自民党政権下における医療政策

―保守政党の社会政策と利益団体―

抄録

  This article explains how LDP had developed post-war medical policy. Having very strong political ties with Japan Medical Association, LDP had supported JMA's claims for higher payment of social health care insurance. Business leaders and mayors as well as workers were all against high payment, but JMA doctors were strongly united and available to simultaneously refuse social insurance contract. Since no health care system would be possible without contracted doctors, LDP was afraid enough for big compromises with them. JMA seemed a successful political giant as a pressure group for medical industry.
  On the other hand, new medical schools graduated 4000 more doctors every year since early 1970s. The expansion against JMA's favor was eagerly supported by local politicians and LDP pursued the programs for more rural doctors. Number of doctors increased rapidly and this was the beginning of the end of JMA era.
  Structural changes inside medical environment happened to make hospitals more focused. Being grown surgical needs and chronic invalids, majority of medical expense went to hospitals. More doctors, nurses, and other medical professionals worked in hospitals. Thus interests within medical industry became greatly diffuse and JMA was no longer an exclusive representative of the business.
  Politics of the medicals was the politics of medical economy for long time and JMA won games against cost bearers and Ministry of Welfare. The policy, however, also had another important element: public control over medical supply such as beds, professionals, and networks. MOW failed to establish authorities on such control so that this constraint limited following attempts for systematic medical service.