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The Reform Of The Public Health Insurance And Economic Growth Of Japan

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  • Toshihiro Ihori, Ryuta Ray Kato, Masumi Kawade, Shun-ichiro Bessho

Abstract

This paper evaluates one of the most drastic reforms of the Japanese public health insurance started in year 2006, by numerically examining the reform in an aging Japan in a dynamic context with overlapping generations within a computable general equilibrium framework. Our simulation results are as follows. First of all, an increase in the co-payment rate, which is one of the most prominent changes in the reform, would result in higher economic growth as well as higher welfare since it stimulates private savings. Secondly, the ex-post moral hazard behavior reduces economic growth. Thirdly, an increasing trend of the future public health insurance benefits can mainly be explained by an aging population, and an increase in the co-payment rate has little effect to reduce the public health insurance benefits in the future. Fourthly, the effect of a decrease in the medical cost, which could possibly be achieved by the improvement in efficiency in the public health insurance, the provision of more preventative medical services, or technological progress in the medical field, on the future burdens is very small. Finally, if the government implements a policy to keep the ratio of the public health insurance benefits to GDP constant, then the government has to keep reducing the public health insurance benefits over time, and the reduction rate should be 45 percent in year 2050. Such a policy also eventuates in lower economic growth until around year 2035. Our simulation results thus indicate that the reform is not so effective to reduce the future public health insurance benefits, but it can achieve higher economic growth and enhance welfare by stimulating private savings.

Suggested Citation

  • Toshihiro Ihori, Ryuta Ray Kato, Masumi Kawade, Shun-ichiro Bessho, 2011. "The Reform Of The Public Health Insurance And Economic Growth Of Japan," Asia Pacific Economic Papers 392, Australia-Japan Research Centre, Crawford School of Public Policy, The Australian National University.
    • Handle: RePEc:csg:ajrcau:392
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    File URL: https://crawford.anu.edu.au/pdf/pep/apep-392.pdf
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Crawford School Working Papers in January 2012
      by David Stern in Stochastic Trend on 2012-02-03 00:03:00
    2. Crawford School Working Papers in February 2012
      by David Stern in Stochastic Trend on 2012-03-02 16:26:00

    Citations

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    Cited by:

    1. Hagiwara, Reona, 2020. "Seigniorage and Japanese fiscal sustainability: Simulation analysis using an overlapping generations model," Economic Modelling, Elsevier, vol. 84(C), pages 340-356.
    2. Agus Budiyono & Ryuta Ray Kato, 2011. "Should Indonesia Suffer from More Reduction of the Subsidy to the Petroleum Sector?," Working Papers EMS_2011_25, Research Institute, International University of Japan.
    3. Okamoto, Akira, 2022. "Intergenerational earnings mobility and demographic dynamics: Welfare analysis of an aging Japan," Economic Analysis and Policy, Elsevier, vol. 74(C), pages 76-104.
    4. Sagiri Kitao, 2017. "When do we Start? Pension reform in ageing Japan," The Japanese Economic Review, Japanese Economic Association, vol. 68(1), pages 26-47, March.
    5. Okamoto Akira, 2020. "Childcare Allowances and Public Pensions: Welfare and Demographic Effects in an Aging Japan," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 20(2), pages 1-25, April.
    6. Okamoto, Akira, 2021. "Immigration policy and demographic dynamics: Welfare analysis of an aging Japan," Journal of the Japanese and International Economies, Elsevier, vol. 62(C).
    7. Miyazato, Naomi, 2020. "Intergenerational Inequality and the Contract Out Policy in Public Health Care," Japan and the World Economy, Elsevier, vol. 54(C).
    8. Yuan-Ho Hsu & Hiroshi Yoshida & Fengming Chen, 2022. "The Impacts of Population Aging on China’s Economy," Global Journal of Emerging Market Economies, Emerging Markets Forum, vol. 14(1), pages 105-130, January.
    9. Isaac Dadson & Ryuta Ray Kato, 2015. "Remittances and the Brain Drain in Ghana: A Computable General Equilibrium Approach," Working Papers EMS_2015_04, Research Institute, International University of Japan.
    10. Akira Okamoto, 2013. "Simulating Public Pension Reforms in an Aging Japan: Welfare Analysis with LSRA Transfers," Public Policy Review, Policy Research Institute, Ministry of Finance Japan, vol. 9(4), pages 597-632, September.
    11. Jiang, Yunyun & Zhao, Tianhao & Zheng, Haitao, 2021. "Population aging and its effects on the gap of urban public health insurance in China," China Economic Review, Elsevier, vol. 68(C).
    12. Kitao, Sagiri, 2015. "Fiscal cost of demographic transition in Japan," Journal of Economic Dynamics and Control, Elsevier, vol. 54(C), pages 37-58.
    13. Reona Hagiwara, 2022. "Welfare Effects of Health Insurance Reform: The Role of Elastic Medical Demand," IMES Discussion Paper Series 22-E-05, Institute for Monetary and Economic Studies, Bank of Japan.
    14. Makoto Kakinaka & Ryuta Kato, 2013. "Regulated medical fee schedule of the Japanese health care system," International Journal of Health Economics and Management, Springer, vol. 13(3), pages 301-317, December.
    15. Ichiro Muto & Takemasa Oda & Nao Sudo, 2016. "Macroeconomic Impact of Population Aging in Japan: A Perspective from an Overlapping Generations Model," IMF Economic Review, Palgrave Macmillan;International Monetary Fund, vol. 64(3), pages 408-442, August.
    16. R. Anton Braun & Douglas H. Joines, 2014. "The Implications of a graying japan for government policy," FRB Atlanta Working Paper 2014-18, Federal Reserve Bank of Atlanta.
    17. Braun, R. Anton & Joines, Douglas H., 2015. "The implications of a graying Japan for government policy," Journal of Economic Dynamics and Control, Elsevier, vol. 57(C), pages 1-23.
    18. Isaac Dadson & Ryuta Ray Kato, 2015. "Remittances and the Redistributive Tax Policy in Ghana: A Computable General Equilibrium Approach," Working Papers EMS_2015_05, Research Institute, International University of Japan.
    19. Nga Le Thi Quynh & Groot, Wim & Tomini, Sonila M. & Tomini, Florian, 2017. "Effects of health insurance on labour supply: A systematic review," MERIT Working Papers 2017-017, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    20. Alper Aslan & Angeliki Menegaki & Can Tugcu, 2016. "Health and economic growth in high-income countries revisited: evidence from an augmented production function for the period 1980–2009," Quality & Quantity: International Journal of Methodology, Springer, vol. 50(2), pages 937-953, March.

    More about this item

    JEL classification:

    • C68 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Computable General Equilibrium Models
    • D58 - Microeconomics - - General Equilibrium and Disequilibrium - - - Computable and Other Applied General Equilibrium Models
    • E17 - Macroeconomics and Monetary Economics - - General Aggregative Models - - - Forecasting and Simulation: Models and Applications
    • E62 - Macroeconomics and Monetary Economics - - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook - - - Fiscal Policy; Modern Monetary Theory
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions
    • H62 - Public Economics - - National Budget, Deficit, and Debt - - - Deficit; Surplus
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O40 - Economic Development, Innovation, Technological Change, and Growth - - Economic Growth and Aggregate Productivity - - - General

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