Keep Us Strong WikiLeaks logo

Currently released so far... 97115 / 251,287

Articles

Browse latest releases

Browse by creation date

Browse by origin

A B C D F G H I J K L M N O P Q R S T U V W Y Z

Browse by tag

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
ETRD EAGR ETTC EAID ECON EFIN ECIN EINV ELAB EAIR ENRG EPET EWWT ECPS EIND EMIN ELTN EC ETMIN EUC EZ ET ELECTIONS ENVR EU EUN EG EINT ER ECONOMICS ES EMS ENIV EEB EN ECE ECOSOC EK ENVIRONMENT EFIS EI EWT ENGRD ECPSN EXIM EIAD ERIN ECPC EDEV ENGY ECTRD EPA ESTH ECCT EINVECON ENGR ERTD EUR EAP EWWC ELTD EL EXIMOPIC EXTERNAL ETRDEC ESCAP ECO EGAD ELNT ECONOMIC ENV ETRN EIAR EUMEM ENRGPARMOTRASENVKGHGPGOVECONTSPLEAID EREL ECOM ECONETRDEAGRJA ETCC ETRG ECONOMY EMED ETR ENERG EITC EFINOECD EURM EENG ERA EXPORT ENRD ECONEINVETRDEFINELABETRDKTDBPGOVOPIC EGEN EBRD EVIN ETRAD ECOWAS EFTA ECONETRDBESPAR EGOVSY EPIN EID ECONENRG EDRC ESENV ETT EB ENER ELTNSNAR ECHEVARRIA ETRC EPIT EDUC ESA EFI ENRGY ESCI EE EAIDXMXAXBXFFR EETC ECIP EIAID EIVN EBEXP ESTN EING EGOV ETRA EPETEIND ELAN ETRDGK EAIDRW ETRDEINVECINPGOVCS EPEC ENVI ELN EAG EPCS EPRT EPTED ETRB EUM EAIDS EFIC EFINECONEAIDUNGAGM EAIDAR ESF EIDN ELAM EDU EV EAIDAF ECN EDA EXBS EINTECPS ENRGTRGYETRDBEXPBTIOSZ EPREL EAC EINVEFIN ETA EAGER EINDIR ECA ECLAC ELAP EITI EUCOM ECONEFINETRDPGOVEAGRPTERKTFNKCRMEAID EARG ELDIN EINVKSCA ENNP EFINECONCS EFINTS ECCP ETC EAIRASECCASCID EINN ETRP EAIDNI EFQ ECOQKPKO EGPHUM EBUD ECONEINVEFINPGOVIZ ENERGY ELB EINDETRD EMI ECONEFIN EIB EURN ETRDEINVTINTCS EIN EFIM ETIO ELAINE EMN EATO EWTR EIPR EINVETC ETTD ETDR EIQ ECONCS EPPD ENRGIZ EISL ESPINOSA ELEC EAIG ESLCO EUREM ENTG ERD EINVECONSENVCSJA EEPET EUNCH ECINECONCS ETRO ETRDECONWTOCS ECUN EFND EPECO EAIRECONRP ERGR ETRDPGOV ECPN ENRGMO EPWR EET EAIS EAGRE EDUARDO EAGRRP EAIDPHUMPRELUG EICN ECONQH EVN EGHG ELBR EINF EAIDHO EENV ETEX ERNG ED
KMDR KPAO KPKO KJUS KCRM KGHG KFRD KWMN KDEM KTFN KHIV KGIC KIDE KSCA KNNP KHUM KIPR KSUM KISL KIRF KCOR KRCM KPAL KWBG KN KS KOMC KSEP KFLU KPWR KTIA KSEO KMPI KHLS KICC KSTH KMCA KVPR KPRM KE KU KZ KFLO KSAF KTIP KTEX KBCT KOCI KOLY KOR KAWC KACT KUNR KTDB KSTC KLIG KSKN KNN KCFE KCIP KGHA KHDP KPOW KUNC KDRL KV KPREL KCRS KPOL KRVC KRIM KGIT KWIR KT KIRC KOMO KRFD KUWAIT KG KFIN KSCI KTFIN KFTN KGOV KPRV KSAC KGIV KCRIM KPIR KSOC KBIO KW KGLB KMWN KPO KFSC KSEAO KSTCPL KSI KPRP KREC KFPC KUNH KCSA KMRS KNDP KR KICCPUR KPPAO KCSY KTBT KCIS KNEP KFRDCVISCMGTCASCKOCIASECPHUMSMIGEG KNNB KGCC KINR KPOP KMFO KENV KNAR KVIR KDRG KDMR KFCE KNAO KDEN KGCN KICA KIMMITT KMCC KLFU KMSG KSEC KUM KCUL KMNP KSMT KCOM KOMCSG KSPR KPMI KRAD KIND KCRP KAUST KWAWC KTER KCHG KRDP KPAS KITA KTSC KPAOPREL KWGB KIRP KJUST KMIG KLAB KTFR KSEI KSTT KAPO KSTS KLSO KWNN KPOA KHSA KNPP KPAONZ KBTS KWWW KY KJRE KPAOKMDRKE KCRCM KSCS KWMNCI KESO KWUN KPLS KIIP KEDEM KPAOY KRIF KGICKS KREF KTRD KFRDSOCIRO KTAO KJU KWMNPHUMPRELKPAOZW KEN KO KNEI KEMR KKIV KEAI KWAC KRCIM KWCI KFIU KWIC KCORR KOMS KNNO KPAI KBWG KTTB KTBD KTIALG KILS KFEM KTDM KESS KNUC KPA KOMCCO KCEM KRCS KWBGSY KNPPIS KNNPMNUC KWN KERG KLTN KALM KCCP KSUMPHUM KREL KGH KLIP KTLA KAWK KWMM KVRP KVRC KAID KSLG KDEMK KX KIF KNPR KCFC KFTFN KTFM KPDD KCERS KMOC KDEMAF KMEPI KEMS KDRM KEPREL KBTR KEDU KNP KIRL KNNR KMPT KISLPINR KTPN KA KJUSTH KPIN KDEV KTDD KAKA KFRP KWNM KTSD KINL KJUSKUNR KWWMN KECF KWBC KPRO KVBL KOM KFRDKIRFCVISCMGTKOCIASECPHUMSMIGEG KEDM KFLD KLPM KRGY KNNF KICR KIFR KM KWMNCS KAWS KLAP KPAK KDDG KCGC KID KNSD KMPF KPFO KDP KCMR KRMS KNPT KNNNP KTIAPARM KDTB KNUP KPGOV KNAP KNNC KUK KSRE KREISLER KIVP KQ KTIAEUN KPALAOIS KRM KISLAO KWM KFLOA
PHUM PINR PTER PGOV PREL PREF PL PM PHSA PE PARM PINS PK PUNE PO PALESTINIAN PU PBTS PROP PTBS POL POLI PA PGOVZI POLMIL POLITICAL PARTIES POLM PD POLITICS POLICY PAS PMIL PINT PNAT PV PKO PPOL PERSONS PING PBIO PH PETR PARMS PRES PCON PETERS PRELBR PT PLAB PP PAK PDEM PKPA PSOCI PF PLO PTERM PJUS PSOE PELOSI PROPERTY PGOVPREL PARP PRL PNIR PHUMKPAL PG PREZ PGIC PBOV PAO PKK PROV PHSAK PHUMPREL PROTECTION PGOVBL PSI PRELPK PGOVENRG PUM PRELKPKO PATTY PSOC PRIVATIZATION PRELSP PGOVEAIDUKNOSWGMHUCANLLHFRSPITNZ PMIG PREC PAIGH PROG PSHA PARK PETER POG PHUS PPREL PS PTERPREL PRELPGOV POV PKPO PGOVECON POUS PGOVPRELPHUMPREFSMIGELABEAIDKCRMKWMN PWBG PMAR PREM PAR PNR PRELPGOVEAIDECONEINVBEXPSCULOIIPBTIO PARMIR PGOVGM PHUH PARTM PN PRE PTE PY POLUN PPEL PDOV PGOVSOCI PIRF PGOVPM PBST PRELEVU PGOR PBTSRU PRM PRELKPAOIZ PGVO PERL PGOC PAGR PMIN PHUMR PVIP PPD PGV PRAM PINL PKPAL PTERE PGOF PINO PHAS PODC PRHUM PHUMA PREO PPA PEPFAR PGO PRGOV PAC PRESL PORG PKFK PEPR PRELP PREFA PNG PGOVPHUMKPAO PRELECON PINOCHET PFOR PGOVLO PHUMBA PRELC PREK PHUME PHJM POLINT PGOVPZ PGOVKCRM PGOVE PHALANAGE PARTY PECON PEACE PROCESS PLN PRELSW PAHO PEDRO PRELA PASS PPAO PGPV PNUM PCUL PGGV PSA PGOVSMIGKCRMKWMNPHUMCVISKFRDCA PGIV PRFE POGOV PEL PBT PAMQ PINF PSEPC POSTS PHUMPGOV PVOV PHSAPREL PROLIFERATION PENA PRELTBIOBA PIN PRELL PGOVPTER PHAM PHYTRP PTEL PTERPGOV PHARM PROTESTS PRELAF PKBL PRELKPAO PKNP PARMP PHUML PFOV PERM PUOS PRELGOV PHUMPTER PARAGRAPH PERURENA PBTSEWWT PCI PETROL PINSO PINSCE PQL PEREZ PBS

Browse by classification

Community resources

courage is contagious

Viewing cable 07TOKYO1817, TOKYO MEDICAL CENTER BREAKS NEW GROUND IN HEALTH

If you are new to these pages, please read an introduction on the structure of a cable as well as how to discuss them with others. See also the FAQs

Understanding cables
Every cable message consists of three parts:
  • The top box shows each cables unique reference number, when and by whom it originally was sent, and what its initial classification was.
  • The middle box contains the header information that is associated with the cable. It includes information about the receiver(s) as well as a general subject.
  • The bottom box presents the body of the cable. The opening can contain a more specific subject, references to other cables (browse by origin to find them) or additional comment. This is followed by the main contents of the cable: a summary, a collection of specific topics and a comment section.
To understand the justification used for the classification of each cable, please use this WikiSource article as reference.

Discussing cables
If you find meaningful or important information in a cable, please link directly to its unique reference number. Linking to a specific paragraph in the body of a cable is also possible by copying the appropriate link (to be found at theparagraph symbol). Please mark messages for social networking services like Twitter with the hash tags #cablegate and a hash containing the reference ID e.g. #07TOKYO1817.
Reference ID Created Released Classification Origin
07TOKYO1817 2007-04-24 05:06 2011-08-25 00:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Tokyo
VZCZCXRO4544
RR RUEHFK RUEHKSO RUEHNAG RUEHNH
DE RUEHKO #1817/01 1140506
ZNR UUUUU ZZH
R 240506Z APR 07
FM AMEMBASSY TOKYO
TO RUEHC/SECSTATE WASHDC 3004
INFO RUEHBJ/AMEMBASSY BEIJING 6768
RUEHUL/AMEMBASSY SEOUL 2836
RUEHFK/AMCONSUL FUKUOKA 0845
RUEHNAG/AMCONSUL NAGOYA 0132
RUEHNH/AMCONSUL NAHA 3292
RUEHOK/AMCONSUL OSAKA KOBE 4381
RUEHKSO/AMCONSUL SAPPORO 1757
RUCPDOC/DEPT OF COMMERCE WASHINGTON DC
RUEHIN/AIT TAIPEI 6400
RUEAUSA/DEPT OF HHS WASHINGTON DC
UNCLAS SECTION 01 OF 03 TOKYO 001817 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPT. PLEASE PASS TO USTR/MICHAEL BEEMAN. HHS FOR OGHA 
STEIGER AND BHAT. 
 
E.O. 12958: N/A 
TAGS: ECON EINV ETRD SOCI TBIO JA
SUBJECT: TOKYO MEDICAL CENTER BREAKS NEW GROUND IN HEALTH 
SERVICES 
 
 
1. (SBU) Summary.  The Tokyo Midtown Medical Center (TMMC), 
located in the newly opened Tokyo Midtown complex in the 
Roppongi area of central Tokyo, boasts Japan's first hospital 
with a foreign affiliation.  TMMC has contracted with Johns 
Hopkins International (JHI), part of the Johns Hopkins 
medical center in Baltimore, Maryland.  Besides providing 
TMMC with an internationally-known brand, JHI will be 
responsible for training TMMC staff and also will provide 
TMMC patients with second opinion consultations.  TMMC will 
offer general medical treatment covered by Japan's national 
health insurance as well as dental care, dermatology, a 
pharmacy, a supplement center, and a women's clinic staffed 
entirely by women. 
 
2. (SBU) The TMMC corporate structure represents a 
breakthrough in Japan's medical system.  Under current 
regulations, most Japanese medical corporations must be run 
under the direction and/or ownership of a licensed Japanese 
physician and on a not-for-profit basis -- precluding any 
foreign direct investment (FDI).  While TMMC has no FDI,  its 
structure allowing foreign training and consultation could 
become a model for similarly structured deals in the future. 
End summary. 
 
--------------------------- 
The Break-through Structure 
--------------------------- 
 
3. (SBU) At an American Chamber of Commerce Japan (ACCJ) 
Healthcare Services sub-committee meeting on April 9, Tokyo 
Midtown Medicine Co. Board member Tetsuya Furukawa introduced 
the newly opened Tokyo Midtown Medical Center (TMMC) and 
explained its complicated business structure, necessitated by 
strict Japanese legal requirements.  Furukawa described how 
Tokyo Midtown's primary developer, Mitsui Fudosan, wanted an 
on-site medical center to service the complex's Ritz Carlton 
Hotel guests and the approx. 20,000 employees and residents 
in the development.  Mitsui Fudosan combined forces with 
Resort Trust Inc., a Japanese company whose principal 
activities include operating membership resort clubs, hotels 
and restaurants but whose interests also include medical 
facilities.  Resort Trust has a wholly owned subsidiary, High 
Technology Medical Complex (HIMEDIC), created in 1992 to 
branch out into medical operations.  HIMEDIC took a 66.5 
percent interest in TMMC while Mitsui Fudosan holds the other 
33.5 percent.  The company then sought an internationally 
recognized medical affiliation, choosing Johns Hopkins of 
Baltimore, US News & World Report's top-rated US hospital for 
the last 16 straight years.  Finally, the company sought 
doctors to create TMMC, the medical service providers and the 
final piece of the puzzle. 
 
----------------------------- 
The Johns Hopkins Affiliation 
----------------------------- 
 
4. (SBU) Johns Hopkins International (JHI) is an organization 
within Johns Hopkins Medicine charged with advancing the 
Johns Hopkins mission of teaching, research and patient care 
internationally, according to its website.  In addition to 
coordinating care for international patients, JHI provides 
services in healthcare consulting, clinical service 
development, laboratory management, and education programs 
for the international medical community.  Besides TMMC, JHI 
has projects in India, China, Turkey, Ireland, Eastern 
Europe, the United Kingdom, Lebanon, UAE, Panama, Mexico and 
Trinidad and Tobago. 
 
5. (SBU) Because JHI is not approved by the Japanese 
government, it can have no ownership or investment in any 
Japanese medical facility; an affiliation is legal, however, 
although relationship with JHI does not extend to TMMC's 
dental care.  JHI has trained TMMC's staff, all of whom speak 
English, and will travel to Japan four times a year to train 
them in the latest technology.  JHI  also will receive fixed 
royalties allowing the affiliation to be advertised. 
Furukawa noted that TMMC has benefited from the recent change 
in the law allowing medical facilities to post photos of 
 
TOKYO 00001817  002 OF 003 
 
 
doctors and advertise the facility.  Furukawa stressed that 
JHI's interests lie in accruing capital gains, not in 
attracting new patients to the hospital's Baltimore location. 
 He also noted that the company's relationship with the 
Ministry of Health, Labor and Welfare (MHLW) is good, 
although MHLW is watching the company very closely to ensure 
that no laws are broken. 
 
--------------------------- 
New Doctor-Patient Protocol 
--------------------------- 
 
6.  (SBU) Furukawa divulged that JHI had learned a lot about 
patient treatment from the Ritz Carlton and Disney, -- two 
companies well known for exceptional service -- much of which 
has been put into practice in Baltimore and now TMMC.  He 
said, for example, that, contrary to current Japanese 
patient-doctor protocols, patients and doctors at TMMC are 
regarded as equals.   Patients will be referred to as 
"o-kyaku-san" or "honored guest" rather than as "patient." 
Doctors will stand and greet patients at the doors of their 
offices rather than waiting for a knock and then granting 
patients leave to enter.  Furukawa admitted that TMMC staff 
had required a fair amount of training and had not yet fully 
adjusted to this new way of handling patients. 
 
------------------ 
American Advantage 
------------------ 
 
7. (SBU) Commenting on how much easier it is for a private 
company to reduce costs, Furukawa outlined four areas where 
TMMC benefits from the JHI affiliation.  First, TMMC profits 
from US-style hospital management and organization 
efficiencies, which he maintains exceed Japan's (Note: as do 
all other analysts of Japan's healthcare system).  Second, 
TMMC offers service excellence, something else American 
hospitals do better than Japanese hospitals, he said.  Third 
is the opportunity for US-Japan medical exchanges, and last 
is the center's ability to offer specialty services not yet 
available in Japan or not as advanced as in the United 
States, such as cancer treatments. 
 
------------- 
TMMC Services 
------------- 
 
8. (SBU) Located on the sixth floor of the complex's tallest 
building, the Center occupies 25,000 square feet, the largest 
in Japan, according to Furukawa.  TMMC has six facilities: 
the Outpatient Division (cardiology, internal medicine, 
gastroenterology, dermatology, sports orthopedics and 
orthopedic surgery, ophthalmology, travel clinic); Health 
Screening Center including a women's clinic; Special Services 
including a comprehensive back pain clinic and an 
international and executive division; Aesthetic Dermatology; 
a Dental Clinic including orthodontistry; and a Supplement 
Center including nutritional counseling.  A seventh area, the 
Pharmacy, is operated by an outside company that has 
contracted directly with TMMC.  Future plans include a 
possible inpatient facility and day surgery that might 
require an overnight stay.  Part of the agreement the Midtown 
Center has with TMMC is that doctors are on call 24 hours a 
day for residents, including guests at the Ritz Carlton 
Hotel. 
 
--------------- 
Risk and Reward 
--------------- 
 
9. (SBU)  Asked who carried the risk in the structure, 
Furukawa said it lay with TMMC and the banks that had 
extended it loans.  Tokyo Midtown Medicine Company, not TMMC, 
owns the facility's physical property and has hired its 
management; it also receives payment for its consulting and 
administration services but will not receive any increase 
unless it renegotiates existing contracts.  TMMC, on the 
other hand, hires and pays the doctors.  If TMMC makes a 
 
TOKYO 00001817  003 OF 003 
 
 
profit one year, TMMC doctors will receive an increase in 
their wages the following year.  Furukawa agreed that 
starting a medical corporation in Japan is not difficult but 
it has to be done by doctors.  The difficulty lies in 
securing a location and then securing and managing it. 
 
----------------------------------- 
National Health Insurance Covers It 
----------------------------------- 
 
10. (SBU) Furukawa observed that some of the press coverage 
of TMMC had been incorrect or had overstated certain aspects. 
 For example, nearly sixty percent of the business will be 
covered by Japanese national health insurance.  He agreed, 
however, that losses incurred from this business would be 
covered by its more elite services such as its Executive 
Health program, which offers participants a series of more 
than 250 tests over several days. 
 
--------------------- 
Net-working Necessity 
--------------------- 
 
11. (SBU) Furukawa admitted that his company had learned a 
lesson from the Roppongi Hills complex's medical center, 
which failed to reach out to and network with area doctors in 
advance of opening.  As a result, the area doctors had caused 
some unspecified trouble for the medical center, which TMMC 
was able to avoid. 
 
------- 
Comment 
------- 
 
12. (SBU) The opening of TMMC has generated plenty of buzz in 
the press and amongst medical professionals.  The ACCJ 
already has hosted a lunch for TMMC staff as well as the 
briefing described above.  Most of the press reports have 
left the impression that TMMC is aimed at the elite, 
something its management is attempting to dispel.  Certainly, 
elite services are on offer but so are national health 
insurance-covered general services.  Nevertheless, the 
overall opulence of the new Tokyo Midtown development may 
dissuade the general population from seeking out TMMC's 
services. 
 
13. (SBU) TMMC's corporate structure is very complex and may 
be difficult to imitate but it offers hope for US businesses 
trying to break into Japan's medical services sector.  As 
long as Japan regulates hospitals to be owned and managed 
solely by individual doctors, however, a thoroughgoing reform 
of healthcare services and entry of foreign providers will 
remain very difficult. 
DONOVAN