Medical Care Policy and Law : Legal studies on the articulation of the compulsory health insurance scheme with medical and pharmaceutical system

本研究搜集并分析了日本、德国、法国等国有关医疗与医药法律的制度以及强制医疗保险制度的书籍、文章和文献。我们在访问德国和法国时，也采访了专门研究这些领域的学者和贵族。首先，我国先后完成了《医疗保险法》的修改和强制医疗保险制度的改革，以适应老龄化社会和医疗费用爆炸的需要。这些修正案和改革恰恰反映了保健政策和强制性保险政策。虽然保健和医药法律的制度与强制医疗制度完全不同，但两者之间存在着很强的联系，而且这种联系还在不断加强。德国和法国也将强制医疗保险与医疗保健和药品法律的计划相结合，而且每个国家都像我国一样，这种结合越来越强。在这两个国家，我们观察到先进的医疗技术并没有引起那么多的关注，可能是因为医院系统与我们的不同。我们还注意到，德国和法国采用的强制医疗保险计划提供的医疗保健服务控制措施与日本的方法不同。德国的最新发展是在强制医疗保险计划领域引入竞争原则，但从欧洲法的角度来看，这一政策引起了严重的法律的问题。

In this research, we collected and analyzed Japanese, German, French and other countries' books, articles and documents on health care and pharmaceutical legal scheme as well as the compulsory medical insurance scheme. We interviewed also scholars and patricians specialized in these fields in visiting in Germany and France. First, our country accomplished successively the amendments of Acts and the reforms on compulsory medical insurance scheme in order to make it adapt to aged society and explosion of medical costs. These amendments and reforms reflect exactly health care policies as well as compulsory insurance policies. Although Health care and pharmaceutical legal scheme is totally distinguished of compulsory medical scheme, there is the very strong articulation between them, and this articulation is more than more strengthen. Articulation of the compulsory medical insurance with health care and pharmaceutical legal scheme is also observed in Germany and France, and each country, this articulation becomes stronger as in our country. In these two countries, we observe the advanced medical care techniques don't attract so much attention maybe because of the difference of hospital system from ours. We remark also the measures for control of medical care services offered by the compulsory medical insurance scheme adapted in Germany and France are not similar to Japanese methods. The recent evolution to be remarked in Germany is introduction of competition principle in the field of compulsory medical insurance scheme, however this policy arises serious legal question from point of view of European Law.