TY - JOUR
T1 - Inefficiencies in the Japanese National Health Insurance system
T2 - A stochastic frontier approach
AU - Yuda, Michio
N1 - Funding Information:
I would like to thank Yoshihiro Kaneko, Hiroyuki Kawaguchi, Masayoshi Hayashi, and Atsushi Yoshida, along with three anonymous referees, for their useful comments and suggestions. This study is financially supported by the Health and Labour Science Research Grant (Policy Sciences Promotion) ( #H22-Policy-General-018 ) from the Ministry of Health, Labour and Welfare in Japan and the Grand-in-Aid for Young Scientists (B) ( #26780180 ) from the Japan Society for the Promotion of Science . Any remaining errors are my responsibility.
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - In this study, I examine the cost inefficiency and production inefficiency of municipal insurers operating under the Japanese National Health Insurance system. I employ insurer-level panel data for 2005 and 2010 and adopt stochastic frontier cost and production models to overcome analytical problems encountered in previous studies. The cost frontier estimates indicate that adverse effects on efficiency are associated with aging of the insured population, soft budget constraints due to government subsidies, insurer contributions to the elder care systems, and an increase in care provider densities. A positive effect on efficiency is associated with an expansion in insurer scale. The production frontier estimates suggest that cost inefficiencies decreased by roughly 15 percent between 2005 and 2010. The correlation between cost inefficiency and technical inefficiency is not particularly strong, whereas the correlation between cost inefficiency and allocative inefficiency is strong and positive.
AB - In this study, I examine the cost inefficiency and production inefficiency of municipal insurers operating under the Japanese National Health Insurance system. I employ insurer-level panel data for 2005 and 2010 and adopt stochastic frontier cost and production models to overcome analytical problems encountered in previous studies. The cost frontier estimates indicate that adverse effects on efficiency are associated with aging of the insured population, soft budget constraints due to government subsidies, insurer contributions to the elder care systems, and an increase in care provider densities. A positive effect on efficiency is associated with an expansion in insurer scale. The production frontier estimates suggest that cost inefficiencies decreased by roughly 15 percent between 2005 and 2010. The correlation between cost inefficiency and technical inefficiency is not particularly strong, whereas the correlation between cost inefficiency and allocative inefficiency is strong and positive.
KW - Cost inefficiency
KW - Decomposition of cost inefficiency
KW - Japan
KW - Japanese National Health Insurance system
KW - Stochastic frontier model
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U2 - 10.1016/j.asieco.2016.01.001
DO - 10.1016/j.asieco.2016.01.001
M3 - Article
AN - SCOPUS:84955311137
VL - 42
SP - 65
EP - 77
JO - Journal of Asian Economics
JF - Journal of Asian Economics
SN - 1049-0078
ER -