The empirical study of the decision mechanism of the premium and the subsidies in the municipality-based health care insurance system in Japan

Research Project

Project/Area Number	23730217
Research Category	Grant-in-Aid for Young Scientists (B)
Allocation Type	Multi-year Fund
Research Field	Economic statistics
Research Institution	Waseda University
Principal Investigator	KAWAMURA Akira 早稲田大学, 政治経済学術院, 招聘研究員 (10422198)
Project Period (FY)	2011-04-28 – 2015-03-31
Project Status	Completed (Fiscal Year 2014)
Budget Amount *help	¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000) Fiscal Year 2013: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000) Fiscal Year 2012: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000) Fiscal Year 2011: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Keywords	市町村国民健康保険 / 介護保険 / 保険料(税) / 国民健康保険料(税) / モラルハザード / 保険料（税） / 自治体財政 / ソフトな予算制約 / 地方政治 / 空間計量経済学
Outline of Final Research Achievements	The aim of the study is to clear the decision mechanism of the premium and the subsidies in the municipality-based health care insurance system in Japan. In the research, I address two questions: first, whether does the subsidy mechanism bring the differences of inefficiency of service use? Second, whether do political factors such as seniority of a mayor or structure of an assembly affect the decision of premium rate? First, I compared the health care insurance with the long-term care insurance in a same municipality. Employing the stochastic cost frontier model, I showed the difference of the inefficiency in two systems. The inefficiency of the health care system was larger than that of LTC. Second, I estimated the regression of the premium equation on the seniority of a mayor and other political factors with some control variables. The estimation result showed that just the seniority of a mayor was positively significant, and other political factors were not significant.