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2023年6月18日 (日)

the annual general meeting of the Nonprofit Cooperative Research Institute "LIFE and LIVING."

On June 17,2023、I participated remotely in the annual general meeting of the Nonprofit Cooperative Research Institute"LIFE and LIVING." The meeting lasted for three hours, and I focused on the screen with some nervousness as I wanted to speak during the discussions.

There were three presentations related to the future vision of a Physicians Union  of Japan(Min-iren), followed by a discussion. First, Chairman Nakagawa Yuichiro addressed the issue of Okinawa. While it may not be exactly as he stated, I personally confirmed the need to always reflect on the current situation in Okinawa, which can be considered as ground zero, when considering future peace plans, namely human security and the inviolability of individuals' right to peaceful existence. (Fukushima also stands as a place with similar significance.)

Next, Vice Chairman Goto Michio discussed the interpretation of "nonprofit" and "cooperative." It was highly stimulating and relevant to my subsequent statement, so I summarized my thoughts there.

The third presentation vividly demonstrated the evolution of Min-i-ren's vision by President of Min-i-ren Masuda Takeshi. However, I felt that the changes were not merely internal and natural phenomena within Min-iren but were deeply connected to external transformations, so I had some reservations.

Now,  I would like to briefly supplement what I said in discusson, without the constraints of time:

Even outside of Min-i-ren,many private and public hospitals inJapan are fundamentally "nonprofit." It is well known that the Japan Medical Association characterizes itself as "social common capital" using terminology borrowed from Hirofumi Uzawa. However, the possibility of nonprofit private hospitals and public institutions truly developing their nature is virtually nonexistent. They will only be tossed around by neoliberalism. This is because "cooperativeness" is essential to maintain a nonprofit status. In terms of the terminology I came up with a year ago, "cooperativeness" would be equivalent to "basic local autonomy." I believe the meaning of "basic local autonomy" can be imagined based on Min-i-ren's open operation in the community alongside cooperative organizations, ensuring transparency to residents through the General Assembly, which acts as a parliament, and the Board of Directors, which acts as the executive body.

So, how can public institutions and governmental hospitals acquire "cooperativeness" and become "basic local autonomous" entities? The need for such awareness arises because even if Min-i-ren alone boasts "cooperativeness," it will have little impact on the entire population. Many hospitals in the community must adopt strategies that lead to such an outcome.

There are several possible paths, but the most viable one is for municipalities to shift towards regional sovereignty and establish "hospital management committees with resident participation" or request hospitals to include representatives of residents and patients in their board of directors. Symbolic changes could occur, such as the hospital meals becoming locally sourced, which may seem insignificant but hold significance.

To achieve the realization of a new welfare state that liberates the people from poverty and inequality, it is essential for municipalities to develop under the principle of regional sovereignty. And it is the prefectural organizations within Min-i-ren that are closest to becoming the catalysts for such movements.

 

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