本論文の課題は，1950年代から60年代の日本において市町村が運営していた国民健康保険事業を検討し，これからの国民健康保険事業のあり方への示唆を得ることである。その事業主体として滋賀県甲賀郡水口町を取り上げる。水口町は国庫補助を求めつつも，広報活動を積極的に行って保険料徴収率を上げ，保険給付率も全国的趨勢に先行して引き上げた。そのことが評価されて政府から表彰されたものの，医療環境の近代化が医療機関の地域格差を広げたことで，1960年代には国民健康保険事業の限界も見え始めた。
This study aimed to examine the national health insurance business operated by municipalities in Japan during the 1950s and 1960s, and to derive insights for the future of the national health insurance system. This study focuses on the case of Minakuchi Town, Koka County, Shiga Prefecture, which served as the insurance operator. Minakuchi successfully improved its premium collection rate through active public relations activities and increased its insurance benefit rate ahead of the national trend, while also securing government subsidies. Although the town was commended by the government for these achievements, the limitations of the national health insurance business became apparent in the 1960s, as modernization of the medical environment widened regional disparities in access to healthcare institutions.

原著論文