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軽症患者の救急搬送は有料化せよ！【第105回日本未来会議】 — Transcript

by 日本未来会議 · 5,622 words · 990 segments · language en · Watch on YouTube

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0:00Emergency transport for minor cases
0:02should be charged.
0:03>> If you try to judge it yourself on the
0:04spot, there is always the worst-case
0:06scenario, right?
0:07>> If you think about overall optimization
0:08, this won't work unless you charge for
0:09it. Because if it drops by even one
0:10minute, the survival rate drops
0:11drastically, making it impossible to
0:12save those who could have been saved.
0:13>> Are there people who do this maliciously
0:15? Instead of...
0:16>> Some people actually use it as a
0:17substitute for a taxi.
0:18>> Wait, really? Let's get started.
0:28Japan Future.
0:31This program is brought to you by the
0:33following sponsors.
0:36Alright, we've started.
0:38Japan Future Conference, Mr. Kuchi,
0:41thank you again this time.
0:43>> Thank you for having me.
0:44>> Now, surprisingly, we have three people
0:46appearing for the first time today.
0:48>> Yes. First, we have Nana Takamatsu. Nice
0:51to meet you.
0:51>> Thank you for having me. Greetings.
0:54I work on youth political participation
0:56. I run a company called Shoka Sonjuku.
0:59I go to schools nationwide to give
1:01lectures on politics, and through a
1:03project called "Reverse Mentor," I work
1:04on projects where high school students
1:06and local governments propose policies
1:08and even implement them in society.
1:10>> I see, Ms. Takamatsu, you're still using
1:13that greeting.
1:13>> Yes, that's right. No, I mean, just like
1:16how young people today don't know the
1:18person who wrote "No One's Perfect,"
1:20more young people don't know that you
1:21were a comedian.
1:23>> See, they didn't know.
1:25>> See?
1:25>> I was originally, yes.
1:27>> A comedian.
1:28>> Some high schoolers tell me they
1:29remember watching "Enta no Kamisama"
1:31when they were in elementary school or
1:33kindergarten.
1:34>> But look, everyone doesn't know. Did you
1:35appear on "Enta" with the co-stars?
1:37Don't joke around. Yes.
1:38>> Now, next is Kei Nishida. Nice to meet
1:41you.
1:41>> Yes. I go by "Nishi." I run a system
1:43development company called Technication
1:45Seed, and I was looking forward to
1:46talking with many different people, so
1:48thank you for having me today.
1:49>> Yes, thank you for joining us.
1:51>> I'm the guy with the noisy trucks.
1:53>> Ah, the trucks are noisy, aren't they?
1:55>> Sorry for the inconvenience.
1:56>> Now, our third guest is Yuki Yohiki.
1:58Nice to meet you.
1:59>> Yes, thank you for having me. On social
2:02media, I'm known as the "Coating Prince
2:04."
2:05>> I run two companies, a coating
2:06manufacturer and an application firm,
2:08and I’m actually from the same place as
2:11Mr. Kaneto.
2:11>> Uh-huh. It's KES.
2:13>> Oh, it’s KES?
2:14>> Yes.
2:14>> Yes. Nice to meet you.
2:16>> So, with some fresh members joining us,
2:18let’s get on with today’s discussion.
2:21Looking forward to it.
2:22>> Likewise.
2:25"
2:25>> Opposition Time," where we identify the
2:27problems and risks in the ideas proposed
2:29for Japan’s future.
2:32"Ruling Time," where we build concrete
2:34measures toward implementation.
2:40A meeting to challenge the evolution of
2:42these proposals through dual approaches
2:44of opposition and support begins now.
2:49Let’s have today’s presenter join us.
2:56My name is Takahito Sekiyama. I
2:58previously worked on the front lines of
3:00emergency services for the Tokyo Fire
3:02Department for eight years.
3:04Currently, I serve as a managing
3:06director at a private ambulance company
3:09called Takasangyo.
3:12The theme I am proposing today is: "
3:14Charge for ambulance transport for
3:16patients with minor conditions."
3:22In 2024, the number of annual ambulance
3:25dispatches in Japan reached
3:27approximately 7.7 million, with the
3:29national average response time at 9.8
3:32minutes.
3:34Additionally, it is estimated that about
3:36half of those transported by ambulance
3:38are patients with minor conditions who
3:40do not require hospitalization after
3:42examination.
3:43In this situation, we need to create a
3:45system that can respond quickly to
3:47patients for whom every second counts.
3:51Should ambulance transport for patients
3:53with minor conditions really be charged
3:55for?
3:57Emergency services in Japan are
3:58currently under critical strain.
4:03In 2024, there were 7.7 million
4:06ambulance dispatches.
4:10Of those, the national average time from
4:12receiving the 119 call to arriving at
4:15the scene has reached 9.8 minutes, an
4:17increase of about 1.1 minutes compared
4:20to before the pandemic. We must protect
4:22a system where ambulances can reach
4:24those for whom every second counts, as
4:26quickly as possible. We know that half
4:28of those transported were found, after
4:30examination, to have only minor
4:32conditions not requiring hospitalization
4:34.
4:35However, I don't want to cause any
4:37misunderstandings, so I want to be clear
4:39: this is not about blaming people who
4:41had minor conditions. If you are in
4:44doubt, do not hesitate to call 119.
4:47I am not saying that all ambulance
4:49services should be charged for.
4:52We will continue to protect free
4:54ambulance services that anyone can call
4:56at 119.
4:57We need to. Furthermore, in cases where
5:00medical professionals can clearly
5:01determine that an emergency is not
5:03urgent at the time of the request, we
5:05should consider a certain level of
5:07out-of-pocket costs to ensure ambulances
5:09reach those who need them, when they
5:11need them, to protect Japan.
5:13That is my proposal for today.
5:16>> Yes, thank you very much. Please return
5:19to your seat for now.
5:21Now, Mr. Sekiyama, we will proceed with
5:24the discussion.
5:26If a majority of these members vote in
5:29favor, and Chairman Noguchi also
5:31approves it, you will receive a prize of
5:33100,000 yen, so please do your best.
5:36>> It hasn't happened yet, of course.
5:38>> Yes. That's right.
5:39>> The truth is still...
5:42>> Well then, I would like the members to
5:43move on to the first vote immediately.
5:49For the first vote, we will have the
5:50future members express whether they are
5:52in favor of or against the proposal from
5:54the presenter at this moment.
5:59Having heard the presentation, please
6:01give your opinion on whether you are in
6:03favor or against it.
6:05Everyone, please vote now.
6:09Oh, wow.
6:12>> Well, the result is 5 votes in favor and
6:142 votes against.
6:18First, I would like to proceed with the
6:20opposition party time.
6:22Opposition party time.
6:24All members, from a position of
6:26opposition, will thoroughly confront the
6:28risks and practical obstacles of the
6:30proposal.
6:31>> Now then, let's start the opposition
6:33party time.
6:34I'd like to ask you something first. I
6:36believe you, Mr. Sekiyama, are involved
6:38in a business regarding private
6:40ambulances.
6:41>> You are someone running that business,
6:43right?
6:44How is the private ambulance business
6:45doing?
6:47What is the current penetration rate in
6:49Japan?
6:51>> Actually, in terms of penetration in
6:53Japan, the numbers have spread quite a
6:56bit, and they do exist all across Japan
6:58, but the awareness...
7:01>> The fact that people don't even know
7:03they exist is a pretty big issue.
7:05>> If you call an ambulance it's free, but
7:06if you call a private one, you get
7:08charged, right?
7:09>> Yes. That's right.
7:10>> That's exactly it. The premise is,
7:12what's up with that?
7:14>> That's true. Yes.
7:16>> I can't picture it at all, but as Mr.
7:18Noguchi just said, an ambulance is free
7:20, but you have to pay for a private one
7:22.
7:24In that situation, what kind of people
7:26pay money to call a private ambulance?
7:28>> Yes.
7:37To give you an actual example, there was
7:38a relatively young person who had a
7:40recurring condition like a lumbar hernia
7:42, which is a type of lower back pain.
7:49That person felt a bit guilty about
7:50calling an ambulance.
7:53Also, it wasn't the kind of emergency
7:55that required immediate surgery.
7:59So, they first called the emergency
8:02consultation center, which is#7119, to
8:05ask for advice.
8:07As a result, they were indeed directed
8:09to a private ambulance service.
8:11>> About how much was it?
8:12>> At that time, it was around 36,000 yen.
8:15One way?
8:15>> Couldn't they use a taxi?
8:18>> Well, a taxi would be fine, but some
8:19people are in a position where they
8:21simply can't sit up.
8:23>> There are people like that, aren't there
8:25?
8:26So in such cases, it's easier for them
8:29to stay lying down on a stretcher.
8:31>> Yeah. Yes.
8:32>> Well, I'm sure you all have many
8:34questions and points you'd like to bring
8:36up. Isn't the current way fine as it is
8:38?
8:38>> Oh?
8:39>> What do you mean?
8:40>> If ambulances are overwhelmed, or if
8:42someone finds it hard to call one, they
8:44can just use a private service, and
8:46services like Fast Doctor can even come
8:48to your house.
8:48>> That's true. They are house-call service
8:51agencies.
8:51>> So, the problem is that ambulances are
8:53overcrowded.
8:54>> Yes. Hospital staff are struggling. So,
8:57instead of charging for ambulances,
8:59private services will keep popping up
9:01and increasing. Sure, some questionable
9:03ones might appear, but that's how
9:05society fills those gaps.
9:07>> That's right.
9:10>> So, I think healthcare will probably
9:12improve, and the reason to oppose
9:14charging for ambulances is that some
9:16people might think "it costs money, so
9:19I'll skip it" and potentially lose their
9:21lives.
9:24Whether it's mild or severe.
9:26>> Yes.
9:27>> Because when you have terrible stomach
9:29pain, you can't really tell if it's
9:30life-threatening or not.
9:32>> At that time, I was told it might cost
9:34money, and I thought, "Maybe I'll skip
9:37it, that's scary." I was a middle
9:39schooler with alcohol poisoning.
9:41>> Can I say that on air? Well, it was when
9:43I was a middle schooler.
9:44>> I was illegally transported, but still.
9:47>> That was free, too. You paid for the
9:48hospital yourself, right?
9:50>> Yes. I was so grateful that I developed
9:53a sense of patriotism.
9:55>> Illegal activity led to patriotism.
9:57>> You still have to pay medical expenses
9:59at the hospital you're taken to, don't
10:01you?
10:03So people who hesitate there will also
10:05hesitate about medical costs, so I think
10:07it's the same thing.
10:10Also, regarding severe cases...
10:13>> I wonder how that's judged.
10:19Doctors would know if it's mild or
10:21severe, but from a layperson's
10:22perspective, I don't know if I'm
10:24currently severe or mild, so I wonder
10:26where the clear line is.
10:33It's scary to leave that undefined, but
10:35at the same time, Japan's insurance
10:37system is incredible, isn't it?
10:42That's why I think it's fine to charge
10:44money regardless of whether it's mild or
10:45severe.
10:46>> Yes. Across the board. I see.
10:48>> Yes.
10:49>> By the way, Mr. Sekiyama.
10:51>> Beyond the line between paid and free,
10:53of course.
10:54>> Yes.
10:55>> I feel that people's opinions might
10:56change depending on roughly how much it
10:58costs. Doesn't it change quite a bit? I
11:00heard that if someone with a mild
11:01condition is taken to a major hospital.
11:03>> They get charged about 10,000 yen, I
11:05heard.
11:06>> Yes.
11:08Ah, what President Yamamoto mentioned is
11:10likely the "Selected Medical Expenses,"
11:13and generally, the most common amount is
11:16around 7,700 yen.
11:18>> Yes. Simply put, there are two reasons
11:20why I'm against it. The first is from a
11:22welfare perspective.
11:23>> Because, although it's no pain for us to
11:26pay 7,700 yen, for elderly people in
11:28real poverty, 7,700 yen might mean they
11:31won't go and end up dying alone, which
11:34is the worst-case risk, so I'm against
11:36it for that reason.
11:39The other is simply from a resource
11:41perspective, but I think the line
11:42between paid and free will be debated
11:44forever because it's ambiguous.
11:47That's true.
11:48>> I think the risk of complaints would be
11:50incredibly high, honestly.
11:52>> Yes.
11:57>> People who complain—well, it's the same
11:59in normal business—are usually the
12:01impoverished.
12:02>> Yeah.
12:04So the poor would be furious about being
12:06charged 7,700 yen, leading to complaints
12:09, which would force the government to
12:11create a dedicated ambulance complaint
12:13department.
12:16>> Even if insurance isn't applied and it
12:18ends up being free, the cost of handling
12:20all those complaints would likely exceed
12:22any savings.
12:23>> Yeah.
12:24>> From our company's perspective, I'm
12:25against it.
12:26>> Oh.
12:26>> I'm against it entirely. The concerns
12:29Mr. Kanazawa mentioned were actually one
12:31of the opinions raised when the
12:33selective medical expense system was
12:35first introduced.
12:37>> Yes.
12:39So, I’d like to introduce some of the
12:41latest data regarding the selective
12:43medical expenses in Ibaraki Prefecture
12:45and point out the differences between
12:47their system and Tokyo's.
12:50>> You're long-winded.
12:52>> Can you get to the conclusion faster?
12:55Please.
12:55>> Understood.
12:58To get to the point, in Tokyo, it's the
13:00hospital that ultimately determines
13:02whether the case is mild or not.
13:06In Ibaraki, however, they make the
13:08judgment on whether it's a minor case at
13:11the moment the 119 call is received.
13:14The person taking the call?
13:15>> Yes, exactly.
13:18The dispatch center assesses whether
13:20it's a minor case right when they
13:21receive the emergency request as one of
13:23their criteria.
13:25For those paid services that cost 30,000
13:28yen or so, are there any other benefits
13:30?
13:30>> Like, negotiating to get a really good
13:33private room at the hospital?
13:35>> Oh, thank you for that. Actually, that
13:37is one of our company's initiatives.
13:39>> You do?
13:39>> We do.
13:40>> That’s great. Also, while being
13:41transported, someone at your side...
13:43>> Like, if the person accompanying you is
13:45super beautiful?
13:46>> Ah, well, we'll consider that for the
13:48future. Don't consider it now! In that
13:50case, I'd use it every time.
13:53Well, we already work with our clinics
13:55on a daily basis, so...
13:57>> Clinics have cooperative medical
13:59institutions, meaning they've already
14:01coordinated in advance with larger
14:03hospitals regarding things like
14:04inpatient beds.
14:06So instead of it being a secondary
14:08option, it becomes the primary choice.
14:10>> That’s right. The public, free-of-charge
14:12systems are like that.
14:14We also get information on how many beds
14:16are open to an extent, so doctors can
14:18coordinate directly with other doctors
14:20when such a case arises, and the
14:22hospital is decided immediately.
14:24>> Ambulances are already doing that anyway
14:26, aren't they? All that communicating, I
14:28mean. But since the demand for
14:30ambulances is so huge, I feel like once
14:32Mr. Sekiyama's company gets bigger, it
14:34will become impossible.
14:35>> That’s true. If you're on the receiving
14:37end, it does become difficult, but
14:39>> well, at the current stage, we are at
14:40least making an effort in that regard.
14:42Yes.
14:43>> Yes. That concludes the opposition
14:45party's time.
14:46>> Now, Mr. Ushi, what do you think so far
14:48?
14:48>> Um, I don't really understand the point
14:50of this.
14:51>> When we talked about the title, it was
14:53about charging for services if the
14:55symptoms are minor, right?
14:57>> I don't understand what the problem is
14:59at all, and listening to this now, I
15:01feel like I'm being sidetracked.
15:05It just sounded like he was here to
15:07promote his private ambulance business
15:09because he wants to make money, so I
15:10really don't get what the theme or issue
15:12is, or what kind of solution he's
15:14proposing.
15:18>> Well, it could be seen as his own
15:19position-taking, but for now, let's set
15:21aside the question of whether it's a
15:23private ambulance service or not.
15:27Basically, the system is failing because
15:29too many people call an ambulance even
15:31when they are perfectly fine, so if we
15:33say we'll charge those people, maybe it
15:35can be controlled properly.
15:38And we should just discuss the downsides
15:40of that, right?
15:42Yes.
15:42>> Yeah.
15:43>> Then, let's move on to the ruling
15:45party's time.
15:47>> Ruling party time.
15:49Everyone becomes a proponent to offer
15:51advice and flesh out concrete measures
15:53to realize the proposal.
15:57Isn't this just completely driven by
15:59emotion?
16:00When you look at the population pyramid
16:02, with the shrinking birthrate and aging
16:04population, there are plenty of older
16:06people who have money, right?
16:09>> And they can, frankly,
16:11>> afford to pay a little bit of money,
16:13can't they? Charging the people who use
16:15it the most—the older demographic—
16:16doesn't feel wrong at all. Anyone
16:18opposing this just seems like someone
16:20who hasn't run a company and is only
16:21thinking about individual optimization.
16:23I’m honestly surprised. Yeah.
16:25>> I’m a bit surprised by Kim-san's take.
16:27Well, Zo-san's as well.
16:28>> Yeah. So,
16:29>> Wait, sorry. Are there really people who
16:31do this with malicious intent?
16:32>> Oh, absolutely.
16:33>> Some people use them as a substitute for
16:35a taxi. Like, "It’s cheaper to call an
16:37ambulance than a taxi," or they call one
16:39just to get a ride. Seriously?
16:41>> Wait, they exist? There can't be that
16:43many, right?
16:44>> If that's the case, I might actually be
16:45in favor of it too.
16:46>> Exactly. The problem, as has been
16:48mentioned, is that resources are scarce
16:49. The presentation at the start noted
16:51that it now takes 10 minutes for an
16:53ambulance to arrive. I looked into this
16:54myself out of curiosity, and 20 years
16:56ago, they arrived in just over 6 minutes
16:58. It’s nearly doubled to 10 minutes now
17:00.
17:01Every minute of delay causes the
17:03survival rate to drop significantly,
17:05meaning people who could have been saved
17:06won't be.
17:11To stop this abuse of ambulances, I
17:13believe the best way to change human
17:15behavior is to attach a cost to it.
17:17I agree with Ao-chan and Pe-san. Instead
17:19of just targeting minor cases, I think
17:21we should charge a flat fee for everyone
17:22. We can make exceptions for those who
17:24can't pay or for critical patients,
17:26perhaps by offering refunds later, but
17:27unless we make it a standard charge,
17:29that 10-minute wait will only keep
17:30getting longer. I think we should
17:31implement this paid ambulance system
17:33immediately.
17:34I’m starting to want to side with the
17:36people who support it.
17:39>> Also, what I’ve been thinking is,
17:41instead of a flat fee, maybe we could
17:43have a system where minor cases are
17:44out-of-pocket and serious ones are
17:46covered by insurance?
17:49>> Yeah. But at the end of the day, if you
17:51try to judge for yourself whether it's
17:52minor or not on the spot, you could end
17:54up in a worst-case scenario, right? For
17:56example, in America, it's not free,
17:58right? Ambulances in America are all...
18:01>> And you know what kind of problem is
18:03happening now?
18:05>> Because it's expensive, people try to
18:07walk there themselves or call an Uber,
18:09and as a result, they arrive too late
18:11when they could have been saved if they
18:13had been a bit faster, and those cases
18:15are increasing significantly.
18:17>> So, it's better now that things like
18:19Uber are available, but I'm sure it
18:21happened even more in the past. Yeah.
18:24>> In other words, since Japan is a country
18:26with wonderful welfare, I think the fact
18:28that ambulances are free is a point we
18:30should continue to protect as a
18:32wonderful home country.
18:34>> That's true.
18:35>> As expected, Kan says good things.
18:37>> You're uncharacteristically wavering
18:38today, aren't you? Wavering. The
18:40question is, how many people actually
18:41die from that? This is ultimately just
18:43an emotional argument; it's a very small
18:45sample size, and while they insist that
18:47"this is how it is," as I said before,
18:48if you think about overall optimization
18:50, it won't work unless we charge for it
18:52. I mean, even if people complain that "
18:54the consumption tax is going up and I'm
18:56barely scraping by, so this is a problem
18:57," if you look at overall optimization,
18:59you have to say it can't be helped,
19:01right? Isn't Japan just getting worse
19:03because we turn a blind eye to those
19:04realistic issues and listen to those
19:06people based on emotional arguments? So
19:07, for example, we could just keep it
19:09free for people on welfare, right?
19:11>> Yeah. So, even though there are ways to
19:13do it, well, nothing is decided yet,
19:14which is why we're having this
19:15discussion, I suppose.
19:16>> I see.
19:17>> Now, Mr. Takamatsu, what do you think?
19:19>> Ah, I'm definitely in favor of the third
19:21option.
19:23Given how strained our medical resources
19:25are, I would agree with keeping things
19:27as they are if Japan truly had an
19:29abundance of wealth.
19:33However, I believe it's important to
19:35introduce some fees, especially charging
19:37those who use ambulances like taxis.
19:44With the number of hospitals accepting
19:46emergencies dwindling and the staff
19:47being paid so little, we must collect
19:49fees where possible and redirect those
19:51funds to support these workers.
19:57We really need to face the fact that if
19:59we continue like this, Japan's medical
20:01system is headed for collapse.
20:05One thing I'd like to ask, though—I'm in
20:07favor of the idea, but for example,
20:09there have been cases where someone
20:11performed CPR on an unconscious person
20:13and was later sued for sexual harassment
20:15.
20:16Right now, because ambulances are free,
20:18people quickly call one if they see
20:20someone collapsed, but if they become a
20:22paid service...
20:23>> Oh, "I didn't want you to call one."
20:25>> Exactly.
20:27I feel like that could lead to trouble
20:29after the fact, so how do you...
20:32>> Who are you thinking should bear the
20:34cost in that scenario?
20:41>> Basically, patients or their families
20:43aren't going to file for damages over
20:45such a small fee, and there hasn't been
20:47a single case of sexual harassment
20:49involving AEDs in Japan, so I’d like to
20:51correct that.
20:54Either way, you’d have to pay once you
20:56arrive at the hospital, so I don't think
20:58that’s much of a point of contention.
21:01If someone is collapsed on the ground,
21:02you’re obviously going to call for help
21:04. If you leave them there and fail to
21:06provide life-saving assistance, you
21:08could actually face legal consequences,
21:10so calling is just the standard thing to
21:11do. I don't think that's a point of
21:13contention either.
21:14>> I just think it's actually really
21:16difficult to know when to call an
21:17ambulance.
21:18Yes.
21:20>> When I get a fever, I wonder if it's
21:22just a regular fever or something more
21:24dangerous.
21:26For example, I once had abnormal
21:28bleeding, and I thought my period was
21:30just off, but when I called#7119, they
21:33told me to come in right away because it
21:35could be a serious illness.
21:39I'm really worried that if people
21:41hesitate to call, lives that could have
21:42been saved won't be.
21:45>> Exactly, I feel the risk of the
21:47worst-case scenario happening, even
21:49though this wouldn't actually solve the
21:51problem, is really scary.
21:54I’d like Mr. Sekiyama to address those
21:56concerns.
21:58Do you know how complaints from people
22:00claiming their case wasn't actually
22:02minor are handled, and how much that
22:04costs?
22:08>> Actually, for Ibaraki Prefecture, we
22:10have the latest data from March to
22:12August 2026. We know that there were six
22:14cases where people filed a formal
22:16grievance during that period.
22:19As for the cost, I apologize. I don't
22:21have that information. Yes. How many
22:23total cases were there? What's the base
22:25number?
22:25>> Let's see, it was about 42,000 cases.
22:28>> Oh, that's perfectly fine. That's
22:30surprisingly low for now, isn't it?
22:32>> Yes.
22:33>> With that, the ruling party's time is up
22:35. Now, Mr. Noguchi, based on the
22:37discussion so far, what are your
22:39thoughts?
22:40>> It's difficult, isn't it?
22:42Every opinion sounds valid.
22:44So, what is the best way to solve this?
22:46>> As a sort of final closing argument...
22:48>> Yes. Now.
22:49>> Yes.
22:50>> If Mr. O takes the lead in summarizing,
22:51he'll just sway the conclusion again. I
22:52want to properly state my opposition as
22:54well. I really, truly want to state my
22:56opposition.
22:56>> There are probably just under 10 million
22:58ambulance dispatches a year, maybe 7
23:00million or so.
23:00>> Yeah.
23:01>> And if we assume this initiative reduces
23:02waste by, say, 1 million cases...
23:04>> Yes.
23:04>> In terms of taxes and such.
23:05>> Yes. 100.
23:07>> 1 million times 10,000 yen is 10 billion
23:08yen, right? If you divide that by 100
23:09million people, it's 100 yen each. Yeah
23:11.
23:11>> Yes.
23:12>> It's just a margin of error, so let's
23:13just make it all free. What do you call
23:15those people with malicious intent?
23:16>> Those who used it like a taxi. Only
23:18penalize those people.
23:20>> No, but you can't really define those
23:22criteria.
23:24Placing standards on something invisible
23:26like malice is unrealistic.
23:30People will just say they were actually
23:31feeling unwell.
23:33>> They'll just insist they were truly sick
23:34and that will be the end of it.
23:36>> We won't just have six complaints, it'll
23:38be far more.
23:38>> Yeah, so I think it's fine to just make
23:40it a paid service for minor cases and
23:42keep it covered by insurance for severe
23:44ones. Wait, you were the one using the
23:46ambulance like a taxi.
23:47>> Yeah, yeah, yeah. Time for the final
23:50arguments.
23:50>> If you look away, if you look away—
23:52>> Final arguments.
23:55Based on the discussions and advice so
23:57far, the proposer will make their final
23:59appeal.
24:01>> Now, Mr. Seki.
24:03>> Please give your final argument.
24:08The reason I proposed charging for minor
24:10cases is, first of all, that in
24:12emergencies, I believe people should
24:14continue to call 119 as they always have
24:16.
24:19And for those who are unsure, they
24:21should consult with emergency
24:22consultation centers.
24:29Regarding the costs, rather than judging
24:31it based on the outcome of being a "
24:33minor case," I thought a safer approach
24:35would be to limit it to cases where, at
24:37the time of the call, it's clear there
24:39is no emergency, such as the frequent
24:40callers Mr. Tsuzuki mentioned.
24:48And after setting that up, I believe
24:50it's necessary to establish a system
24:52that can handle everything, including
24:54local consultation services, private
24:56ambulance services, and directing
24:58patients to the appropriate medical
24:59facilities.
25:02Yes, that concludes my statement.
25:04>> All right, thank you.
25:06>> Now, following that final argument,
25:08let's move on to the statements from the
25:10Future Assembly members.
25:13>> Statements of opinion.
25:15After the debate, the members express
25:17their final votes.
25:20Representatives for and against will
25:22make their final arguments to Chairman
25:24Noguchi, who holds the deciding vote.
25:29>> First, based on these discussions, I
25:31would like to hear your final positions
25:33.
25:35Ready? Go ahead, all at once.
25:37>> Oh, no change.
25:39>> Still the same, then.
25:40The result is five in favor and two
25:42against.
25:44Now, for the affirmative statement,
25:46Kita-san, the floor is yours. Yes. I
25:49would like to discuss the proposal to
25:50charge for ambulance services for minor
25:52injury patients from an affirmative
25:54standpoint. Of course, free services are
25:56a wonderful thing. I understand the
25:58desire to keep them that way, and I also
26:00understand the concern that charging
26:02might discourage people from seeking
26:04help, potentially leading to lost lives
26:06. However, the current shortage of
26:08ambulances and resources is more severe
26:10than most people realize.
26:11Currently, it now takes ten minutes for
26:13an ambulance to arrive. In the past,
26:15ambulances would arrive in five to six
26:17minutes.
26:18It is said that for every minute lost,
26:20the survival rate drops by about 10
26:22percent. If it takes ten minutes, that
26:24could mean a 100 percent loss of life.
26:26Considering how cornered we are in this
26:28situation, it is clear that the risk of
26:30delayed ambulance arrival is higher than
26:32the risk of people avoiding care.
26:35Therefore, we at the Future Conference
26:37call for widespread support to create a
26:39country where help arrives promptly by
26:40at least making ambulance transport for
26:42minor cases a paid service; that
26:44concludes my affirmative argument.
26:48Yes, thank you.
26:50Now, let's hear the opposition statement
26:52. Yes. Regarding the bill to impose
26:54charges on the emergency transport of
26:55minor injury patients, I speak from the
26:57opposing side.
26:58>> Oh, you're mimicking me.
26:59>> Yes.
27:00>> Your opinion. No, that's no good.
27:04>> Please do it in your usual style.
27:07>> Look, it's not about being free or paid
27:09; we're all already paying for it.
27:12By splitting the costs through taxes and
27:14such.
27:14>> I'd bet we're likely wasting about 100
27:16yen per person a year.
27:17>> Why not just pay that? Let's just
27:19increase the number of ambulances and
27:20make them arrive in three minutes. Keep
27:22it all free. That’s what makes us Japan
27:24. And for those who abuse the system,
27:27we’ll just give them a lecture. You can
27:29tell just by looking into their eyes.
27:30Look into their eyes.
27:31>> If you look them in the eyes, they'll
27:33confess, that's the kind of country we
27:34are. Yes.
27:35>> If that's the case, we don't need police
27:37.
27:37>> Yes.
27:39>> With that said, both parties have
27:40finished their arguments, so we will now
27:42move to the final vote.
27:45Now, before the final vote by
27:46Chairperson Noguchi, a word from our
27:48sponsors.
27:50Today's topic for the Japan Future
27:52Conference is as follows.
27:54Solve call center labor shortages with
27:56AI.
27:58There’s no way current AI technology can
28:00handle complex call center support,
28:02right?
28:03>> It can’t. We don’t need any of that.
28:05I’ll handle it all myself.
28:06>> Yes. No doubt about it.
28:08>> Mr. Noguchi, please give us your final
28:10verdict.
28:11>> It is passed.
28:12>> Indeed.
28:12>> Yes.
28:13>> Whether it's technical issues or sheer
28:15willpower, Callways can solve it.
28:17>> Really?
28:17>> Huh.
28:23For AI phone support, go to Callways.
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28:32>> Now then, for this topic, passed or
28:35rejected—Mr.
28:37Noguchi, please give us your final
28:39decision.
28:42>> I struggled with this immensely.
28:44Passed.
28:45>> It passed.
28:46>> Yes.
28:49Well, you see, I think we've reached our
28:51limit.
28:52>> Between the shortage of doctors and the
28:54ambulance situation, we've reached a
28:55point where if we don't change something
28:57, those truly in need won't be saved. So
29:00, I understand the need for private
29:02ambulances to increase volume, but that
29:04carries costs.
29:05That’s why I think insurance should be
29:08involved, so instead of paying 100%, it
29:10could be 30%or 10%, making it more
29:12affordable. Since we’re currently paying
29:14100%, if that dropped to 30%, it would
29:16help with tax burdens, right? Yeah.
29:19>> Though, after hearing today's discussion
29:20, I wonder if there's a gravity to it.
29:22If it’s a severe case, maybe it should
29:23be free. Or 100%covered. But for minor
29:26cases, it should be covered by insurance
29:28at 30%or so.
29:30I also suspect there are truly malicious
29:32users, so for those cases, they should
29:34just pay the full 100%.
29:38If we don't implement some form of
29:40burden based on severity, we can't stop
29:42those who abuse the system, and since
29:44supply is lacking, I think we're at a
29:45point where we need to consider charging
29:47fees.
29:49So, although it took a while, I have
29:51decided to pass it.
29:54With that, five members are in favor,
29:56and with Chairman Noguchi's vote to pass
29:58, this program marks its first—
30:01>> Prize money decision.
30:02>> Amazing.
30:04>> It’s 100,000 yen.
30:06>> Wonderful.
30:07>> Incredible.
30:08>> Congratulations.
30:09>> Thank you very much.
30:12By the way, if this is truly passed by
30:14the nation and the ambulance shortage is
30:16somewhat resolved, your business, Mr.
30:18Sekiyama, might go under, but you still
30:20think that would be for the best?
30:22>> That is what I think in this day and age
30:23.
30:24>> Oh, what a wonderful aspiration.
30:26>> Yes. Well then, it has been successfully
30:28passed. May we have your thoughts?
30:30>> Actually, this is a theme I've been
30:32considering since my university days.
30:37Even without a clear answer, when I
30:39think about what the immediate problems
30:41are, I believe we are in a phase where
30:42we must solve them one by one.
30:49By appearing on a program like this, I
30:51hope to receive opinions from our
30:53viewers, and I believe that could lead
30:55to new solutions, so thank you very much
30:56for this opportunity today.
31:00Congratulations.
31:04Well, that brings us to the conclusion:
31:06the motion to charge for ambulance
31:08services for minor cases has been passed
31:10.
31:11Personally, listening to the discussion
31:13, I felt it came down to data versus
31:15philosophy.
31:18If we look at the data, as discussed
31:20today, there is the risk of people
31:22losing their lives by avoiding care due
31:24to the cost, versus lives being saved
31:26because ambulances arrive faster for
31:27those who really need them.
31:32Should we focus on which number would
31:34increase when we analyze that data?
31:37Or, as was mentioned, should we push
31:38forward with the philosophy that since
31:40ambulances are funded by taxes and
31:42everyone pays, everyone should be able
31:44to use them properly—that approach would
31:46significantly change the conclusion, I
31:48think.
31:49What did you all think?
31:51Please share your thoughts and comments
31:53in the comment section below.
31:56And please don't forget to subscribe to
31:57the channel and leave a like.
31:59See you next time at the Japan Future
32:01Conference.
32:02Thank you.
32:04>> Thank you.
32:04>> Now, Mr. Noguchi.
32:06>> Yes.
32:06>> Believe it or not, this Japan Future
32:08Conference
32:08>> the number of channel subscribers
32:10>> believe it or not
32:11>> unbelievably
32:12>> has reached 30,000. Oh!
32:13>> It has surpassed it.
32:14>> Amazing.
32:15>> Amazing.
32:16>> Amazing.
32:17>> We just talked about hitting 20,000 the
32:19other day,
32:19>> and now it has already grown by another
32:2110,000 to reach 30,000.
32:22>> That's fast.
32:22>> It's growing at an incredible speed.
32:24>> Maybe it's thanks to Aochan-pe.
32:26>> Because Logi-san looks like DiCaprio. Oh
32:28, just by 1%, though. They say he only
32:30looks like him from one angle.
32:31>> Alright, so everyone, please make sure
32:33to subscribe to the channel and leave a
32:35like. Let's work hard toward 40,000
32:37subscribers. 40,000.
32:39>> Thank you, everyone. One.
32:43>> Let's recognize polygamy and polyandry.
32:46>> I want to have many husbands.
32:48>> The weak won't be able to get married
32:50anymore in this world.
32:51I get it. What you're saying. Divorce
32:53should be banned for life. The word "
32:55divorce" shouldn't exist.

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