Japan's health policy

Abstract

In his Offline piece on Japan's health system (Sept 11, p 858),1Horton R Offline: Japan: a mirror for our future.Lancet. 2010; 376: 858Summary Full Text Full Text PDF Scopus (6) Google Scholar Richard Horton criticises the fact that large vested interests dominate and that the voice of the academic community is almost silent in Japan. The Ministry of Health, Labour and Welfare (MHLW) was indeed formerly the only think tank involved in Japan's health policy, but the political power shift in 2009 enabled the public to participate in policy making.Before the regime change, MHLW held absolute authority over policy decisions and some problems inevitably could be pointed out. First, MHLW bureaucrats exclusively selected members of policy board meetings.2Tomoko O Who is paying the price of health care? Japan Times.http://search.japantimes.co.jp/cgi-bin/fs20060314a3.htmlDate: 2010; March 14Google Scholar Such a procedure tapped into a limited range of opinions, leading to biased policy making. Second, scientists and doctors could not express their opinion against MHLW's policy. They feared offending the bureaucrats since they had the power to shuffle personnel.However, the regime change enabled patients, doctors, and scientists to convey their opinions to the government. Medical students appealed for an increase in the number of doctors on television and the newspapers, and I was provided with an opportunity to discuss the matter with several politicians. These actions contributed to an increase in medical school quotas after a 24-year stagnation. This public-led reform seems similar to that of the UK during the Blair administration.We hope that this trend will continue; however, the government and bureaucrats could collude again. We should take note of whether the Democratic Party truly maintains public participation in policy making.We declare that we have no conflicts of interest. In his Offline piece on Japan's health system (Sept 11, p 858),1Horton R Offline: Japan: a mirror for our future.Lancet. 2010; 376: 858Summary Full Text Full Text PDF Scopus (6) Google Scholar Richard Horton criticises the fact that large vested interests dominate and that the voice of the academic community is almost silent in Japan. The Ministry of Health, Labour and Welfare (MHLW) was indeed formerly the only think tank involved in Japan's health policy, but the political power shift in 2009 enabled the public to participate in policy making. Before the regime change, MHLW held absolute authority over policy decisions and some problems inevitably could be pointed out. First, MHLW bureaucrats exclusively selected members of policy board meetings.2Tomoko O Who is paying the price of health care? Japan Times.http://search.japantimes.co.jp/cgi-bin/fs20060314a3.htmlDate: 2010; March 14Google Scholar Such a procedure tapped into a limited range of opinions, leading to biased policy making. Second, scientists and doctors could not express their opinion against MHLW's policy. They feared offending the bureaucrats since they had the power to shuffle personnel. However, the regime change enabled patients, doctors, and scientists to convey their opinions to the government. Medical students appealed for an increase in the number of doctors on television and the newspapers, and I was provided with an opportunity to discuss the matter with several politicians. These actions contributed to an increase in medical school quotas after a 24-year stagnation. This public-led reform seems similar to that of the UK during the Blair administration. We hope that this trend will continue; however, the government and bureaucrats could collude again. We should take note of whether the Democratic Party truly maintains public participation in policy making. We declare that we have no conflicts of interest.