[Sachmo]

Japan's meat wagons are refusing to meet emergency calls, according to Shukan Taishu (4/16).

The number of hospitals capable of dealing with emergency cases has dropped by 10 percent over the past five years, but the actual number of emergency cases has increased.

Ambulance services have responded to the crisis by refusing to answer some callers, or sending them hither and thither for hours -- sometimes with deadly results.

Ministry of Internal Affairs and Communications figures show that it takes ambulances over an hour to arrive on the scene in 5 percent of all emergency cases, but this figure shoots up to a staggering 14.4 percent in Tokyo.

"Ambulances and the doctors who deal with the cases they bring in have to be on call 24 hours, which is extremely inefficient and costs a lot. But the amount they can claim through the health insurance system for emergency cases is only slight, so the more a hospital devotes to providing emergency care, the more of a loss it's going to make," Atsushi Suzuki, a doctor at Kawasaki Municipal Ida Hospital and author of "Japan's Crumbling Medical Care," tells Shukan Taishu. "Local governments are holding up the system by paying subsidies. Physicians have given the system everything they've got, but I really think we've reached the limit."

It's not likely to get better, either. Until now, about 70 percent of freshly minted doctors have served an internship at a hospital operated by the university from which they graduated and they have formed the core of the country's emergency services. However, changes to the law that made internships two years long also gave new doctors the right to choose where they want to serve the time. In hierarchical Japan, it's a move that doesn't bode well for those in country areas.

"Everybody will want to do their internships at famous hospitals in central Tokyo," Suzuki says. "The number of people serving internships at university affiliated hospitals (forming the core of emergency services) will plummet."

Some say the situation will force people to become more realistic.

"There is greater demand for ambulances year by year. But there are too many people calling for emergency help when they've only got something like a cold or minor symptoms," a reporter on the medical beat for a major national daily tells Shukan Taishu. "There's no mistake that the number of ambulances refusing to answer calls will drop drastically if only patients who need emergency care call for it." (By Ryann Connell)