On April 1, the Ministry of Health, Labor and Welfare notified local governments that from now on welfare recipients entitled to free medical care must only use generic pharmaceuticals rather than more expensive brand-name drugs. Almost immediately the plan was attacked in the media, which implied that the government was once again treating poor people like dirt. During a Cabinet meeting on April 28, health minister Yoichi Masuzoe acknowledged the criticism by saying that the wording of the directive would be changed.

It sounds like a cynical response, and the original directive does sound a bit judgmental. It stated that since welfare recipients pay nothing for their medical care they have no "incentive" to choose less expensive drugs, and that if someone opts for brand-name drugs with no "legitimate medical reason" for doing so, then that person will lose his or her benefits. The new wording will supposedly soften the tone while retaining the main purpose, which is to encourage the use of generics and save the government about ¥1 trillion a year.

However, the problem may have less to do with the government's poor communication skills than with the public's — not to mention the media's — incomplete knowledge about generic drugs. According to the Mainichi Shimbun, generics account for about 60 percent of all prescription drug sales in the West, while in Japan the share is only about 17 percent and has remained at that level since the early part of the decade when the government first started promoting generics.