The concept of gemeinschaft in health planning and management: A Japanese perspective

Abstract

The rationale for public involvement in the health sector lies mainly in realizing equity values. As the Gesellschaft relationship of utility maximization cannot be relied upon to arrive at a level of health care regarded as equitable in geographic and other terms, this article argues that there is need to focus on the Gemeinschaft relationship of humanitarian concern. Policy-makers would, firstly, have to define explicitly the objectives at each policy level; and, secondly, to convince and educate the public and the health providers that such is the way forward. At the operational level, the Japanese-style management with its emphasis on the mutual commitment of the management and the workers to the organization, would seem to offer a way to unify the fragmented interests within the hospital setting. A comparative study of the health systems of the UK, Japan and the US is made to evaluate the constraints and opportunities each country faces, or would face, in realizing the Gemeinschaft concept at the policy and operational levels. The conclusion reached is that, despite the difficulties, this concept appears to offer a viable alternative to the intensified conflict for resources in the health sector.

Health Technology Development in Japan

“…Nevertheless, Japan has had a successful record of planning within a market economy through the Gyoseishido (governmental guidelines) in commerce and industry. It remains to be seen whether it can be equally effective in the health sector (8).…”