The coronavirus crisis that could not be made use of…Medical issue

Government response to the corona crisis

When the COVID-19 infection spread, the government requested all medical institutions to accept patients without dividing them into levels (capacity to treat to unknown infectious diseases).

To do this, they even went so far as to offer subsidies of nearly 10 million yen per one bed if they were prepared to accept hospitalization.

However, forcing many medical institutions to accept patients means dispersing the source of infection, and increasing the risk of spreading the infection.

In such cases, I think the basic approach would be to prepare a base hospital that specializes in treating COVID-19 patients and gather patients there to prevent the spread of infection, but the government’s measures are the exact opposite.

Respond with an understanding of the differences in management between private and national hospitals

Private hospitals do not provide medical care as a charity, but conduct the business of medical care with the aim of making a certain amount of profit.

Therefore, they often do not have the expensive system in place to respond to unknown infectious diseases, and even if they do, the costs put a strain on management.

On the other hand, in the case of national and public hospitals, management deficits are covered by taxes, so by preparing a system to respond to unknown infectious diseases, hospitals will not go bankrupt even if they are in the red.
In other words, if public hospitals cannot treat special diseases that private hospitals cannot treat due to financial issues, there is no meaning to pouring tax money into public hospitals.

Given this background, in the event of an unknown infectious disease like this one, wouldn’t it have been better to create base hospitals among public hospitals, gather specialists there to provide intensive treatment, and refer only patients with complex conditions that cannot be treated there to advanced medical institutions such as university hospitals?

In that way, medical institutions other than the base hospitals could focus on treating patients who are not infected with COVID-19.

Since all staff at public hospitals, including doctors, are civil servants, it should not be difficult for the national and local governments to organize such a system at their discretion, and tax should be used for that aim.

Regarding the government’s response after the crisis has passed

In the end, the coronavirus weakened before any fundamental measures could be taken, and restrictions on COVID-19 were lifted in May 2023.

With the lifting of coronavirus restrictions, the Ministry of Health, Labor and Welfare sent a notice to each medical institution stating that “refusing to treat patients because they are coronavirus patients is a violation of the obligation to respond,” and essentially forced all medical institutions to treat coronavirus patients regardless of their capabilities.
The lifting of coronavirus restrictions does not mean that coronavirus will suddenly disappear.
In medical institutions that are not prepared to prevent infection, many medical staff are at high risk of contracting coronavirus, and if that happens, there will be no medical staff to treat illnesses other than coronavirus.

This pandemic was an opportunity to significantly change Japan’s medical system, such as the nature of public and private hospitals and the construction of a medical system that can flexibly respond to pandemics, but it is regrettable that we were not able to take advantage of this opportunity.

Even after coronavirus is gone, there is a possibility that new infectious diseases will emerge, and we need to build a medical system that can respond to them now.
We must not let coronavirus end with “we forget the pain once it’s over.”