Abstract
Households and companies bear the burden of insurance contributions in return for government providing services. The burden is imposed collected in the form of insurance contributions based on the conditions of the households and companies. However, not all households and companies are able to pay taxes and social insurance premiums. Having a sufficiently high tax collection rate and insurance contribution payment rate is very important for the government to pay for administrative services.
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- 1.
The payment rates were derived from the Ministry of Health, Labour and Welfare’s “Report on the Status of National Health Insurance Operations.” Here, the payment rates cited are for the insurers of municipalities, partial-affairs associations, and wide-area unions.
- 2.
There are two methods for collecting insurance contributions : the insurance contributions method of collecting them as national health “insurance contributions ,” and the insurance tax method of collecting them as national health “insurance tax.” According to the Ministry of Health, Labour and Welfare’s (2010) “National Health Insurance Operations Report (Operations Annual Report),” slightly under 90% of insurers use the national health “insurance tax” method. Insurers can select the insurance contributions or the insurance tax method, but below they are collectively called “insurance contributions ,” unless otherwise specified.
- 3.
Please refer to Chap. 4 pp. x for non-statutory transfers and previous fiscal year carry-forward funds.
- 4.
Please refer to Sect. 3 of this chapter for a definition of the current year’s payment rate .
- 5.
With regard to the benefit portion of insurance contributions , insurance contributions are partially reduced, mainly for low-income insured persons, through supplementing funds from national revenue . This reduced portion is transferred from municipalities’ general accounts ; three quarters of financial resources are derived from the prefecture and one quarter from the municipality.
- 6.
The insurance contributions portion corresponding to income is income-based contributions and the portion corresponding to fixed assets is assets-based contributions, and these are ability-to-pay contributions, according to the person’s ability to bear the burden. On the other hand, there are also benefit contributions according to benefits, such as equal contributions that are levied on each household and the per capita-based contribution levied on each insured person as an individual. Insurers collect insurance contributions as a combination of these four types.
- 7.
Yamada (1998), Kishida (2002), Izumida (2003), and Yuda (2010) focused on the costs of administrative work and management work in the National Health Insurance, and clarified that economies of scale have an effect on improving the efficiency of finances. Also, as noted in Yuda (2010), many of the studies on the theme of National Health Insurance contributions have focused on the relationship between scale in terms of number of insured persons and financial problems.
- 8.
Yuda (2006) analyzed that National Health Insurance contributions influence non-subscriptions by using the data of “Panel Survey on Consumption Life” of the Institute for Research on Household Economics.
- 9.
This chapter is based on Adachi and Uemura (2013c).
- 10.
From the “Report on the Status of National Health Insurance Operations (Operations Annual Report),” the following were used: “Table 13 Report on the Status of National Health Insurance Operations (Operations Annual Report) Table A,” “Table 14 Report on the Status of National Health Insurance Operations (Operations Annual Report) Table B (1),” and “Table 14–2 Report on the Status of National Health Insurance Operations (Operations Annual Report) Table B (2).”
- 11.
From the implementation of the latter-stage elderly medical care system in April 2008, the categories of latter-stage elderly aged 75 years and above and early-stage elderly with a disability were withdrawn from health insurance and incorporated into the latter-stage elderly medical care system . Therefore, data on the persons in question collected before and after fiscal 2008 shows differences in the “Report on the Status of National Health Insurance Operations (Operations Annual Report) (https://www.e-stat.go.jp/stat-search/files?page=1&toukei=00450396&result_page=1: Browsing date February 5, 2018).” In this chapter, data from fiscal 2008 and onward were used in consideration of the implementation of the latter-stage elderly medical care system .
- 12.
The number of insurers in fiscal 2008 was 1646, and in fiscal 2009 and 2010, it was 1587. In preparing the panel data, the number of insurers in each fiscal year was unified as 1587.
- 13.
The definition of payment rates for the current year’s portion and carried-forward delinquent payments use the calculation formulas actually used by the insurers.
- 14.
In the “Report on the Status of National Health Insurance Operations (Operations Annual Report),” as it is not possible to separate the costs of measures for the collection of payments from “general affairs costs,” in this chapter, “general affairs costs” is used.
- 15.
The reduction rate is determined by the rate of collection of insurance contributions , according to the number of insured persons.
- 16.
The methods for calculating income-based contributions include the resident tax method, the main text method, and the former provisional method, with practically all the insurers adopting the former provisional method. In these methods, the basis for calculating income-based contributions is different. Therefore, in this chapter, data on the insurance contributions rate of income-based contributions of insurers adopting the former provisional method is used for analysis, and data on insurers using the other methods is not adopted. For the future, the policy is to unify the methods into the former provisional method.
- 17.
Insurers adopting an unequal pay-as-you-go system as a result of mergers or other reasons are given a 0 in the insurance contributions data in the “Report on the Status of National Health Insurance Operations (Operations Annual Report).” Therefore, in this chapter, insurers with an unequal pay-as-you-go system were removed from the data set to be analyzed.
- 18.
In this chapter, for taxable income, insurance contributions in the “National Health Insurance Operations Report (Operations Annual Report)” are used. The various forms of insurance contributions include income-based contributions, assets-based contributions, equal contributions, and per capita-based contributions, but income-based contributions are related to the income of the insured person. The basis for calculating income-based contributions are “① taxable income amount (basic deduction),” “② taxable income amount (various types of deductions),” “③ municipal resident tax income-based contributions tax amount,” “④ municipal resident tax amount, etc.,” and “⑤ other.” But in this chapter, data on insurers adopting the method of income after the basic deduction from “① taxable income amount (basic deduction)” was used. The reasons for this were that these data were abundant compared to other data; that from fiscal 2013 onwards, it was decided to unify the methods into the method of income after the basic deduction, and it is also considered to be the most suitable as data on the income of insured persons.
- 19.
Following the introduction in fiscal 2008 of the latter-stage elderly medical care system , the National Health Insurance system is intended for the early-stage elderly aged less than 75 years. So, in this chapter, the effects of population aging on the early-stage elderly rate 】 are analyzed.
- 20.
It was decided to use a logarithmic linear function in order to interpret the coefficients obtained from the estimations as elastic values.
- 21.
For example, Tanaka (2005) and others have pointed to the existence of regional characteristics in payment rates.
- 22.
General affairs costs include the costs of measures for the collection of payments, but data on the cost of measures for the collection of payments could not be established and, therefore, we conclude that its effects on the payment rate could not be detected. Or, while one may suspect that effective measures for the collection of payments are not being carried out, it is not possible to confirm this because of data constraints.
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Adachi, Y. (2018). Analysis of the Payment Rate of National Health Insurance Contributions. In: The Economics of Tax and Social Security in Japan. Springer, Singapore. https://doi.org/10.1007/978-981-10-7176-8_7
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DOI: https://doi.org/10.1007/978-981-10-7176-8_7
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