[Activity of clinical laboratory physicians in national health insurance]

As places of activity of clinical laboratory physicians in national health insurance, there are committees of the Japan Medical Association and the Social Insurance Union of Societies Related to Internal Medicine. In 1996, additional management fee was approved due to the efforts of the then President Kinya Kono, and subsequently, fees were increased after every revision, markedly contributing to the income at the department of clinical laboratory in hospitals. Another activity of clinical laboratory physicians is work in the Social Insurance Union of Societies Related to Internal Medicine and that Related to Surgery toward the 2006 revision of medical insurance fees. The former union presented a request paper in cooperation with each scientific society for the revision of medical insurance fees, and clinical laboratory physicians played the central role in summarizing requests associated with laboratory tests. We describe the contents of the request paper for the 2006 revision of medical insurance fees presented by this union. In the previous revisions (2004), after the Ministry of Health, Labour, and Welfare counseled with the Japan Medical Association, the Central Social Insurance Medical Council made the final decisions. In the future, the power of the Ministry of Health Labour, and Welfare may increase. In activities of clinical laboratory physicians in medical insurance fees, clinical laboratory tests and physiological function tests should be evaluated according to each items, and the income/expenditure balance should be improved. In the 2006 revision of medical insurance fees, a marked reduction in medical costs for the increase in medical insurance for the elderly is expected. For this reduction, laboratory tests for which a reduction is easy may become targets. The government reported the principle that reimbursement in 2006 will be reduced by 2-5% to put the brakes on the rise in national medical costs due to the aging of society. The prospective payment system mainly by the diagnosis procedure combination (DPC) is performed mainly at university hospitals at present, and attention is paid to its future progress.