Health Spending in Japan: Macro-Fiscal Implications and Reform Options

40 Pages Posted: 27 Aug 2014

See all articles by Masahiro Nozaki

Masahiro Nozaki

International Monetary Fund (IMF)

Kenichiro Kashiwase

University of Michigan at Ann Arbor

Ikuo Saito

International Monetary Fund (IMF)

Date Written: August 2014

Abstract

Health spending has risen rapidly in Japan. We find two-thirds of the spending increase over 1990–2011 resulted from ageing, and the rest from excess cost growth. The spending level will rise further: ageing alone will raise it by 3½ percentage points of GDP over 2010–30, and excess cost growth at the rate observed over 1990–2011 will lead to an additional increase of 2–3 percentage points of GDP. This will require a sizable increase in government transfers. Japan can introduce micro- and macro-reforms to contain health spending, and financing options should be designed to enhance equity.

Keywords: Health care spending, Japan, Aging, Fiscal policy, Public health, Fiscal reforms, health spending, long-term care, health care, capita health spending, budget caps, health system, public health spending, price controls, health insurance, long-term care spending, private spending, public spending, demand for health care, health care system, health care providers, hospital beds, public health insurance, insurance system, demand for health, public insurance, fee-for-service, pocket payments, public insurance system, public hospitals, health providers, health care systems, health care reforms, price control, care systems, elasticity of health care, public long-term care insurance, risk factors,

JEL Classification: H51, I10, I13, I18

Suggested Citation

Nozaki, Masahiro and Kashiwase, Kenichiro and Saito, Ikuo, Health Spending in Japan: Macro-Fiscal Implications and Reform Options (August 2014). IMF Working Paper No. 14/142, Available at SSRN: https://ssrn.com/abstract=2487900

Masahiro Nozaki

International Monetary Fund (IMF) ( email )

700 19th Street, N.W.
Washington, DC 20431
United States

Kenichiro Kashiwase

University of Michigan at Ann Arbor ( email )

500 S. State Street
Ann Arbor, MI 48109
United States

Ikuo Saito

International Monetary Fund (IMF) ( email )

700 19th Street, N.W.
Washington, DC 20431
United States

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