Politically Favorable Alternatives for Japan's Public Health Policy Reform - Evaluation of Risk Recognition and Preference

Posted: 22 Jun 2007

See all articles by Masayo Sato

Masayo Sato

Hokkaido University Public Policy School (HOPS)

Toshiyuki Uemura

Toyo University - Faculty of Economics

Date Written: 2007


The aim of this paper is to exam Japanese people's recognition to their health risks through the investigation of opinions on Japan's public health care system and to find some feasible alternatives for system reform.

The health care system is an important infrastructure supporting the livelihood and Japan's system has been achieved in this idea. (The universal coverage system has basically assumed a social insurance format through compulsory subscription.) However, while the socioeconomic structure is seeing great changes taking place due to population aging, the deterioration of state finances due to economic recession, and so on, the people's consciousness are also undergoing modification. And the progressing increase in costs is taking a more serious toll on public finance. So the system reform in response to such situations has been a very big subject.

By carrying out a original internet survey in September 2006, and analyzing 1707 consistent samples, we have grasped Japanese consciousness to the public health insurance, and were able to know the alternatives of policy reform. Main result and implication are as follows.

- 55.9 to 74.8% of respondent is doing the error in fact by 6 of 10 questions that ask the system and the knowledge about the result. The Japan's system is a complex arrangement because of the way application was thus extended in stages. Therefore, although the concern about a system is strong, the degree of comprehension to a system is very low. These mean the shortage of explanation by the government as the complexity of a system.

- About the reform menu, the coverage is considered to be more important than mitigation of contributions (i.e. premium, tax, etc.). The negative opinion occupied 63.5% for limiting the coverage in order to maintain the present contribution level. Other results also show the tendency to look for maintaining/expanding the coverage, even if contributions are added.

- 54.2% is affirmative for making a smoker's premium higher than a nonsmoker, and 62.5% is affirmative for making the co-payment rate of children lower than status quo. It became clear that an agreement for giving change to contributions according to a situation is obtained.

- About favorable options of public insurance, many chose a premium will become low if you don't receive medical care benefits during the specific period (72.0%), and a bonus being granted you don't receive medical care benefits during the specific period (65.3%). Although it was the result of being expected beforehand since there were few samples with bad health condition, flexible structure is required.

(Besides these results, about the relation between the amount of knowledge and the favorable public health system, the risk aversion degree for every attribute, the health check-up the feeling to health, the big expectation and the dependence to the public health insurance were shown numerically.)

Keywords: Health policy reform, Health risk recognition, Politically favorable altenatives

Suggested Citation

Sato, Masayo and Uemura, Toshiyuki, Politically Favorable Alternatives for Japan's Public Health Policy Reform - Evaluation of Risk Recognition and Preference (2007). iHEA 2007 6th World Congress: Explorations in Health Economics Paper, Available at SSRN: https://ssrn.com/abstract=994609

Masayo Sato (Contact Author)

Hokkaido University Public Policy School (HOPS) ( email )

Kita 9 Nishi 7, Kita-ku
Sapporo, 0600809

HOME PAGE: http://www.hops.hokudai.ac.jp/english/

Toshiyuki Uemura

Toyo University - Faculty of Economics ( email )

5-28-20 Hakusan
Tokyo 112-8606

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