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Can the health insurance reforms stop an increase in medical expenditures for middle- and old-aged persons in Japan?

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  • Tamie Matsuura
  • Masaru Sasaki

Abstract

Using two-period panel data from the Nippon Life Insurance Research Institute, this paper tests the hypothesis that an increase in the self-pay ratio of medical expenditures associated with the Japanese health insurance reforms of April 2003 reduced household medical expenditures. We find that the increase in the self-pay ratio had a positive but insignificant effect on the share of medical expenses in household expenditure. However, when we employ the data as repeated cross-sectional observations to increase the sample size, the increase in the self-pay ratio has a significantly positive effect on the share of medical expenditures. This provides corroborating evidence that middle- and old-aged persons were unable to reduce their demand for medical services with the increase in the self-pay ratio. An additional finding is that medical services are a necessary good, particularly for those aged 61 years or older and those with medical expenditures accounting for a relatively high share of medical expenditures in high household expenditure.
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Suggested Citation

  • Tamie Matsuura & Masaru Sasaki, 2012. "Can the health insurance reforms stop an increase in medical expenditures for middle- and old-aged persons in Japan?," International Journal of Health Economics and Management, Springer, vol. 12(2), pages 163-187, June.
  • Handle: RePEc:kap:ijhcfe:v:12:y:2012:i:2:p:163-187
    DOI: 10.1007/s10754-011-9102-x
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    More about this item

    Keywords

    Health insurance; Medical expenditures; Engle curve; Middle- and old-aged persons; Japan; I11; I18;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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