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

2020 Fiscal Year Research-status Report

• Project/Area Number: 20K13509
• Research Institution: Hitotsubashi University
• Principal Investigator: Wang Hongming 一橋大学, 社会科学高等研究院, 特任講師 (20867048)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: health insurance / health / education / earnings / employment / gender

Outline of Annual Research Achievements

In the previous year, I applied for administrative data to study the employment, mobility, and health outcomes of individuals who were exposed to the 1961 universal health insurance reform in early childhood (age 0-5). Using these data, I find that insurance exposure increased education attainment for both genders, and increased college enrollment especially for women. Insurance also improved the marriage market outcomes for women who are more likely to marry college-educated men. Within households, the female head increased labor market hours and earnings relative to the male head, although total hours and earnings did not increase with insurance. These results suggest that universal insurance may have larger benefits for individuals with less access to insurance prior to the reform.

Current Status of Research Progress

1: Research has progressed more than it was originally planned.

Reason

The original plan was to obtain the datasets needed for the research. These data include surveys on employment, mobility, and social and economic activities, records of inpatient visits, and historic data on insurance rates across prefectures before the 1961 reform. I have obtained access to these data and hence completed the intended progress in the first year of research.

Moreover, I conducted preliminary analysis of the data, focusing on education, employment, and marriage market outcomes. I find that early-life insurance exposure increased education especially for women, and further improved women's marriage market outcomes. Within households, employment and earnings increased differentially for women. These results were originally scheduled for the second year of the research.

Strategy for Future Research Activity

In the coming year, I will conduct additional analyses on the health and employment outcomes of cohorts with early-life exposure to universal insurance. Specifically, I will examine the health impacts of insurance and the potential differences by gender using the hospital records in the Patient Survey. I will also conduct robustness checks across multiple datasets, especially for education and employment outcomes that appear in several surveys. The full set of evidence would then inform the potential mechanism of the long-run impacts, and may suggest additional research drawing from new sources of data. Without significant complications in the research results, however, I expect to complete a first draft of the paper by the end of the budget year.

Causes of Carryover

The balance will be added to the research budget for the second year, for a total of 962,018 YEN. Most of it will provide software support for the project, including statistical analysis, computing, and text editing. It will also support registrations for conferences and journal subscriptions, travel expenses, and potential employment of a research assistant.