Physicians' Conflicts of Interest in Japan and the United States: Lessons for the United States

34 Pages Posted: 11 Apr 2007

See all articles by Marc A. Rodwin

Marc A. Rodwin

Suffolk University Law School; Harvard University - Edmond J. Safra Center for Ethics

Etsuji Okamoto

National Institute of Public Health, Japan

Abstract

Japanese health policy shows that even with physician ownership and the absence of for-profit, investor-owned health care, physicians' conflicts of interest thrive. Physician dispensing of drugs and ownership of hospitals and clinics were justified in Japan as ways to avoid commercialization of medicine. Instead, they create physicians' conflicts and fuel patient overuse of services. Japan's Ministry of Health and Welfare (MHW) has responded by introducing per-diem payment, thereby creating incentives to decrease services in ways similar to those of American managed care organizations, but with none of their benefits, such as coordination of care, oversight of physicians practices, and quality assurance.

Although the United States and Japanese health care systems are organized and financed differently there is convergence in the source of their physicians' conflicts and the way they are addressed. The United States is starting to integrate institutional and physician payment and align their incentives, in a traditional Japanese way. In so doing, the United States creates new physicians' conflicts and reduces the role of countervailing incentives and power, an advantage of previous policy. Japan, in turn, has combined incentives to increase and decrease services, thus moving closer to the U.S. policy.

Suggested Citation

Rodwin, Marc A. and Okamoto, Etsuji, Physicians' Conflicts of Interest in Japan and the United States: Lessons for the United States. Journal of Health Politics, Policy and Law, Vol. 25, p. 343, 2000, Available at SSRN: https://ssrn.com/abstract=979299

Marc A. Rodwin (Contact Author)

Suffolk University Law School ( email )

120 Tremont Street
Boston, MA 02108-4977
United States
617-573-8354 (Phone)
617-305-3087 (Fax)

HOME PAGE: http://www.law.suffolk.edu/faculty/directories/faculty.cfm?InstructorID=48

Harvard University - Edmond J. Safra Center for Ethics ( email )

124 Mount Auburn Street
Suite 520N
Cambridge, MA 02138
United States

Etsuji Okamoto

National Institute of Public Health, Japan ( email )

2-3-6, Minami
National Institute of Public Health
Wako-shi, Saitama 351-0197
Japan
81484586208 (Phone)
81484586208 (Fax)

HOME PAGE: http://atoz.org

Do you have negative results from your research you’d like to share?

Paper statistics

Downloads
89
Abstract Views
1,564
Rank
516,629
PlumX Metrics