2021 Fiscal Year Annual Research Report
The Long-Run Health and Economic Benefits of Universal Health Insurance in Japan
| Project/Area Number |
20K13509
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| Research Institution | Hitotsubashi University |
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Principal Investigator |
Wang Hongming 一橋大学, 社会科学高等研究院, 特任助教 (20867048)
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| Project Period (FY) |
2020-04-01 – 2022-03-31
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| Keywords | universal insurance / public policy / health |
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| Outline of Annual Research Achievements |
This research exploits the historic onset of universal insurance in Japan to estimate the long-term impacts on health and economic outcomes as well as the inequality across gender. In 1956, the Japanese government launched the universal insurance reform which required all prefectures to expand public insurance and implement universal insurance by April 1961. I focus on the 1956-1965 birth cohorts who were differentially exposed to universal insurance in age 0-5. In these cohorts, exposure to universal insurance was greater for those born closer to 1961 and increased more during the reform in prefectures with lower insurance rates in 1955. Exploiting the policy variations, I find significant impacts of universal insurance on health in prime age. Specifically, a ten percentage point increase in exposure reduced diabetes prevalence rates by 0.89 percentage points and reduced hypertension prevalence rates by 0.85 percentage points. Both effects were concentrated in women. For men, the exposure reduced mortality by 1.1 per 100,000 individuals, driven by the reduction in cancer-related deaths. Exposure further increased women's college education, and the education gain increased women's probability of marrying a college-educated spouse as well as women's employment and earnings relative to men. Within households, the homemaker's role shifted to men as full-time employment increased for women. The impacts on women's socio-economic status suggest that universal insurance could contribute to building an inclusive and equitable society through improved access to social services.
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Research Products
(1 results)
