The iron triangle of Japan's health care

doi:10.1136/bmj.330.7482.55

BMJ 2005;330:55-56 (8 January), doi:10.1136/bmj.330.7482.55

Editorial

The iron triangle of Japan's health care

The Japan Medical Association is losing its grip on healthcarepolicy

The first 150 words of the full text of this article appear below.

Medical associations around the world influence healthcare policiesin their respective countries. Policy makers turn to professionalsfor guidance on complex issues, so it is only natural that medicalassociations exert their influence through their knowledge.However, expertise alone cannot explain the influence of theJapan Medical Association on healthcare policy in post war Japan.The association's post war foundation was built during the 25year presidency of Taro Takemi from 1957 to 1982. Takemi's uncle-in-law,Shigeru Yoshida, was Japan's first post war prime minister.This connection gave Takemi and the association unrivalled accessto Yoshida and his successors in the ruling party. Through itsinfluence on the ruling party, the association forced Japan'sMinistry of Health, Labour, and Welfare to take heed and dictatedmuch of healthcare policy.

Building on the legacy that Takemi created, currently the associationboasts a membership of 159 000, a budget of 16bn . . . [Full text of this article]

James Kondo, associate professor

Healthcare Policy Unit, Research Center for Advanced Science and Technology, University of Tokyo, Komaba, Meguro-ku, Tokyo 153-8904, Japan (kondo@hsp.u-tokyo.ac.jp)