GRIPS 政策研究センター Policy Research Center


Mar 1, 2009 Report No:08-19

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

  • Hiromi SaitoGRIPS
  • Wataru SuzukiFaculty of Economics, Gakushuin University
Field Economics
Language English

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.

Keywords Mixed treatments, Equity in access to health care, Freedom of choice in health care, Contingent Valuation Method.
attachment 08-19_rev_web2.pdf