The roles of public and private insurance for the health-care reform of Japan

Eiji Tajika and Jun Kikuchi
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Eiji Tajika: Hitotsubashi University, Tokyo
Jun Kikuchi: National Institute of Population and Social Security Research, Tokyo

Public Policy Review, 2012, vol. 8, issue 2, 123-144

Abstract: The purpose of this paper is to identify the main features of Japanese health-care system and to present a direction for reform. It offers the following three as the distinct features of Japanese health-care system: the first is that pubic insurance dominates the health- care market; the second is that insurers fail to play the role as an agent of patients; and the third is that health-care costs has been contained by the price control in a centralized fashion. Based on the conceptualization and the practice of the roles of public and private health-care insurances, it looks into the construction of Japanese health-care system. One of its major findings is that many apparently different problems in Japan have stemmed from the government's significant subsidies to insurers. As for the direction of reform, restoring the cost-reflecting premium is an important step toward a virtuous circle that would ultimately lead to a more sustainable health-care system in Japan.

Date: 2012
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