An article from Kyodo News on November 15, 2017, Ministry of Health, Labour and Welfare announced that people who visit a hospital without a letter of introduction from family physician or clinic are charged more than 5,000 yen that will be started from year of 2018.\r\nThis system is already started on April 2016. The main purpose of this system are performing the different function of the medical institution and giving the high quality medical care to patients. Currently, an advanced treatment hospital and hospitals who have more than 500 beds charge more than 5,000 yen other than doctor’s fee if patients do not have a letter of introduction. In other case, hospital charges 2,500 yen if patients visit same hospital even though they have received a letter of introduction for visiting other hospitals.

The new system will be started from 2018, and hospitals who have more than 400 beds will start to charge more than 5,000 yen as a special charge. Ministry of Health, Labour and Welfare recommend going to family physician or clinic before going to large hospitals.

Not all hospitals charge 5,000 yes as a special charge for patients who does not have the letter. Ministry of Health, Labour and Welfare just said large hospitals who have more than 400 beds could charge more than 5,000 yen. It means hospitals could set the price. The data from Ministry of Health, Labour and Welfare said 94.2% of hospitals who have more than 500 beds charge between 5,000 and 6,000yen. 0.5% of the hospitals charge either between 6,000 and 7,000 yen or 7,000 and 8,000 yen. And 3.7% of the hospital charge more than 8,000 to the patients. 8.7% of hospitals who have more than 200 beds and less than 600 beds are already charged more than 5,000 yen as the special fee even the system has not started yet.

People have some reasons for visiting large hospitals, but family doctors and clinics have connection with large hospitals. If family doctors think you need to visit a large hospital for medical treatment, the doctor will write a letter of introduction for you. If you are not in critical situation, please find a doctor near your house.