Update:April 1, 2010

(5) Medical Aid by Yokkaichi City for the Relief of Pollution-related Patients (1964)

2.The Advance of Environmental Pollution Control Policy

Since around 1960, the public health problem has been a crucial issue in Yokkaichi, as the number of pollution-related patients suffering from respiratory diseases dramatically increased. Medical payments borne by patients soon became excessive, and groups of residents and medical associations in the city began actions to claim for "public responsibility to bear medical expenses". In 1964, inresponse to the above, Yokkaichi City tentatively introduced the system for bearing medical payments at public expenses to support inpatients with advanced pollution-related diseases. Decisive enforcement of the above system was started in May 1965 as Japan's earliest attempt, covering not only serious cases but those with lighter symptoms derived from air pollution.
This system was intended for pollution-related patients officially recognized by the Pollution-related Medical Care Screening Board. The city shoulders amount which cannot be covered by health insurance to alleviate patients from the financial burden associated with medical treatment. Patients were recognized as having "pollution-related" afflictions if they fulfill the following two requirements: 1 to have more than 3 years' residence in designated areas and 2 to be afflicted with any of the three designated diseases, i.e., vesicular emphysema, bronchial asthma, or chronic bronchitis (See Table 2-1). Such decision of Yokkaichi was historically unique at that time, when the causal relation of air pollution to those diseases had not yet been established. It was also a risky challenge, since no legal background to support such efforts had been established on the national basis, and the city had to bear all the cost required.
In those days, around 1965, every institution was groping its way to abate pollution without proper guidelines. Therefore, the system immediately came to public notice since it was a direct measure for the relief of pollution sufferers extended by a municipal government which is not as powerful as the national government or prefectural governments. The system was later developed into the national regulation, the Law concerning Special Measures for the Relief of the Pollution-related Patients, thereby dedicating itself to the aid of pollution-related patients nationwide.