expenses are published on the website of the Ministry of Health, Labor and Welfare as Medical Institution Medias (MEDIAS).[13].

      A summary of medical fee points, expenses, cases, days, etc. processed by the examination and payment institutions (Social Insurance Medical Fee Payment Fund and National Health Insurance Association) is published as an approximate medical expense database.Includes medical expenses for inpatients, out-of-hospitals, dentistry and dispensing, dietary treatment at admission, and home-visit nursing care.

      Medical cost problem

      National medical expenses increased by 2000% in the 2010 years from 10 to 24.1[9], Publicly funded medical expenses increased from 1999 billion yen (26% of national income) in 3,863 to 7,24 billion yen (2009% of national income) in 30.[15], Japan's medical expensesGDPAnd is increasing at a pace that exceeds national income.

      Medical expenses are increasing at a pace that exceeds gross domestic product and national income due to multiple causes such as improvements in medicine and medical technology, an increase in life expectancy, an increase in the elderly population, a decrease in the birth rate, and a decrease in the working generation population. However, no effective solution has been found, and the people, the Diet, the Ministry of Health, Labor and Welfare, and the government are searching for a solution.

      Increase in dispensing pharmacies

      DispensingpharmacyIt is,Ministry of Health, Labor and Welfare OfDivision of laborIt has been increasing steadily for the purpose of.The aim of the effect is as follows.

      1. Division of laborBypatient OfDrugged medicineTo prevent.
      2. The family dispensing pharmacy manages drug duplication and patient history.

      National medical expensesに含まれる薬局調剤医療費は、平成7年の1兆2,662億円(国民医療費の4.7%)から平成18年の4兆7,061億円(同14.2%)まで急増している。その伸びは11年で372%以上、国民医療費での比率にして3倍強である。[16][17]

      Delinquent medical expenses

      According to the Medical Practitioners Act, doctors cannot refuse medical treatment unless certain requirements are met, but patients may postpone payment of medical expenses.Procrastination of medical payments by patients can put pressure on the management of medical institutions.


      [How to use footnotes]
      1. ^ a b Health at a Glance 2013 (Report). OECD. (2013-11-21). two:10.1787 / health_glance-2013-en. ISBN 978-92-64-205024. 
      2. ^ a b c d e f g h i j k l m World Health Statistics 2013 (Report). WHO. Pp131-141, 7 Health Expenditure. http://www.who.int/gho/publications/world_health_statistics/EN_WHS2013_Full.pdf. 
      3. ^ CIA – The World Factbook: Infant Mortality RateArchived from the original on December 18, 2012 (Older data). Retrieved May 15, 2013.
      4. ^ "Mortality amenable to health care" Nolte, Ellen.Variations in Amenable Mortality—Trends in 16 High-Income Nations”. Commonwealth Fund. April 2012, 2Browse.
      5. ^ data for 2003
        Nolte, Ellen.Measuring the Health of Nations: Updating an Earlier Analysis”. Commonwealth Fund. April 2012, 1Browse.
      6. ^ “Illness and injury as contributors to bankruptcy.” the journal Health Affairs. PMID 15689369. 
      7. ^ Akira Kashihara 1982.
      8. ^ Insurance Bureau Investigation Division (2019-03-13). Basic data on medical insurance Lifetime medical expenses 28 (Report). Ministry of Health, Labor and Welfare. https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/iryouhoken/database/zenpan/kiso.html. 
      9. ^ a b c d MHLW White Paper 2013, Document pp33-34.
      10. ^ High senility and low medical costs (Nikkei) December 2017, 12 morning edition
      11. ^ Outline of the range of national medical expenses and the estimation method(Ministry of Health, Labor and Welfare)
      12. ^ Takeshi Shimizu, Senior Researcher, Economic and Social Policy Research Center. To control excess medical expenses caused by smoking, exhaust gas, and alcohol abuse. Japan Research Review May 2003 POLICY PROPOSALS
      13. ^ Approximate medical expenses database
      14. ^ Social security cost statisticsMinistry of Health, Labor and Welfare
      15. ^ MHLW White Paper 2013, Document pp21-22.
      16. ^ Overview of national medical expenses in 8
      17. ^ Overview of national medical expenses in 18


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