Tasks Involved in “Independent Patients” on Japanese Health Care Policy

Abstract

Objectives: The purpose of this study is to examine health care policy in Japan from the adoption of neoliberal principles in 1982 until now. I clarified tasks involved in “independent patients” aspired in neoliberal health care policy on the basis of the debate over independence.
Methods: I selected literature on medical policy published from 1982 to 2010 as primary and secondary sources, and conducted literature research regarding “independent patients” in the multi-layered structure of politics, economy, and society.
Results: Japan's health care policy since 1982 aims for inducing patients to be indepedent, that is, the creation of independent patients who can make their choices on information gathering and medical treatment by their own responsibility. Yet, it is dangerous to place absolute trust in the policy of independence because it would exclude patients who cannot be independent from objects of protection and support. This policy change also widened inequalities in access to health care.
Conclusions: Independence is a double-edged sword. It is indispensable for making patients mature and dignified. It may, however, destroy human life. The policy of independence in health care policy must care about dependency relationship among patients and between patients and medical staffs and seek the establishment of independence based on the right to life.