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


  • Hiromi Saito

    (National Graduate Institute for Policy Studies)

  • Wataru Suzuki

    (Gakushuin University)


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.

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  • Hiromi Saito & Wataru Suzuki, 2009. "Theoretical and Empirical Analysis of Mixed Medical Care Services in Japan ~ What is Equity? ~," GRIPS Discussion Papers 08-19, National Graduate Institute for Policy Studies.
  • Handle: RePEc:ngi:dpaper:08-19

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    1. repec:lje:journl:v:2:y:2007:i:2:p:27-48 is not listed on IDEAS
    2. Jorge Martinez-Vazquez, 2001. "The Impact of Budgets on the Poor: Tax and Benefit," International Center for Public Policy Working Paper Series, at AYSPS, GSU paper0110, International Center for Public Policy, Andrew Young School of Policy Studies, Georgia State University.
    3. Lavy, V. & Quigley, J.M., 1993. "Willingness to Pay for the Quality and Intensity of Midical Care; Low- Income Households in Ghana," Papers 94, World Bank - Living Standards Measurement.
    4. Ablo, Emmanuel & Reinikka, Ritva, 1998. "Do budgets really matter? - evidence from public spending on education and health in Uganda," Policy Research Working Paper Series 1926, The World Bank.
    5. Agar Brugiavini & Noemi Pace, 2011. "Extending Health Insurance: Effects of the National Health Insurance Scheme in Ghana," RSCAS Working Papers 2011/27, European University Institute.
    6. Aaron, Henry & McGuire, Martin, 1970. "Public Goods and Income Distribution," Econometrica, Econometric Society, vol. 38(6), pages 907-920, November.
    7. Ssewanyana, Sarah & Nabyonga, Juliet O. & Kasirye, Ibrahim & Lawson, David, 2004. "Demand for Health Care Services in Uganda: Implications for Poverty Reduction," Research Series 150529, Economic Policy Research Centre (EPRC).
    8. Edward Morey & Kathleen Rossmann, 2008. "Calculating, With Income Effects, the Compensating Variation for a State Change," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 39(2), pages 83-90, February.
    9. van de Walle, Dominique, 1998. "Assessing the welfare impacts of public spending," World Development, Elsevier, vol. 26(3), pages 365-379, March.
    10. Jehu-Appiah, Caroline & Aryeetey, Genevieve & Spaan, Ernst & de Hoop, Thomas & Agyepong, Irene & Baltussen, Rob, 2011. "Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?," Social Science & Medicine, Elsevier, vol. 72(2), pages 157-165, January.
    11. Ahmed Nawaz Hakro & Muhammed Akram, 2007. "The Incidence of Government Expenditures on Education and Health: Microeconomic Evidence from Pakistan," Lahore Journal of Economics, Department of Economics, The Lahore School of Economics, vol. 12(2), pages 27-48, Jul-Dec.
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    More about this item


    Mixed treatments; Equity in access to health care; Freedom of choice in health care; Contingent Valuation Method.;

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