"An Invitation to Health Economics: A Review Essay: Ryu Niki, Shigeru Tanaka, Naoki Ikegami, Shuzo Nishimura, and Hisao Endo eds. Koza Iryokeizai-Seisakugaku (Lecture Series on Health Economy and Health Policy Research) Tokyo: Keiso-shobo, 2005-2007"(in Japanese)

This is an invitation to the field of health economics, for those who have followed the literature in Japan, for those interested in health-care policy issues, and especially for professionals in the medical field. I particularly welcome readers who wonder why the Japanese government has been so reluctant to adopt incentive reforms which apparently would cut costs without dramatically cutting service quality. The Japanese expression "iryo-keizaigaku" literally means "health economics" or "the economics of medical care". As practiced, however, iryo-keizaigaku has almost no relationship to the rapidly growing applied microeconomic field of health economics. Instead, the Japanese fields of iryo-keizaigaku and iryoseisaku kenkyu (literally, health policy research) have a long and independent history. In the current debate over health spending and the putative health-care "crisis," scholars in this tradition have obtained a wide public support. Yet they -- as well as the bureaucrats and public commentators working in the tradition -- are strongly hostile to standard microeconomics. Naturally, they are hostile to the field of health economics as well. Unfortunately, this hostility toward basic economic principles among the writers in the field will impoverish public debate and lead to bad policy. The leaders in this field have now published a six-volume series on Iryo-keizaigaku, which captures the substance of their achievement. In this review essay, I first (Sections II~V) critically review this lecture series, and explain its independence from standard health economics. Partly because of its independence, the lecture series pays little attention to several of the most basic aspects of health care. Section VI discusses four such issues. I conclude (Sections VII and VIII) with an invitation to health economics, and add several basic instructions to potential readers and potential entrants to this field. I suggest that they proceed directly to health economics proper, and not waste time and energy in studying iryo-keizaigaku.