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

Ramseyer, J. Mark

doi:10.1093/jla/2.2.621

Cited by 10 publications

(3 citation statements)

References 28 publications

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“…Both coverage rate of UEBMI and URBMI were negatively associated with the malpractice lawsuits, but only statistically signi cant for coe cients for UEBMI. Ramseyer (2009) [34]found that universal health insurance system in Japan prompted the government to cover the rudimentary health services and suppressed the price for sophisticated procedures. Hence, it was possible that the medical malpractices showed a decreasing trend because patients were less likely to sue over primary health care.…”

Section: Resultsmentioning

confidence: 99%

Incidence of Medical Malpractice Lawsuits and Its Relationship to the Growth of Private Hospitals

Sun¹,

Liu²,

Wang³

et al. 2020

Preprint

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BackgroundDoctor-patient relationship has become an intense concern in public health in recent years. Medical malpractice lawsuits have presented an increasing trend over past decade. This study aims to describe distributions of medical malpractice lawsuits across different provinces and to investigate its relationship to the growth of private hospitals.MethodsData was drawn from China Judgments Online, the China Health Statistic Yearbooks and China Statistical Yearbooks between January 1, 2010 to December 31, 2016. Private hospitals expansion was measured by the number and proportion of private hospitals, the ratio of outpatient visits from private to public hospitals and the ratio of discharges from private to public hospitals. Fixed-effects negative binomial regressions were utilized to estimate the association between the growth of private hospitals and the number of medical malpractice lawsuits.ResultsIn total, we identified a total of 18220 lawsuits relevant to medical malpractices across China between 2010 and 2016. The regression results revealed that more private hospitals, larger proportion of private hospitals and higher ratio of discharges from private to public hospitals were significantly associated with fewer medical malpractice lawsuits. An increase of 100 private hospitals in health care market was associated with a decrease in the number of medical malpractice lawsuits by 21%. The ratio of outpatient visits from private to public hospitals was not significantly associated with the number of malpractice lawsuits. ConclusionsThere was great disparities of incidences of medical malpractice lawsuits across different provinces. Greater expansion of private hospitals was associated with fewer medical malpractice lawsuits at province level. This negative association indicated that more private hospitals in health care market might provide more incentives for hospitals to contain the incidences of medical malpractice cases.

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Section: Resultsmentioning

confidence: 99%

Incidence of Medical Malpractice Lawsuits and Its Relationship to the Growth of Private Hospitals

Sun¹,

Liu²,

Wang³

et al. 2020

Preprint

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“…Each year, only 1,100 Japanese file medical malpractice suits either. 19 Again, the substantive law is close to that in the U.S. Median damage awards are close.…”

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confidence: 79%

Bottom-Feeding at the Bar: Usury Law and Value-Dissipating Attorneys in Japan

Ramseyer¹

2013

SSRN Journal

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Abstract:Critics have long complained that lawyers dissipate value. Some do, of course. Some legal work dissipates more value than others, and the lawyers who focus on the most notorious rent-seeking sectors extract a heavy toll in the U.S. Whether lawyers choose to focus on value-dissipating or value-enhancing work depends on the institutional structure in place, and the American legal system apparently generates high returns to value-dissipating work. The Japanese legal system traditionally holds down such returns, and Japanese attorneys have invested much less in those sectors.In 2006, the Japanese Supreme Court unilaterally invented an entirely new field of rentseeking: it construed usury law to let borrowers sue for refunds of "excessive" interest they had explicitly and knowingly --and with statutory authorization --agreed to pay. Although borrowers swamped the courts with refund claims, the field did not attract either experienced or talented attorneys. Instead, it attracted two groups: new lawyers who had entered the bar under the relaxed licensing standards, and the least talented lawyers. At least in this sector of the rentseeking field, the returns to experience and talent in Japan apparently remain lower than in valueenhancing sectors of the bar.* Mitsubishi Professor of Japanese Legal Studies, Harvard University. I gratefully acknowledge the generous financial assistance of the Harvard Law School. Ramseyer: Page 2Bottom-feeding at the Bar Usury Law and Value-Dissipating Attorneys in Japan © 2013. J. Mark Ramseyer. All rights reserved.We have a problem in the U.S., and it involves lawyers. We have many, and all too many of them focus on value-dissipating work. Japan has few, and until recently most of them focused on work that added net value. Since 1990, however, the Japanese government has quadrupled the number of new lawyers it licenses each year. Has the increase changed the character of the work lawyers do? Have lawyers begun to turn to rentseeking work? And if some of them have, are they the more or less able of the new lawyers?Consider two facts: First, the Japanese government recently slashed its licensing requirements. In 1990, it licensed 500 new lawyers (less judges and prosecutors) every year, but by 2012 licensed 2000. Second, in 2006 the Supreme Court unilaterally created an entirely new field of rent-seeking: it construed usury law to let borrowers sue for refunds of any "excessive" interest they had knowingly and explicitly --and with statutory authorization --agreed to pay.The two facts are tied, for the new Japanese lawyers have migrated in two very different directions. The most talented have entered the large Tokyo law firms where they serve as Ronald Gilson's "transaction cost engineers," helping firms negotiate transactions and bring products to the market. 1The partners at the large Tokyo firms had urged the government to increase the size of the bar, and they seem to have calculated correctly: the increased pool of talented young lawyers has let them build efficient and profit...

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“…According to Ramseyer (2010), physicians in Japan have been facing increasing risks in malpractice claims. Among all malpractice claims, 46.3 % are surgery related.…”

Section: Japanmentioning

confidence: 99%

Winners and Losers of Universal Health Insurance: A Macroeconomic Analysis

Wang

2019

The B.E. Journal of Theoretical Economics

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This paper studies the supply-side distortions and the consequences resulted from provider-side cost containing universal health insurance (UHI) scheme. A two-sector overlapping generations model of endogenous physicians’ specialty choice is presented. We find that the general public is possible to be benefited from the cost containing UHI if the quality of medical services does not deteriorate too much. However, physicians in the medical service sector suffer from such scheme and end up earning lower incomes, regardless of one’s specialty and talent. Inequality among physicians also increases.

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

Cited by 10 publications

References 28 publications

Incidence of Medical Malpractice Lawsuits and Its Relationship to the Growth of Private Hospitals

Incidence of Medical Malpractice Lawsuits and Its Relationship to the Growth of Private Hospitals

Bottom-Feeding at the Bar: Usury Law and Value-Dissipating Attorneys in Japan

Winners and Losers of Universal Health Insurance: A Macroeconomic Analysis

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