OSAKA - Around 60 percent of hospitals across Japan are operating in the red, creating a critical situation where closures and bankruptcies are no longer a distant threat. Behind the figures lies a deepening financial crisis that is raising questions about whether patients can continue to rely on stable access to medical care.
Five medical associations in Osaka Prefecture held a press conference on October 2nd to sound the alarm.
Osaka Medical Association President Yasushi Kano said: "Having hospitals and clinics you can always rely on nearby—can we still take that for granted? A quiet but serious shift is taking place in Osaka’s medical system. Both clinics and hospitals are facing a crisis in their operations."
An emergency survey by the Japan Hospital Association found that about six out of ten of the more than 1,800 hospitals that responded nationwide were running deficits.
A visit to Tsukuba University Hospital in Ibaraki Prefecture revealed the realities of this financial strain. In the outpatient waiting area, chairs were left in tatters, and walls near doors were patched with tape instead of repairs. Although the building, nearly 50 years old, is due for replacement, the budget is unavailable.
Tsukuba University Hospital Director Yuji Hiramatsu explained: "The deficit is about 2.8 billion yen, the largest since the hospital’s founding. The biggest factor is rising personnel costs, up roughly 1.8 billion yen compared to two years ago. In the past, we managed to cover expensive advanced medical care with revenue from other areas, but now expenses across the board are rising, upsetting the overall balance."
The strain extends to emergency care. At a hospital in Sakai City, Osaka Prefecture, doctors stressed the importance of sustaining services despite mounting losses.
Physician Michihiko Kosaka said: "Emergency care is absolutely essential. Recently, more people are stepping away from it, but it is necessary, so as a team we try to transform the effort into the joy of saving patients."
However, with budgets under pressure, even updating medical equipment has become difficult. "Normally machines are replaced every ten years, but in some cases we continue using old ones. Still, we must replace them when possible because precision is directly tied to the quality of care," Kosaka said.
Rising costs are also hitting other areas. The disposal of special medical waste generated when treating infectious patients rose by 6 million yen over the previous year due to higher labor costs at contractors.
To stay afloat, some medical corporations have been offsetting hospital deficits with profits from nursing care businesses within the group, but this is only a temporary solution.
Kyoko Tanaka, administrative director at the Sakai hospital, emphasized: "Even though management is tough, we still maintain staffing to ensure emergency and non-refusal care. For hospitals providing emergency services, finances are extremely severe. As long as we continue such essential care, deficits are inevitable. We strongly hope that medical service fees will be revised so that appropriate compensation is provided for proper medical treatment."
When asked about potential ways forward, Hiramatsu of Tsukuba University Hospital gave a grim assessment: "There really are no options left. We have done everything we can. Some might think if a university hospital goes bankrupt, another hospital can simply take over, but these institutions are crucial social infrastructure for training doctors. Everyone is desperately enduring to continue providing advanced medical care."
Source: YOMIURI
