1999 年 1999 巻 p. 1998-1-007-
This article describes the gap between service programs and actual needs in Japanese health and welfare policies; what kinds of gaps are discernible in the health and welfare polices; what problems are created by the cleavage; and why the government can hardly succeed in reforms to bridge the gap.
To fulfill all the needs for health and welfare, the government must implement the policies that cover the following four categories, i.e., acute cure, chronic care, long-term care, and terminal care. While adults’ diseases, such as cancer, heart diseases and diabetes, have been the most familiar illnesses that the Japanese people have suffered since the 1950s, long-term care policy for the frail and disabled elderly has also been increasingly important since the 1980s.
The existing health care and welfare system, however, is suitable for acute cure. The absence of chronic and long-term care services has caused three problems: namely, waste of resources, patients’ distrust of a doctor and heavy burdens of family members for the elderly care. The author concludes that policy inertia produced by the existing system per se is resistant to reform.
