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Second-Best JusticeThe Virtues of Japanese Private Law$
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J. Mark Ramseyer

Print publication date: 2015

Print ISBN-13: 9780226281995

Published to Chicago Scholarship Online: May 2016

DOI: 10.7208/chicago/9780226282046.001.0001

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Medical Malpractice (II)

Medical Malpractice (II)

(p.125) Chapter Five Medical Malpractice (II)
Second-Best Justice

J. Mark Ramseyer

University of Chicago Press

Japanese file few medical malpractice claims because the national health insurance system suppresses costs by limiting the amounts it pays doctors—and caps the prices it pays for technologically sophisticated services at particularly low levels. In the process, it alters the mix of procedures that doctors provide: more of the primitive medical care commanding the relatively higher prices, and less of the technologically complex services commanding the relatively lower prices. Yet observably bad outcomes do not as often occur when physicians see fundamentally healthy patients, work in small settings, and do relatively little of consequence. Neither do such doctors often commit legally defined malpractice. Instead, bad outcomes and provable malpractice occur when physicians see high-risk patients, work with a team of medical specialists, and undertake complex and technically sophisticated procedures. The Japanese insurance, in other words, cuts malpractice claims by cutting the provision of services that generate the most observable bad outcomes and provable negligence.

Keywords:   national health insurance, malpractice, high-risk patients, negligence

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