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Observation

1. In Japan, there are public hospitals and private hospitals. Public hospitals are run by
public organization like local government. Private hospitals are run by Medical
Corporation.
2. Both types of hospitals have to work non-profit.
Cabinet Office, Government of Japan 15
Q) Medical services have to be non-profit. (omit) The legal ground consists in Article 7-5 of the
Medical Service Law, which says (governors) can prohibit for-profit (UQ
3. HE actually the non-profit nature of private hospital run by Medical Corporation is not
ensured. They partly work for-profit.
Doctor of Economics 10
Q) The global wide criteria for for-profit is Whether or not the profit finally belongs to a certain
person or not. (omit) In contrast, in Japan, out of the total of 8708 hospitals, about 5300 hospitals
are medical corporations with equity. As for medical corporations with equity, even though they
cant distribute surplus money according to Article 54 of the medical service law, the investor can
acquire the accumulated surplus money by the selling or dissolution of the medical corporation, so
according to the above criteria, it is classified as for-profit hospital. (UQ
4. TF USQ, there is a gap between the actual situation and what is written in the Medical
Service Law.

On this point, Id like to show following Plan and ADs
Plan
The Japanese Government should allow the hospital management by joint-stock companies.
Mandate
1. Shall amend the medical service law so as to allow the hospital management by joint-stock
companies.
2. As for the treatment not covered by health insurance, the joint-stock company can freely set the
price.
3. Shall take necessary adjustment to ensure the nonprofit nature of Medical Corporation.
4. Shall also take other necessary adjustments.

AD1 Corporate Financing
a) inh
1. Hospitals cant get enough funding due to their inability to issue stock. (
)
The Liberty Web 2011
Q) In present hospitals, capital investment on expensive medical equipment like CT and MRI is
essential. However hospitals in Japan are required a through non-profit nature by the medical
service law and medical corporations are prohibited from issuing stock or corporate bond. As a
result loan from banks is the only way to get fund, so the service become poor because it is hard
to do appropriate investment, and brings the result that more than 70% of hospital are in the red.
(UQ
2. TF, all hospitals cant buy new medical equipment so the medical technology is
averagely poor.
JUST Landed 2014 available
Q) Despite Japan's image as one of the premier countries for technology, it does lag behind other
nations in medical technology. Due to the cost saving measures put in place by the central
government, the newest (and most costly) medical technologies are not always available.(UQ


b) imp
1. Japanese patients cant receive the state-of-the-art medical treatment.
IVD 2011
Q) As for the medical care in Japan, the rate of those who answered that the improvement of the
quality of medical care is important were general public 90%, patients 87% and were very high,
and also as for the reason for not being satisfied with Japanese medical care the rate of those
who mentioned it because they cant receive the state-of-the-art medical treatment like foreign
in Japan, were general public 35%, patients 53%. (UQ
2. Japanese doctors go abroad to use good medical equipment.
Professor 10
Q) There is information that some doctors go to foreign countries to study because of the block up
of Japanese medical situation. To prevent such a thing, it is also important to do necessary
investment so that doctors who studied abroad can come back to Japan and do the same level of
medical care. (UQ

c) sol
1. AP, joint-stock companies can get enough funding from issuing stock please extend a)
1
st

2. Actually investors have motive to buy stock of hospitals.
Dr. 05
Q) Why are investors interested in the medical field? The reason is simple; it is because this market
will surely expand. In other markets, without long term observation, we can't tell whether it will
expand or not. On the other hand, healthcare industries, such as the medical market, are the
target of attention. (UQ
3. Therefore AP, hospitals can enhance their medical equipment and advance the quality of
medical care. Its EP in Germany
Economist Roeder 12
Q) In 2010, the German hospital sector consisted of 2,064 acute care hospitals roughly divided in
three between the categories of private for-profit, private not-for-profit and public ownership.
(omit) The access to additional capital puts private for-profit hospitals at an advantage when it
comes to the realization of necessary investments, especially those which decrease operating
costs such as investments aimed at increasing energy efficiency. Private for-profit hospitals have
the highest investment per case(about 64% higher than public hospitals), which leads to more
state-of-the-art treatment and newer medical equipment (UQ

AD2 Happy Doctors
a) inh
1. USQ, doctors must manage hospitals. So hospitals neglect the labor law.
Researcher 2013
Q) Unless there is the approval from the governor, the president of Medical Corporation must be a
doctor or a dentist. (omit) At such hospitals, the so-called unpaid overtime is common, and even
the overtime work that can be subject of overtime payment is beyond the regular hours, and it is
in a harsh working condition that is incomparable with Europe and America. (omit) In joint stock
companies that obey the present company law, it is required that the representative recognizes
compliance and has the ability of governance for the sake of the companys sustainable
development. (UQ
2. TF, many doctors are overwork.

b) imp
1. Due to bad working condition, doctors commit suicide.
Medical Confidential 2012
Q) According to Outline of Suicide by National Police Agency, the suicide rate of doctors was 1.3
times that of the whole in 2005 and 2006. (omit) According to Katunori Kondo, Professor of
Nihon Fukushi University, who is familiar with medical affairs in England, where the medical fee
was restricted for many years, in England the number of doctors and nurses was in shortage in the
1990s, and because of the burnout syndrome by long time labor, the suicide rate of doctors was 2
times, nurse was 4 times that of other jobs. (UQ
2. Overwork sometimes even leads to medical error.
/2013
Q) The rate of those who answered that they feel exhausted were; doctor 65.9%, nurse 83.7%,
medical technologist 66.9%, medical clerk 57.1%. (omit) Those who had chilling of startling
experience that may have led to medical error (near miss experience) in their current work place
this month were; doctor 38.2%, nurse 54.4%, and medical technologist 30.7%. (UQ


c) sol
1. AP, joint-stock companies will manage hospitals so they put more emphasis on labor
law, please extend a) 1
st


2. TF, companies will introduce a more efficient system, so that doctors can work less
hours.
Doctor of Medical Science 2004
Q) That is because, if the hospitals become like joint-stock companies, all of the patients become
clients, and the hospitals have no choice but to completely eradicate medical error because it has
a big influence on hospital management. Look at YUKIJIRUSI, a company is bound to collapse by
making just one mistake. So, because the current staff organization is impossible, naturally, they
must make many efforts, secure the staff resource, and do intensive education. (UQ

2. It is EP in Germany.
Dr. Mache 2009
Q) The current study is the first to evaluate physicians work efficiency in German general hospitals
and its variation depending on type of ownership using real-time recording. (omit)
Unexpectedly, our study results showed that physicians of private, for-profit hospitals work
significantly fewer hours and have a smaller amount of overtime work, but treated more patients
than physicians of public or non-profit hospitals. (UQ