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Health insurance reform and economic growth: Simulation analysis in Japan

Author

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

Abstract

This paper evaluates the drastic reforms of Japanese public health insurance initiated in 2006. We employ a computable general equilibrium framework to numerically examine the reforms for an aging Japan in the dynamic context of overlapping generations. Our simulation produced the following results: first, an increase in the co-payment rate, a prominent feature of the 2006 reform, would promote economic growth and welfare by encouraging private saving. Second, the ex-post moral hazard behavior following the increase in co-payment rates, however, reduces economic growth. Third, Japan's trend of increasing the future public health insurance benefits can mainly be explained by its aging population, and increasing the co-payment rate does little to reduce future payments of public health insurance benefits. Fourth, the effect on future economic burdens of reducing medical costs through efficiencies in public health insurance, emphasis on preventive medical care, or technological progress in the medical field is small. Finally, a policy of maintaining public health insurance at a fixed percentage of GDP will require reducing public health insurance benefits, perhaps up to 45% by 2050. Such a policy also reduces economic growth until approximately 2035. Our simulation indicates that the reform does not significantly reduce future public health insurance benefits, but it can enhance economic growth and welfare by encouraging private saving.

Suggested Citation

  • Ihori, Toshihiro & Kato, Ryuta Ray & Kawade, Masumi & Bessho, Shun-ichiro, 2011. "Health insurance reform and economic growth: Simulation analysis in Japan," Japan and the World Economy, Elsevier, vol. 23(4), pages 227-239.
  • Handle: RePEc:eee:japwor:v:23:y:2011:i:4:p:227-239
    DOI: 10.1016/j.japwor.2011.07.003
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    References listed on IDEAS

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    1. Fumio Hayashi & Edward C. Prescott, 2004. "The 1990s in Japan: a lost decade," Chapters,in: The Economics of an Ageing Population, chapter 2 Edward Elgar Publishing.
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    Cited by:

    1. 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.
    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. Yan Ma & Zhenjiang Shen & Dinh Thanh Nguyen, 2016. "Agent-Based Simulation to Inform Planning Strategies for Welfare Facilities for the Elderly: Day Care Center Development in a Japanese City," Journal of Artificial Societies and Social Simulation, Journal of Artificial Societies and Social Simulation, vol. 19(4), pages 1-5.
    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. Braun, R. Anton & Joines, Douglas H., 2014. "The Implications of a graying japan for government policy," FRB Atlanta Working Paper 2014-18, Federal Reserve Bank of Atlanta.
    6. 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.
    7. 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.
    8. 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.
    9. Akira Okamoto, 2013. "Welfare Analysis of Pension Reforms in an Ageing Japan," The Japanese Economic Review, Japanese Economic Association, vol. 64(4), pages 452-483, December.
    10. 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.
    11. 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.
    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. 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.

    More about this item

    Keywords

    Public health insurance; Japan; National medical expenditure; Economic growth; Aging population; Dynamic CGE model;

    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
    • 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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