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Medical expenditures over the life-cycle: persistent risks and insurance

Author

Listed:
  • Taiyo Fukai

    (Gakushuin University)

  • Hidehiko Ichimura

    (University of Arizona)

  • Sagiri Kitao

    (National Graduate Institute for Policy Studies (GRIPS)
    Research Institute of Economy, Trade and Industry (RIETI))

  • Minamo Mikoshiba

    (Nagoya University)

Abstract

This paper builds a life-cycle model of single and married households and evaluates the roles of the national health insurance system. We use the administrative data on nationwide health insurance claims in Japan to analyze medical expenditure risks and calibrate the model with the stochastic process that varies by age and gender. Economic and welfare effects of health insurance reform depend on household income levels and generosity of the welfare program. Without health insurance, high-income households turn to self-insurance, significantly increasing aggregate savings. Low-income households, especially low-skilled single men and women, reduce savings and many of them become welfare recipients. Raising copayment rates for the elderly increases household savings, but depletes wealth of low-income households and leads to a rise in the number of welfare recipients.

Suggested Citation

  • Taiyo Fukai & Hidehiko Ichimura & Sagiri Kitao & Minamo Mikoshiba, 2025. "Medical expenditures over the life-cycle: persistent risks and insurance," The Japanese Economic Review, Springer, vol. 76(2), pages 285-336, April.
    • Handle: RePEc:spr:jecrev:v:76:y:2025:i:2:d:10.1007_s42973-025-00190-z
    DOI: 10.1007/s42973-025-00190-z
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    Cited by:

    1. Reona Hagiwara, 2022. "Welfare Effects of Health Insurance Reform: The Role of Elastic Medical Demand," IMES Discussion Paper Series 22-E-05, Institute for Monetary and Economic Studies, Bank of Japan.
    2. Ono, Taiki, 2024. "Bequests and wealth inequality in Japan," Journal of the Japanese and International Economies, Elsevier, vol. 72(C).
    3. Hagiwara, Reona, 2024. "Welfare effects of health insurance reform: The role of elastic medical demand," Economic Modelling, Elsevier, vol. 141(C).
    4. Sagiri KITAO & Minamo MIKOSHIBA, 2022. "Why Women Work the Way They Do in Japan: Roles of Fiscal Policies," Discussion papers 22016, Research Institute of Economy, Trade and Industry (RIETI).
    5. Masayuki Okada, 2023. "The optimal earnings test and retirement behavior," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 30(4), pages 1036-1068, August.

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