抄録
This paper discuss how to deal with the issues of Emergency medical system (EMS) in Japan under the financial difficulties.
There are three issues; a regional difference of EMS provider, an increase of urgency patient and an extension of transportation time by ambulance. These issues could be resolved by increase of providers by public fiscal action. However, national and local government face financial difficulties. Ministry of Health, Labour and Welfare (MHLW) and Ministry of Internal Affairs and Communications (MIC) aim to improve efficiency of EMS and to reduce a public spending. For example, public hospital demand to be privatization, closure or restructuring, even though public hospitals have an important role in EMS. But, this action may make worse the issues.
In addition, Ministry of Finance (MOF) suggest that ambulance service should take charge, in order to reduce a spending and a number of ambulance users. Now, financial resource of ambulance service is a general accounting of local government, and an ambulance user need not to pay for an ambulance service. There are arguments both for and against the suggestion. This paper introduce a financial system of ambulance service in France, UK and Germany, and insist a rightness for taking a payment for ambulance service.
