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The story
A survey by Tokyo Shoko Research found that 59 “medical institutions” went bankrupt in Japan between January and September 2026, a record high since comparable data collection began in 2008. The decline is said to be especially visible among everyday clinics and dental practices. On 5ch, posters pointed to a growing number of doctors turning to non-insurance (out-of-pocket) treatments because insurance-covered care alone isn’t profitable, and criticized the twisted system in which medical supplies are subject to consumption tax but that cost isn’t reflected in reimbursement rates. Others fired back with harsher takes like “it’s fine if there are fewer medical institutions” and “elderly healthcare spending should be cut,” making for a divided thread.
Published Sun, Oct 18, 7:03 AM JST
Tokyo Shoko Research
Bankruptcy Trends Among “Medical Institutions,” Jan-Sep 2026
Source: news.yahoo.co.jp / Original article here
What people said
With that in hand, you can make a living no matter what.
Dentistry's rough, isn't it?
Clinic-type doctors can always fall back on becoming a salaried physician at a big hospital, but dentists don't really have that option.
Something's off.
They're needed, but a lot of places barely turn a profit on insurance-covered care, where you can't set your own prices.
There's definitely been a shift toward dentistry and cosmetic surgery, fields where doctors can set their own fees through out-of-pocket treatment and earn comparatively more.
That's actually good news.
Medical supplies get hit with consumption tax, but reimbursement fees are barred from passing that tax on.
Inflation drives up supply costs, yet reimbursement fees see small-to-large cuts.
Inflation pushes up labor costs too (etc.)
They mandate compliance with the My Number national ID system, but the cost of implementing and maintaining it
isn't reflected in reimbursement fees.
Isn't that just faking a loss to dodge taxes?
Classic move.
Instead of fixing the tooth that's actually hurting, they go mess with some other tooth first so you can't escape.
Go bankrupt already, all of you.
Medical institutions could be cut in half, honestly.
We don't need that many at all.
That just means they'll start cutting corners on treatment materials more often.
Unless doctors start struggling to make a living, medical costs will just keep ballooning, so it can't be helped.
Though it's not like just bashing elderly people who go to the hospital solves anything either.
The actual number of people going to the hospital doesn't change, so total medical costs will barely change either.
If medical institutions and doctors disappear, people won't be able to go to the hospital at all.
They'd just go to a different medical institution instead.
On top of that, welfare recipients ("namapo") get their transportation costs covered, so it'd be a net loss anyway.
Making it impossible to see a doctor at all would really be putting the cart before the horse…
Anyone who stops and thinks for a second instead of running on autopilot can see that.
Doctors are the ones manufacturing sick people in the first place, so we don't need them.
Future elderly healthcare services are already guaranteed to get cut anyway, so it's more rational to
have it cut from today's elderly ASAP,
get a tax break out of it,
and have everyone redirect that money into their own savings and investments instead.
once the baby-boomer doctors are gone,
private practitioners are going to vanish from towns entirely.
A third of young doctors go into cosmetic medicine, and the rest become salaried hospital staff.
That's the resentment-fueled world you all wanted, isn't it?
Japan has way too many clinics, so fewer is better.
That way we can cut taxes too.
I actually know what healthcare is like in the real countryside, and honestly, there's not much that can be done about it there.
There's barely anyone living there to begin with… most of the elderly population there will probably shrink drastically in another 10 years, maybe even 5.
Not my story, but a friend of mine made ¥25 million in a busy year.
Depends on how you run it. Setting aside location, rent, and all that —
if you do it properly and seriously, opening your own practice probably nets you around ¥8 million take-home? That's a pretty rough estimate.
Build it around a bigger staff and run it staff-first, and it's ¥20 million.
Exploit every loophole in the insurance system to the max, and it's ¥50 million-plus.
Tuition is flat or dropping, but it costs about twice as much to open a practice as it did 20 years ago.
Still, I don't think it's changed that dentistry is a job you can get into even starting from mediocre grades, and still earn a stable, respectable income.
I used to grind it out doing out-of-pocket treatment, but lately I'm tired and prioritizing my personal life, so I hired a salaried associate and now run mostly insurance care for about ¥8 million.
The countryside might actually pay better relative to the effort.
https://assets.st-note.com/img/1666744836278-OPpRxwbpp6.png
Areas with fewer dentists are the sweet spot to target.
Where I am, booking a cavity treatment means waiting like a week for an appointment.
If you're going bankrupt, come out to the countryside.
There's a pretty big gap depending on where you are Re: #143
we'll be in an era where you want medical care but can't get it,
or where accessing a medical institution at all becomes difficult.
The ones who'll suffer are you guys yourselves.
For internal medicine, AI will be able to examine you from home and have your medicine delivered right away — pretty convenient,
as long as the medical industry's vested interests don't put up a futile fight against it.
The government's been slashing hospital beds like crazy as policy, so "hospitalization refugees" (people who can't find an open bed) are likely to become a social problem before long.
they know their own limits.
So I'll go develop a way to get a bird's-eye view of that referral network, using Claude.
Exactly this.
They don't even have proper diagnostic equipment.
A clinic can only manage a half-assed physical exam at best,
so just write the referral already, is the point.
For my impacted wisdom tooth, they just referred me out right away.
Picked out a hospital for me too, saying it'd be fine either way since the doctors there are all from Osaka University anyway.
Staffing-ratio regulations tie your hands.
That one clinic that declared war on the famous clinic in Nishi-Hachioji ended up getting swallowed in an M&A instead.
Apparently the cause of its collapse was over-expanding locations.
Labor costs add up quite a bit too, so it seems like you need real staying power to keep it going.
Assistants.
Nurses.
Equipment investment matters too, but labor costs are what really bite you in the long run.
Huh, is that so.
The famous one just seems bright and fun, so I only ever had a good image of them.
Even that story about getting scolded by their family for overspending on advertising makes them seem like a genuinely nice person.
Jumping in to compete with that after the fact must be pretty tough.
Meanwhile I'm a salaried doctor stuck at some backwater hospital.
In the end, medicine really is just arithmetic (a twist on the old saying that "medicine is the art of benevolence").
Your junior's definitely dabbling in some illegal stuff.
There's no escaping an AI audit.
Running a clinic sounds like boring-as-hell work anyway.
And ending up at a backwater hospital as a salaried doctor is just the result of your own ability and choices.
Background and Key Points of This Discussion
Japan’s medical reimbursement fees are government-set prices that medical institutions cannot choose to raise, while at the same time, purchasing medical supplies is subject to consumption tax — creating an asymmetric structure where rising supply and labor costs from inflation are hard to pass through into prices. Smaller clinics and dental practices tend to feel the profit squeeze more acutely, and businesses centered on insurance-covered care are said to be especially hard-pressed. At the same time, many thread posters pointed out just how high dentists’ incomes can run, showing the industry isn’t uniformly struggling — the gap, driven by factors like out-of-pocket treatment and running multiple practices, can be wide, something hard to see from the main article alone. The rise in bankruptcies is also thought to be linked to hospital bed reductions and doctors concentrating in urban areas and non-insurance treatment, though the thread didn’t dig much into the impact on regional healthcare access.
*This article is excerpted and summarized from the 5ch (News Speed+) thread “[Medical] “Medical Institution” Bankruptcies Jan-Sep: Record High of 59, Hardship Clear at Everyday Clinics and Dental Practices.”
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