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The Long-Run Health and Economic Benefits of Universal Health Insurance in Japan

Research Project

Project/Area Number 20K13509
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 07050:Public economics and labor economics-related
Research InstitutionHitotsubashi University

Principal Investigator

WANG Hongming  一橋大学, 社会科学高等研究院, 特任助教 (20867048)

Project Period (FY) 2020-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000)
Fiscal Year 2021: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2020: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywordsuniversal insurance / long-run impacts / health and employment / education / gender inequality / public policy / health / health insurance / earnings / employment / gender / Universal Healthcare / Health Policy / Public Economics
Outline of Research at the Start

This research studies the long-run impacts of universal health insurance on the health and economic outcomes of prime-age workers in Japan. To estimate the long-run impacts, I exploit the fact that the 1961 universal insurance reform expanded insurance more in prefectures with lower insurance rates prior to the reform, and increased the insurance access early in life for cohorts born closer to the reform. I use the estimates to inform policy debates on the cost-effectiveness of universal health insurance in countries with publicly financed insurance systems.

Outline of Final Research Achievements

This research studies the long-run impacts following the onset of universal insurance in Japan in 1961. Focusing on health and economic outcomes, I compare cohorts borne shortly before and after the reform and hence differentially exposed to universal insurance early in life. I find that exposure had significant impacts on health in prime age, reducing chronic conditions such as diabetes and hypertension for women and cancer-related mortality for men. Moreover, exposure increased the share of women with college education, and the education gain increased women's employment and earnings relative to men as well as women's marital outcome measured by the education attainment of her spouse. As full-time employment increased, the homemaker's role shifted to men within households. Universal insurance thus contributes to an inclusive and equitable society with improved socio-economic status of women.

Academic Significance and Societal Importance of the Research Achievements

この研究は、日本の国民皆保険制度について健康と経済利益に関する長期的な調査として初めてのものとなる。国民皆保険は、医療へのアクセスを確保し、恵まれない人々が直面している健康的/経済的な不平等さを軽減するために、多くの国により議論し続けられている。日本において健康保険制度が国民の健康維持に大きく寄与し、さらには女性の経済的自立を促しているという研究結果は、現在国民皆保険制度の導入を進めている国々にとって有益な指針となる。

Report

(3 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • Research Products

    (1 results)

All 2022

All Presentation (1 results) (of which Int'l Joint Research: 1 results)

  • [Presentation] Reducing Inequality While Improving Health: The Long-Run Impacts from the Onset of Universal Health Insurance in Japan2022

    • Author(s)
      Hongming Wang
    • Organizer
      European Health Economics Association
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research

URL: 

Published: 2020-04-28   Modified: 2023-01-30  

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