By John Creighton Campbell
In comparison to the remainder of the area, Japan has a fit inhabitants yet can pay rather little for therapy. Taking a comparative point of view, the authors describe the politics of healthiness care in Japan, the range of services, the common medical health insurance procedure, and the way the cost agenda constrains expenditures. detailed cognizance is paid to problems with caliber, to the tough difficulties of assuring sufficient high-tech drugs and long term care, and to attainable classes for the United States
Low wellbeing and fitness care spending in Japan -- Actors, arenas, and agendas in future health coverage making -- health and wellbeing care services -- The egalitarian medical insurance procedure -- The macropolicy of price containment -- The micropolicy of fee containment -- the standard challenge
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Most often, however, they unite with the Welfare bureaucrats in their mutual distaste for the JMA. The local governments that serve as the carriers for Citizens' Health Insurance for the non-employed are organized into one national federation, and the various mutual-aid associations for public employees are also represented, but the lead is taken by the Federation of Health Insurance Societies, or Kenporen. Kenporen is made up of the more than 1,800 individual societies that cover employees in large firms.
Still, we would expect a reestablishment of the basic pattern of most decision making being handled through established relationships among bureaucrats, politicians, and interest-group representatives who specialize in a particular policy area. Of course, in the future as in the past, some issues will spill over subgovernment boundaries and involve actors who usually pay no attention to specialized policy concerns - even those at the highest levels of the governmental system. The General Arena Although the great majority of policy decisions are made by specialized actors at the subgovernment level in all advanced nations, the most important issues have to be dealt with by "heavyweight" actors, the leaders in the 20 The PARC structure parallels that of Diet standing committees.
The interesting point is that these and other big interest groups do not do much more. 34 Actors, Arenas, and Agendas in Health Policy Making That is, from the perspective of mid-1990's America, it is striking that major social interest groups are not much concerned with health-care issues except in the most narrow sense. In comparison with the United States, one important difference is that there are no major private health insurance companies with thousands of employees and vast amounts of money trying to defend their interests.