Revision of Medical Care System as I See It / 日本農村医学会雑誌

ABSTRACT

It is said that medical care is a social application of medicine to the benefit of community or individual. In step with progress in medicine, medical care has been made all the more complicated. Moreover, the system supporting medical care has fallen behind the times when its surroundings have been changing drastically. This situation could be ascribed to the institutional fatigue that the system itself is suffering from after a long period of existence. It also can be pointed out that there have been revolutionary changes in traditional Japanese cultural values together with the awareness of people concering health. However, the primary factor that lies behind need of reform is financial difficulties. At present, in connection with deregulation of medical care, the introduction of mixed medical care and the entry of joint-stock corporations are taken up for discussion as topics of the day. In the meantime heated debates are being held over the subjects of institutional reform including the setting up of medical care for the aged as part of the fee-for-service system and reconstruction of the network of providers of health care and services. Moreover, the institutions that are engaged in the practice of medicine are expected to tackle a broad range of tasks- -catching up with ever-progressing information technology, disclosure of information, and strengthening of safety measures against medical accients, among many others. However, these are not the issues which have cropped up in recent years. Many have been brought up and discussed from an angle a little different from what it is today. It is now high time for us to discuss these issues through and through in light of actual situations while looking back on the history of medical care and its system. In this paper the author shall dwell on the development of the nation's medical system and point out some problems confronting us today with the use of some materials thus far presented by the Japan Medical Association. His view is based on his personal experience in hospital management and with the Japan Medical Association.