Theoretical and Empirical Analysis of Mixed Medical Care Services in Japan ～ What is Equity? ～

The aim of this study is to examine the manner in which a Japanese medical regulation affects equity in health care within an economic framework. The regulation is termed “the ban on mixed treatment.” Mixed treatment is the mixed use of treatments covered by public health insurance as well as those not covered by such insurance in the course of treating an illness. In principle, the Japanese Health Ministry bans mixed treatment. In order to examine the effect of mixed treatment on equity in health care, we explain the background of Japanese mixed treatment. Thereafter, we introduce a simple economic model and provide suggestions regarding the behavior of patients under the ban rule. Based on the theoretical model, we simulate the behavior of patients using questionnaire data and analyze the results from various perspectives. Here, we create data using the Contingent Valuation Method (CVM). The results suggest that lifting the ban could reduce differences in treatments among income/asset class but would make payment for health care regressive slightly. The results also suggest that the behavior of patients is different even within the same income/asset class, and there are other factors for receiving uninsured treatment besides capacity to pay.