Legal intervention against medical accidents in Japan

Yasunaga, Hideo

doi:10.2147/rmhp.s4755

“…As the specialty preferences are different in female physicians, a further increase of physicians will also affect the specialty distribution of physicians (Koike et al 2009b). Demoralisation of physicians because of emotional public reports of medical errors has been seen (Yasunaga 2008). In such a situation, university hospitals need to undertake a more flexible approach rather than a paternalistic approach, and so, university hospitals will be able to assist physicians in their career development and, in coordination with other hospitals, to function as a centre for continuing education.…”

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confidence: 99%

Residency hospital type and career paths in Japan: An analysis of physician registration cohorts

Koike

¹

,

Kodama

²

,

Matsumoto

³

et al. 2010

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“…Several observers (e.g., Feldman, 2009: 264;Yasunaga, 2008;Leflar, 2009a;Maeda, Sakamoto, & Nobutomo, 2001) argue that the traditional Japanese fee schedule discourages malpractice claims. Under this schedule, clients initially pay their attorney a fraction of the amount they demand as a nonrefundable retainer.…”

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The Effect of Universal Health Insurance on Malpractice Claims: The Japanese Experience

Ramseyer

¹

2010

Journal of Legal Analysis

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Japanese patients file relatively few medical malpractice claims. Most scholars try to explain this phenomenon by identifying ''faults'' in the Japanese judicial system. Largely, the faults they identify do not exist. Instead, a substantial part of the reason for the malpractice claiming patterns may lie in the national health insurance system. In order to contain the cost of this system, the government suppresses the price it pays for the technologically most sophisticated procedures. Predictably as a result, Japanese doctors have focused instead on more rudimentary care. Yet, for reasons common to many societies, Japanese patients are less apt to sue over rudimentary care. They are more likely to sue over sophisticated care. In part, Japanese patients may bring relatively few malpractice suits because the government has (for reasons of cost) suppressed the volume of the services (namely, highly sophisticated services) that would otherwise generate the most malpractice claims. I explore this issue with a dataset covering all malpractice suits that generated a published district court opinion from 1995 to 2004. Potentially, universal health insurance programs do not just alter the supply and distribution of medical services; potentially, they also shape claiming and litigating behavior in malpractice disputes. After all, the programs reduce the direct cost of medical services to patients. The lower costs boost demand, and-to prevent the drain on the public fisc-the government could (and usually does) respond by suppressing the amounts it pays suppliers.

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“…get us very far. Scholars (Yasunaga, 2008; Feldman, 2009: 269;Maeda, Sakamoto, & Nobutomo, 2001) also attribute the scarcity of malpractice claims in Japan to the length of the court proceedings.50 Malpractice 50 Leflar (2009a: 444-445) rightly notes that delays in Japan were substantial only before the recent reforms. In attributing the low claiming levels to delays, however, other observers draw on a tradition in American scholarship that blames low Japanese litigation rates in part on court delays (Haley, 1978).…”

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“…get us very far. Scholars (Yasunaga, 2008; Feldman, 2009: 269;Maeda, Sakamoto, & Nobutomo, 2001) also attribute the scarcity of malpractice claims in Japan to the length of the court proceedings.…”

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The Effect of Universal Health Insurance on Malpractice Claims: The Japanese Experience

Ramseyer¹

2009

SSRN Journal

0

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Japanese patients file relatively few medical malpractice claims. Most scholars try to explain this phenomenon by identifying ''faults'' in the Japanese judicial system. Largely, the faults they identify do not exist. Instead, a substantial part of the reason for the malpractice claiming patterns may lie in the national health insurance system. In order to contain the cost of this system, the government suppresses the price it pays for the technologically most sophisticated procedures. Predictably as a result, Japanese doctors have focused instead on more rudimentary care. Yet, for reasons common to many societies, Japanese patients are less apt to sue over rudimentary care. They are more likely to sue over sophisticated care. In part, Japanese patients may bring relatively few malpractice suits because the government has (for reasons of cost) suppressed the volume of the services (namely, highly sophisticated services) that would otherwise generate the most malpractice claims. I explore this issue with a dataset covering all malpractice suits that generated a published district court opinion from 1995 to 2004. Potentially, universal health insurance programs do not just alter the supply and distribution of medical services; potentially, they also shape claiming and litigating behavior in malpractice disputes. After all, the programs reduce the direct cost of medical services to patients. The lower costs boost demand, and-to prevent the drain on the public fisc-the government could (and usually does) respond by suppressing the amounts it pays suppliers. By cutting the price it pays suppliers, a universal insurance program alters both the quality and the mix of medical services sold. Facing statemandated prices below market-clearing levels, suppliers will cut the quality of the services they provide. But because the program also changes the relative prices of the various medical services, suppliers will shift the mix of services they sell as well. They will offer relatively more of those services commanding the higher mandated prices. They will offer less of those commanding the lower prices. 3For malpractice claiming patterns, these changes create potentially cross-cutting effects. On the one hand, all else held equal, as the suppressed prices induce sellers to degrade quality, malpractice claims should rise. On the other hand, as sellers change the mix of services they offer in response to the new price structure, they might-plausibly-shift the mix away from those services that generate the most malpractice claims. 4Consider the logic (explained in more detail below). To suppress the potentially exploding costs of its insurance program, suppose a legislature cuts the relative price it pays for the more sophisticated (and expensive) services. Technologically intensive, physically invasive, implemented by a team of medical specialists, and targeted toward high-risk patients, these services often cause more observably adverse events than ordinary primary care. They also generate the most legally cognizable...

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Legal intervention against medical accidents in Japan

Cited by 21 publications

References 8 publications

Residency hospital type and career paths in Japan: An analysis of physician registration cohorts

Residency hospital type and career paths in Japan: An analysis of physician registration cohorts

The Effect of Universal Health Insurance on Malpractice Claims: The Japanese Experience

The Effect of Universal Health Insurance on Malpractice Claims: The Japanese Experience

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