Releasing 70,000 Psychiatric Patients Shows How Deep Japan's Debt Problems Are

If I remember correctly, they did the same in San Francisco in the Reagan years?

Anyway, when you reach such extreme decision, it really means that you are back to the wall and have hard time finding space to breath.

Yet again, the case for the unintended consequences of the government's action are highlighted (see below).

In any case, this is sad and lives are at stake. But there's no way out of this and nature's law will prevail.

Sept. 14 (Bloomberg) -- [...] the government [...] wants to empty 70,000 beds to reduce the highest rate of psychiatric hospitalization among developed nations, lowering its 1.8 trillion yen ($23.5 billion) annual mental-health payments. Facing the world’s largest public debt and the fastest aging society, Prime Minister Yoshihiko Noda is trying to curtail growth in the country’s 34.8 trillion yen-a-year health bill. 

“The only thing the government has in mind is cutting medical costs,” said Yugo Miyata, who runs Yokohama Camellia Hospital on the outskirts of Tokyo. “If hospitals force out 70,000 patients immediately, we must be ready for several thousand of them to be homeless on the street.” 

The effort to reverse a five-decade policy of isolating psychiatric cases is unrealistic because most patients have no living relatives or have been hospitalized too long to cope outside, and because of the stigma in Japan of having a mentally ill relative [...] 

Care of the mentally ill accounts for 5.2 percent of the nation’s 34.8 trillion yen medical bill.

While the U.S. and western Europe began closing asylums and integrating patients into the community in the 1960s, in Japan the stigma of mental illness has ensured that the nation’s 1,076 psychiatric hospitals maintain a 90 percent occupancy rate. Japan has 13.5 times more psychiatric beds per 100,000 people than the U.S. and 4.5 times more than the U.K., according to OECD data. [...]

The mentally ill have been largely separated from society in Japan since the 1950s, when the government prohibited people from locking up sick relatives at home.  [...] 

“Many patients don’t need medical care,” said Okazaki at Tokyo Metropolitan Matsuzawa Hospital. “But they have no home to return to as their parents have died and their siblings don’t feel they have a duty to support them.” 

Treating Japan’s more than 300,000 psychiatric in-patients costs about 400,000 yen per patient per month on average, according to a 2009 health ministry survey. Between 70 percent and 100 percent of that cost is covered by the government, depending on the patient’s age and relatives’ ability to pay. For seniors, the state pays as much as 90 percent of the bill.
[...] 

With large subsidies, psychiatric hospitals, 90 percent of which are owned by doctors, have little incentive to release patients, according to the OECD report. Government payouts for seniors had “the unintended effect of turning hospitals into de facto nursing homes,” the report said. “Keeping patients in beds is an easy way to gain revenue.” 

Psychiatric patients in Japan are hospitalized for 307 days on average, compared with just over a week in the U.S. and about 11 weeks in the U.K., according to government figures. [...]