The Administrative Management Methods in Medical Policy since 1975 in Japan
Since 1975, Japan has faced a turning point in its medical policy history. The purpose of this report is to retrace the process of change in the medical policy from the standpoint of administrative management method. In this report, the subject is approached from the following three aspects; control of medical expenditures, control of medical care supplies, and the composition of policy resources. The main topic of the section on the control of medical expenditures is the increase in medical expenditures due to the modification of the management of the medical fee system. The section on the control of medical supplies Is divided into the following two subsections; the control of demand in relation to the function of demand containment and the control of supply in a narrow sense which is related to the medical service supply system itself. I argue that superficially the emphasis in the administrative management method shifted from the control of medical expenditures to the control of supply, but that substantially the control of medical expenditures was maintained as an implicit purpose. In the section on the composition of policy resources including nodality, treasure, authority, and organization, I show that the administrative method has been diversified by utilizing three of the resources, except treasure, which has traditionally been overemphasized.