Reinterpreting Medical Innovation: The Social Adoption of Automated Multiphasic Health Testing and Services in Japan, 1937–2023
研究了美国开发的自动化多相健康检测服务（AMHTS）为何在日本被广泛采纳，即使未被纳入公共医保。日本医生将其重新定义为低成本、可及的体检替代方案，通过保险协会补贴推广至中产阶级，实现了精英医疗服务的“民主化”。
This paper examines how automated multiphasic health testing and services (AMHTS), which were originally developed in the United States but never widely adopted there, gained traction in Japan despite being excluded from the country’s public health insurance system. Drawing on Fitzgerald et al.’s theory of interlocking interactions, we show how Japanese physicians and other stakeholders reframed AMHTS as a streamlined and affordable alternative to Ningen Dokku , Japan’s high-cost, elite medical checkup service. This creative reinterpretation helped spur efforts by actors such as the National Federation of Health Insurance Societies ( Kenporen ) to provide health screening subsidies outside the formal insurance framework, which supported the widespread adoption of the AMHTS by middle-class consumers. We introduce the concept of the “democratization of premium health services” to explain how care originally designed for elite users was redefined as both accessible and trustworthy. By highlighting how symbolic framing can promote innovation diffusion even beyond formal institutional boundaries, this study contributes to the business history of health care.