Japan panel proposes fertility treatment insurance coverage

A government panel Wednesday proposed that fertility treatment be covered by the country’s public health insurance program as part of efforts to tackle the declining birthrate.

The Central Social Insurance Medical Council, which advises the health minister, sought the coverage in its proposal on the fiscal 2022 revision of the official medical service fees, adopted at a general meeting in the morning.

The council also called for raising initial consultation fees that medical institutions collect from those seeking online diagnosis, hoping to promote online medical examinations, currently allowed in exceptional cases amid the novel coronavirus pandemic.

This will be the first medical service fee revision since the coronavirus began to spread in Japan in 2020. The fees are revised every two years in principle.

The council’s proposal includes fee changes to facilitate the resolution of problems highlighted by the COVID-19 crisis and promote cooperation among medical institutions as the country’s dankai first baby boomers started turning 75 this year.

The insurance coverage for fertility treatment was sought by former Prime Minister Yoshihide Suga, the immediate predecessor of Prime Minister Fumio Kishida.

From the start of fiscal 2022 in April, fertility treatment such as artificial insemination and in vitro fertilization will join the list of items covered by the public insurance. The coverage will be available to women under age 43, for up to six times.

At present, patients receive fertility treatment outside the scope of the insurance and therefore have to pay the treatment costs almost entirely.

The addition to the list will make a big difference because the out-of-pocket expenses for patients receiving the treatment will drop to 30% of all costs for the treatment in principle.

This time, however, the council stopped short of proposing the insurance coverage of assisted reproduction using sperm or eggs donated by a third party and preimplantation tests to check for chromosomal abnormalities in fertilized eggs.

Amid the coronavirus crisis, Japan has already introduced special additional medical fees for hospitalization and treatment of infected patients. The measure will continue for the time being.

The council aims to promote broader-based regional cooperation among medical institutions to combat COVID-19, proposing additional medical fees for clinics that work with large hospitals and strengthen infection prevention measures in their facilities.

Given that online medical examinations will become permanently available from April, the council called for raising initial consultation fees from ¥2,140 to ¥2,510 to promote the online method by reducing the difference between online and face-to-face consultation fees.

Ahead of the introduction of restrictions on overtime hours for doctors in fiscal 2024, the council proposed measures to support medical institutions working to reduce the burden of doctors and implement work style reform.

The fee for first visits to major hospitals without referral will be raised from the current ¥5,000 to ¥7,000 as part of efforts to ease the concentration of patients at such institutions and to let town doctors play a bigger role.

A prescription refill system will also be introduced, which allows the use of a single prescription repeatedly over a certain period.

To help young caregivers under the age of 18 looking after family members, the council proposed an additional medical fee for hospitals collaborating with educational institutions to ensure they receive assistance.

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