医療政策の現状と課題(<特集>脳神経外科医療と社会環境)  [in Japanese] The Present Status and Problems of Healthcare Policies(<SPECIAL ISSUE>Social Environment Surrounding Neurosurgery)  [in Japanese]

医療崩壊の実態に触れ,このような事態に陥った根本的な原因はどこにあるのかを明確にし,日本の医療のあるべき方向性を提示した.119番通報を受けてから患者が医療機関に搬入されるまでの時間(全国平均)は,1996年の24.4分から2006年には32.0分に延びた.分娩を実施した施設は,1996年の3,991施設から2005年には2,933施設に減少した.日本の対GDP総医療費をOECD平均並みにするには,総医療費を約10%引き上げる必要がある.2002〜2006年度までに,社会保障費の国庫支出は累年で3.3兆円抑制された.この中の医療費分の削減は約8兆円であったが,これを10年間続けた場合,1年間の国民医療費に相当する約31兆円が削減される.社会保障財源の確保は国家の責務である.医療関係者の一致団結による,社会保障とりわけ医療を守る行動が切望される.

Acknowledging the disintegration of healthcare in Japan, this paper clarifies the fundamental causes of this situation and presents the direction that Japanese healthcare should take in the future. The time taken for patients to be transported to a medical facility after a 119 emergency call has been received (national average) increased from 24.4 minutes in 1996 to 32.0 minutes in 2006. The number of medical institutions with childbirth facilities decreased from 3,991 in 1996 to 2,933 in 2005. Japan must raise its total health expenditures by approximately 10% to bring the current level in line with the OECD's average total health expenditure as a percentage of GDP. Between fiscal 2002 and 2006, national treasury funding of social security expenses was cut year-on-year by 3.3 trillion yen. Of this, treasury funding of healthcare expenses decreased by 8 trillion yen, and if this situation were to continue for 10 years, the decrease would be approximately 31 trillion yen-equivalent to the total national health expenditures for one year. Securing resources of funding for social security is the responsibility of the national government. It is imperative that medical professionals unite in taking action to protect social security, and healthcare in particular.