Abstract
Since the establishment of the National Health Insurance system in 1961, with municipalities as the main insurers, insurance benefit costs.
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Notes
- 1.
The calculations came from data on insurers, most of which were municipalities, in the Ministry of Health, Labour and Welfare’s “Report on the Status of National Health Insurance Operations (Operations Annual Report 2010)” (including wide-area union and partial-affairs associations). The long-term care portion and the latter-stage elderly support funds portions were omitted. The same also applies to the analysis below.
- 2.
The National Health Insurance contributions (tax) payment rate (current year’s portion) in fiscal 1991 was 94.16%; in fiscal 1996 it was 93.00%; in fiscal 2001 it was 90.87%; in fiscal 2006, 90.39%; in fiscal 2007, 90.49%; in fiscal 2008, 88.35%; in fiscal 2009, 88.10%; and since then it has continued to decline year by year. However, the drop from fiscal 2008 onwards can be partly attributed to the effects of the introduction of the latter-stage elderly medical care system .
- 3.
For example, in several prefectures, the establishment of an environment toward implementing projects on the unit of prefectures, such as for joint projects targeting the expanding medical care costs, has been discussed. Please refer to the Social Security Weekly Editing Bureau (2012a, b). The prefectures of Japan consist of 47 pref ectures. They form the first level of jurisdiction and administrative division of Japan. Th ey consist of 43 prefectures proper, two urban prefectures , one “circuit” or “territory” and one “metropolis”.
- 4.
Suzuki (2001) analyzed the effects of subsidies in the National Health Insurance finances. Moreover, while not focusing on the National Health Insurance system , existing research that has verified economies of scale for the cost of administrative work (general affairs costs) in the public long-term care insurance system includes Yamauchi (2006) and Hirota and Yunoue (2009).
- 5.
In the “Report on the Status of National Health Insurance Operations (Operations Annual Report),” “Table 13 Report on the Status of National Health Insurance Operations (Operations Annual Report) Table A,” “Table 14 Report on the Status of National Health Insurance Operations (Operations Annual Report) Table B (1),” and “Table 14 Report on the Status of National Health Insurance Operations (Operations Annual Report) Table B (2)” were used.
- 6.
Following the launch in fiscal 2008 of the latter-stage elderly medical care system , the latter-stage elderly aged 75 years and above and the early-stage elderly with a disability were withdrawn from the health insurance system and incorporated into the latter-stage elderly medical care system . Therefore, data on the persons in question differs in the “Report on the Status of National Health Insurance Operations (Operations Annual Report)” from before and after fiscal 2008. In this chapter, data from fiscal 2008 and onwards was used in consideration of the implementation of the latter-stage elderly medical care system .
- 7.
Number of insurers in fiscal 2008 was 1646 and in fiscal 2009 and fiscal 2010, it was 1587. When preparing the panel data, the number of insurers in each fiscal year was unified as 1587.
- 8.
It was decided to use a logarithmic linear function in order to interpret the coefficients obtained from the estimations as elastic values. Izumida (2003) organizes the value as a costs function and the coefficient corresponding to cost elasticity.
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Adachi, Y. (2018). Expanding the Scope and Improving the Efficiency of National Health Insurance Administrative Work. In: The Economics of Tax and Social Security in Japan. Springer, Singapore. https://doi.org/10.1007/978-981-10-7176-8_8
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DOI: https://doi.org/10.1007/978-981-10-7176-8_8
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