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1 Bulletin of Osaka University of Pharmaceutical Sciences 1 (2007) Articles Medical Reform and Medical Service Market for Restructuring of the Community Medical System Isao ABE Osaka University of Pharmaceutical Sciences, 4-2-1, Nasahara, Takatsuki, Osaka , Japan (Received November 27, 2006; Accepted December 15, 2006) In Japan, medical reform acts were approved in Their ends are mainly to reduce of national medical expenditure and thus to maintain official medical insurances. However, with this reform, the basic problems of the Japanese medical system may not be solved, including restraint of national medical expenditure. And medical insurances for all people will be on the verge of crisis, and our medical system on the whole might be destructed. In this report, 1) we survey this medical reform and extract its problems, and 2) inquire into a new concept of public, discussing against the present public activities and social welfare policy. Then, 3) we study the problems of the present medical fee system and management system of medical bodies for analyzing factors of medical expenditure increase. In conclusion, for the sake of the coming reform, we propose three points: 1) the standard of medical fee shall be limited to the pure value for medical service cost, without capital cost, 2) main medical inspections need to be outsourced to third parties, such as local medical centers or private companies, in order to save the capital cost and 3) the whole medical system shall be restructured around family doctor in the community medical system, and all medical resources should be networked around it. Key words medical reform medical fee system; medical insurances; family doctor; communal; community medical system

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