The Anatomy of the Welfare-Zoku: The Institutional Complementarity of the Party Commissions and the National Reform Councils in LDP Decision Making

Political networks and the so-called "zoku" are often presumed to be the culprits in preserving the status quo against market-oriented reforms in Japan. Yet these networks have rarely been thoroughly mapped or investigated. This article shows that Japan's parliamentary system under LDP rule has decentralized decision-making authority in party commissions and administrative consultation bodies, with important consequences on decision-making. The commissions have strengthened the linkages between interest groups and lawmakers and reduced the influence of the prime minister. This distinguishes Japan's parliamentary system from other countries with a similar constitution. This article investigates Japan's institutions of policy making by mapping one of the most influential groups in Japanese politics-the medical associations and the welfare "zoku". Relying on data provided by the Ministry of Management, it quantifies financial linkages between interest groups and members of the Commission for Medical Care of die LDP as evidence of this influence. Historical cases of policy reform failures provide insights into complex policy-making processes and the influence of interest groups. Inversely, the article argues that the creation of supra-party decision-making institutions was necessary for the success of major market-oriented reforms. The national reform councils of Prime Ministers Nakasone and Hashimoto emerged as the only possible answer to carry out reforms by challenging existing LDP policy-making networks in the 1980s and 1990s. The supra-party national reform councils challenged the paternalistic authority that medical professionals held since the creation of Japan's universal health insurance system in 1962 and made reforms possible in areas where previous institutional processes preserved the status quo.