Coping with Physicians’ Conflicts of Interest in Japan
This chapter discusses how the Japanese state addresses physicians' conflicts of interest. The Ministry of Health, Labor, and Welfare (MHLW) regulates medical practice mainly through controlling payment and primarily to constrain spending. However, reforms that reduce incentives to supply services have helped address conflicts of interest. The Japan Medical Association (JMA) has blocked the state and insurers from using utilization review, practice guidelines, and other oversights. Legislation stopped the formation of new physician-owned medical corporations that can own hospitals and clinics. The MHLW offered incentives for physician-owners to convert their medical facilities into organizations that resemble American tax-exempt hospitals. The state bans kickbacks and gifts to publicly employed physicians. To promote open markets, the Japan Fair Trade Commission (JFTC) restricts individual drug firms from paying premiums to physicians and medical associations.
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