Consideration on History of Free/Low-Cost Medical Services

2019 Fiscal Year Final Research Report

• Project/Area Number: 19K20917
• Project/Area Number (Other): 18H05720 (2018)
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund (2019); Single-year Grants (2018)
• Review Section: 0108:Sociology and related fields
• Research Institution: Japan Women's University
• Principal Investigator: AGAWA Chihiro 日本女子大学, 人間社会学部, 研究員 (40825288)
• Project Period (FY): 2018-08-24 – 2020-03-31
• Keywords: 無料低額診療事業 / 無低診療 / 生活困窮者医療 / 第2種社会福祉事業

Outline of Final Research Achievements

The “Free/Low-Cost Medical Services” is in the genealogy of free medical treatment before the war was defined as postwar social welfare, but it was planned to reduce or/and abolish after health care system is extensive.The function as medical facility has been “absorbed” by Free/Low-Cost Medical Services in mid-1950’s when medical facility of public assistance act was organized by context of proper medical aid. The welfare patients were included to the calculation of the user to business standard of the same business. The movement of reduction or/and abolishment of Free/Low-Cost Medical Services was repeated afterwards, but its unfulfilled.Currently, it is used by people who have difficulty to receive medical treatment which will not be connected to any other public system, but the role in a health care system and the support system for a needy people is restrictive.

Free Research Field

生活困窮者への医療保障

Academic Significance and Societal Importance of the Research Achievements

社会的認知度の低い無料低額診療事業について、先行研究で明らかにされていない社会福祉事業の歴史を史料実証的に述べ、特に今日の無料低額診療事業制度が持つ課題の根源が、すでに1950年代にあったことを指摘した。
さらに、現実として無料低額診療事業が果たしている役割について意義を見出すとともに、その役割はあくまでも限定的であること、現在の医療体制で取り残される受療困難者への対策として、まずは、医療保険と生活保護制度の不備・不徹底を改善する中で、保護に至らない生計困難者に医療を提供する社会福祉事業としての位置付けを、医療保障全体で再構築することが必要、という示唆が得られた。