title: Can the health insurance reforms stop an increase in medical expenditures for middle- and old-aged persons in Japan?
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.
authors.affiliation: NLI Research Institute, Tokyo, Japan.
authors.forename: Tamie
authors.initials: T
authors.lastname: Matsuura
authors.forename: Masaru
authors.initials: M
authors.lastname: Sasaki
mesh_terms: D000328:Adult; D000368:Aged; D003625:Data Collection; D005260:Female; D018166:Health Care Reform / Q000191:economics*; D005102:Health Expenditures / Q000639:trends*; D006801:Humans; D007348:Insurance, Health; D007564:Japan; D008297:Male; D008875:Middle Aged