Local Government Financing of Health Insurance and the Revitalization—Facilitating Migration of the Elderly
The decline in Japan’s birth rate, the most rapid in the world, and the aging of its population are not uniform throughout the country. The number of elderly residents of Japan’s regional areas has already begun to decline, while those numbers in Tokyo and other large cities will surge in the future. Because prices are regulated in Japan’s medical and nursing care sectors, we cannot rely on the adjustment of supply and demand based on the price mechanism. The Japanese government should implement measures to correct the uneven regional distribution on the demand side by promoting migration of the nation’s elderly population to regional areas. This chapter proposes reforms to the National Health Insurance and nursing care insurance systems, which currently hinder the movement of Japan’s elderly citizens to regional areas.
KeywordsRegional revitalization National Health Insurance Long-term care insurance Soft budget constraints Regulatory reform Risk adjustment
- Hatta, Tatsuo (1996), “Remark,” in Hatta, T. et al. (eds.), Fukushi wa Toushi Dearu (Welfare is an Investment), Nihon Hyoron Sha Press, pp. 172–173.Google Scholar
- Hatta, Tatsuo (2015), “Chiho soseisaku o tou (Ge): Iju shoheki teppai koso senketsu (Scrutinizing the Regional Revitalization Policy (Part 2): The First Issue is the Removal of Barriers to Internal Migration),” Keizai Kyoshitsu, Nihon Keizai Shimbun Morning Edition, February 6, 2015 (in Japanese).Google Scholar
- Hatta, Tatsuo (2018), “Provision of National Health Insurance “Model Benefits” to Japan’s Prefectures,” in T. Hatta (ed.), Economic Challenges Facing Japan’s Regional Areas, Plagrave Macmillan, pp. 115–128.Google Scholar
- Hayashi, Masayoshi (2018), “Health Care, Long-term Care, and Local Public Finances: Intergovernmental Financing of Social Insurance Programs,” in T. Hatta (ed.), Economic Challenges Facing Japan’s Regional Areas, Plagrave Macmillan, pp. 103–113..Google Scholar
- Iwamoto, Yasushi (1996), “Shian: Iryohokenseido Ichigenka (Designing an Integration of Health Insurance Groups),” Nihon Keizai Kenkyu (JCER Economic Journal), No. 33, November, pp. 119–142 (included in Hatta, T. and Yashiro, N. (eds.) (1998), “Shakaihoken Kaikaku (Social Insurance Reforms),” Series Gendai Keizai Kenkyu Vol. 16 (Contemporary Economic Study Series Vol. 16), Nihon Keizai Shimbun) (in Japanese).Google Scholar
- Iwamoto, Yasushi (2018), “Designing New Systems Through Risk Adjustment,” in T. Hatta (ed.), Economic Challenges Facing Japan’s Regional Areas, Plagrave Macmillan, pp. 99–102.Google Scholar
- Japan Policy Council (2014), Sutoppu shoshika / chiho genki senryaku (Strategies for Boosting Japan’s Birth Rate and Reviving its Regions), May 8, 2014 (www.policycouncil.jp/pdf/prop03/prop03.pdf) (in Japanese).
- Suzuki, Wataru (2015), “Shakai hosho kaikaku no shiten (Jo): “Kongo kaigo” de rodoryoku kakuho o tokuyo no toji kaikaku isoge koreisha no chiho iju o sokushin (Perspectives on Social Security Reform (Part 1): Secure a Labor Force for “Mixed Care” and Reform the Administration of Intensive-care Old People’s Homes to Encourage the Movement of the Elderly to Japan’s Regions),” Keizai Kyoshitsu, Nihon Keizai Shimbun Morning Edition, April 6, 2015 (in Japanese).Google Scholar