Unique mixtures of public and private funding in Japan - The ban on billing for mixed medical care service -

The purpose of this research is to consider theoretically the influence which the lifting the ban on billing of mixed medical care services on Japanese health care system from a viewpoint of both "equity" and "efficiency." As a result, about equity, it was suggested that the access gap by an income bracket actualizes, while access to new medical technology improved by lifting of the ban. Although this gap will improved by use of private health insurance, it turned out that assistance should be considered for low income earners by the government, such as regulation of imposing the community rating system to the private insurances. About efficiency, it was shown that fear of both the supplier induced demand by asymmetric information and the ex post moral hazard by use of the private health insurance concerned is also strong. Additionally, in case of gradual expansion of government controlled mixed medical care service (Specified Mixed Medical Care Coverage System),it is thought that the scale is limited as compared with the lifting the ban of billing of mixed medical service, but there is also problems of an access gap and an ex post moral hazard. On the other hand, the problem of supplier induced demand would be reduced to the level of insured medical care services by both intervention and supervision of Japanese government in Specified Mixed Medical Care Coverage System.