This dissertation investigates the position that interest groups occupy in the decisionmaking
process of the government of Japan from case studies in the area of health
policy. Three important points are demonstrated. First, the medical associations have
created strong interdependent linkages to the party in power and have obtained their
policy preferences from within the party's decision-making organs. Second, the policy
design process in Japan's leading political party, the Liberal Democratic Party, has left
little room for the prime minister's initiatives in health care policy. The party has
deconcentrated the policy approval process in various councils over which the prime
minister has little or no influence. This stands in sharp contrast to the situation
prevailing in most parliamentary systems. Third, the thesis demonstrates how the prime
minister can, through the design of supra-partisan national councils for reforms,
temporarily bypass the normal policymaking channels of the party and enhance its
ability to carry out policy adaptation. Two such national councils are investigated: the
Nakasone Provisional Council on Administrative Reform (1981-84) and the Hashimoto
Administrative Reform Council (1997-98). The temporary national councils are
investigated as institutions complementary to the normal policymaking channels of the
ministerial and party committees. In the field of health care, the national councils have
introduced policy options which had been rejected for years by the medical body and
the party in power. The Hashimoto national council, in particular, introduced marketoriented
policies that significantly altered Japan's health care system. Three policy areas
are investigated: the introduction of principles of information disclosure through the
provision of medical files, the creation of transparent price determination mechanisms,
and the attempt at reforming the medical fee schedule. These policy changes are seen as
a first step toward the introduction of market principles in Japan's service economy.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:BVAU.2429/12777 |
| Date | 11 1900 |
| Creators | Leduc, Benoit Rousseau |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Relation | UBC Retrospective Theses Digitization Project [http://www.library.ubc.ca/archives/retro_theses/] |
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