IDEAS home Printed from https://ideas.repec.org/a/eee/asieco/v42y2016icp65-77.html
   My bibliography  Save this article

Inefficiencies in the Japanese National Health Insurance system: A stochastic frontier approach

Author

Listed:
  • Yuda, Michio

Abstract

In this study, I examine the cost inefficiency and production inefficiency of municipal insurers operating under the Japanese National Health Insurance system. I employ insurer-level panel data for 2005 and 2010 and adopt stochastic frontier cost and production models to overcome analytical problems encountered in previous studies. The cost frontier estimates indicate that adverse effects on efficiency are associated with aging of the insured population, soft budget constraints due to government subsidies, insurer contributions to the elder care systems, and an increase in care provider densities. A positive effect on efficiency is associated with an expansion in insurer scale. The production frontier estimates suggest that cost inefficiencies decreased by roughly 15 percent between 2005 and 2010. The correlation between cost inefficiency and technical inefficiency is not particularly strong, whereas the correlation between cost inefficiency and allocative inefficiency is strong and positive.

Suggested Citation

  • Yuda, Michio, 2016. "Inefficiencies in the Japanese National Health Insurance system: A stochastic frontier approach," Journal of Asian Economics, Elsevier, vol. 42(C), pages 65-77.
    • Handle: RePEc:eee:asieco:v:42:y:2016:i:c:p:65-77
    DOI: 10.1016/j.asieco.2016.01.001
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S1049007816000026
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.asieco.2016.01.001?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Meeusen, Wim & van den Broeck, Julien, 1977. "Efficiency Estimation from Cobb-Douglas Production Functions with Composed Error," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 18(2), pages 435-444, June.
    2. Federico Belotti & Giuseppe Ilardi, 2012. "Consistent Estimation of the “True” Fixed-effects Stochastic Frontier Model," CEIS Research Paper 231, Tor Vergata University, CEIS, revised 18 Apr 2012.
    3. Battese, G E & Coelli, T J, 1995. "A Model for Technical Inefficiency Effects in a Stochastic Frontier Production Function for Panel Data," Empirical Economics, Springer, vol. 20(2), pages 325-332.
    4. Greene, William, 2005. "Reconsidering heterogeneity in panel data estimators of the stochastic frontier model," Journal of Econometrics, Elsevier, vol. 126(2), pages 269-303, June.
    5. Willam Greene, 2005. "Fixed and Random Effects in Stochastic Frontier Models," Journal of Productivity Analysis, Springer, vol. 23(1), pages 7-32, January.
    6. Federico Belotti & Silvio Daidone & Giuseppe Ilardi & Vincenzo Atella, 2013. "Stochastic frontier analysis using Stata," Stata Journal, StataCorp LP, vol. 13(4), pages 718-758, December.
    7. Jarraya, Bilel & Bouri, Abdelfettah, 2012. "Efficiency concept and investigations in insurance industry: A survey," MPRA Paper 53544, University Library of Munich, Germany, revised 2013.
    8. Laurie J. Bates & Kankana Mukherjee & Rexford E. Santerre, 2010. "Medical Insurance Coverage and Health Production Efficiency," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 211-229, March.
    9. Greene, William H., 1980. "On the estimation of a flexible frontier production model," Journal of Econometrics, Elsevier, vol. 13(1), pages 101-115, May.
    10. Schmidt, Peter & Knox Lovell, C. A., 1979. "Estimating technical and allocative inefficiency relative to stochastic production and cost frontiers," Journal of Econometrics, Elsevier, vol. 9(3), pages 343-366, February.
    11. Yuda, Michio, 2013. "Medical Fee Reforms, Changes In Medical Supply Densities, And Supplier-Induced Demand: Empirical Evidence From Japan," Hitotsubashi Journal of Economics, Hitotsubashi University, vol. 54(1), pages 79-93, June.
    12. Julian Le Grand, 2007. "Introduction to The Other Invisible Hand: Delivering Public Services through Choice and Competition," Introductory Chapters, in: The Other Invisible Hand: Delivering Public Services through Choice and Competition, Princeton University Press.
    13. Aigner, Dennis & Lovell, C. A. Knox & Schmidt, Peter, 1977. "Formulation and estimation of stochastic frontier production function models," Journal of Econometrics, Elsevier, vol. 6(1), pages 21-37, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Zhou, Sheng & Xu, Zhiwei, 2022. "Energy efficiency assessment of RCEP member states: A three-stage slack based measurement DEA with undesirable outputs," Energy, Elsevier, vol. 253(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Giovanni Marin & Alessandro Palma, 2015. "Technology invention and diffusion in residential energy consumption. A stochastic frontier approach," IEFE Working Papers 81, IEFE, Center for Research on Energy and Environmental Economics and Policy, Universita' Bocconi, Milano, Italy.
    2. Marin, Giovanni & Palma, Alessandro, 2017. "Technology invention and adoption in residential energy consumption," Energy Economics, Elsevier, vol. 66(C), pages 85-98.
    3. Lundgren, Tommy & Marklund, Per-Olov & Zhang, Shanshan, 2016. "Industrial energy demand and energy efficiency – Evidence from Sweden," Resource and Energy Economics, Elsevier, vol. 43(C), pages 130-152.
    4. Gangopadhyay, Partha & Jain, Siddharth & Bakry, Walid, 2022. "In search of a rational foundation for the massive IT boom in the Australian banking industry: Can the IT boom really drive relationship banking?," International Review of Financial Analysis, Elsevier, vol. 82(C).
    5. Keller, Michael, 2020. "Wasted windfalls: Inefficiencies in health care spending in oil rich countries," Resources Policy, Elsevier, vol. 66(C).
    6. Sickles, Robin C. & Song, Wonho & Zelenyuk, Valentin, 2018. "Econometric Analysis of Productivity: Theory and Implementation in R," Working Papers 18-008, Rice University, Department of Economics.
    7. Russ Kashian & Nicholas Lovett & Yuhan Xue, 2020. "Has the affordable care act affected health care efficiency?," Journal of Regulatory Economics, Springer, vol. 58(2), pages 193-233, December.
    8. Hailu, Kidanemariam Berhe & Tanaka, Makoto, 2015. "A “true” random effects stochastic frontier analysis for technical efficiency and heterogeneity: Evidence from manufacturing firms in Ethiopia," Economic Modelling, Elsevier, vol. 50(C), pages 179-192.
    9. Ceyhun Elgin & Selman Çakır, 2015. "Technological progress and scientific indicators: a panel data analysis," Economics of Innovation and New Technology, Taylor & Francis Journals, vol. 24(3), pages 263-281, April.
    10. Sickles, Robin C. & Hao, Jiaqi & Shang, Chenjun, 2015. "Panel Data and Productivity Measurement," Working Papers 15-018, Rice University, Department of Economics.
    11. Viktoriya Galushko & Samuel Gamtessa, 2022. "Impact of Climate Change on Productivity and Technical Efficiency in Canadian Crop Production," Sustainability, MDPI, vol. 14(7), pages 1-21, April.
    12. Zarkovic, Maja, 2020. "Cap-and-trade and produce at least cost? Investigating firm behaviour in the EU ETS," Working papers 2020/12, Faculty of Business and Economics - University of Basel.
    13. Sabrina Auci & Laura Castellucci & Manuela Coromaldi, 2021. "How does public spending affect technical efficiency? Some evidence from 15 European countries," Bulletin of Economic Research, Wiley Blackwell, vol. 73(1), pages 108-130, January.
    14. Farsi, Mehdi & Filippini, Massimo, 2009. "An analysis of cost efficiency in Swiss multi-utilities," Energy Economics, Elsevier, vol. 31(2), pages 306-315, March.
    15. Cristian Barra & Nazzareno Ruggiero, 2022. "How do dimensions of institutional quality improve Italian regional innovation system efficiency? The Knowledge production function using SFA," Journal of Evolutionary Economics, Springer, vol. 32(2), pages 591-642, April.
    16. Dorn, Florian, 2023. "Elections and Government Efficiency," VfS Annual Conference 2023 (Regensburg): Growth and the "sociale Frage" 277700, Verein für Socialpolitik / German Economic Association.
    17. Horrace, William C. & Rothbart, Michah W. & Yang, Yi, 2022. "Technical efficiency of public middle schools in New York City," Economics of Education Review, Elsevier, vol. 86(C).
    18. Xiang, C. & Huang, J., 2018. "The Roles of Exotic Wheat Germplasms in Wheat Breeding and Their Impacts on Wheat Production in China," 2018 Conference, July 28-August 2, 2018, Vancouver, British Columbia 277017, International Association of Agricultural Economists.
    19. Martini, Gianmaria & Scotti, Davide & Viola, Domenico & Vittadini, Giorgio, 2020. "Persistent and temporary inefficiency in airport cost function: An application to Italy," Transportation Research Part A: Policy and Practice, Elsevier, vol. 132(C), pages 999-1019.
    20. Xiang, Cheng & Huang, Jikun, 2020. "The role of exotic wheat germplasms in wheat breeding and their impact on wheat yield and production in China," China Economic Review, Elsevier, vol. 62(C).

    More about this item

    Keywords

    Cost inefficiency; Decomposition of cost inefficiency; Stochastic frontier model; Japanese National Health Insurance system; Japan;
    All these keywords.

    JEL classification:

    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models
    • H71 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Taxation, Subsidies, and Revenue
    • H72 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Budget and Expenditures
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I1 - Health, Education, and Welfare - - Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:asieco:v:42:y:2016:i:c:p:65-77. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/asieco .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.