Revision of Cap for High-cost Medical Expense

Prime Minister Shigeru Ishiba announced that he would freeze the governmental plan to raise expense cap of high-cost medical care, which had been set to start in this August. Although he has been insisting on maintaining the plan, Ishiba finally gave up his idea of the introduction, receiving worries of his party colleagues about negative impact on next election of the House of Councillors this summer. Plan B is going to be presented in this fall or later.

While Japan has a universal medical care system, the government has been anxious about financial restriction for maintaining current system. It decided without consultation with patients last December that the upper limit of patients’ payment for expensive medical care, such as advanced treatment for cancer, would be raised with three phases between August 2025 and August 2027. For a family with average income, it was estimated that the cap for monthly payment would rise from 80 thousand yen to 139 thousand yen.

 

The expense cap hike would bring fatal consequence for a family with mortal disease. The top opposition party, Constitutional Democratic Party of Japan (CDPJ), demanded Ishiba in Diet discussion to revise the schedule of the hike. When the head of CDPJ, Yoshihiko Noda, requested Ishiba to review the plan late February, Ishiba indicated possibility of thinking twice. However, Ishiba kept the schedule of introducing the first phase in this August.

 

Trying to avoid criticisms on system change without hearing from the patients, Ishiba had a meeting with the patients of cancer on March 7th. The patients asked Ishiba freezing expense cap hike for this August. Ishiba then discussed with the leaders of leading coalition and announce the freeze. “It is not desirable for me to introduce the new system, while the patients are worried about their expenses,” told Ishiba to the reporters.

 

This redirection of policy showed Ishiba’s indecisiveness. In mid-February, he announced freezing the cap for patients who needed long-term care. Then, he made additional revision in late February to freeze the second and third phase of cap hike scheduled in 2026 and 2027. But he insisted on keeping the starting point of this August 2025. Nevertheless, Ishiba finally accepted freezing of the starting.

 

The FY 2025 budget, which includes high-cost medical care expense hike, has passed the House of Representatives with approval of the LDP, Komeito and Japan Innovation Party (Nippon Ishin-no Kai). If Ishiba abandons the cap hike in this August, the budget bill will need to be revised. The bill will be returned to the Lower House, right after the Upper House passed the revised bill, which will make another example of unusual procedure of budget bill.

 

Ishiba accepted the request from the opposition party to support election campaign of LDP Upper House candidates for this summer. However, Ishiba was late in hearing the patience and revealed an aspect of weakness as the leader of government.

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