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1. The Political Process Involved in Formulating Healthcare Policy in Japan: With a Particular Focus on Advisory Councils, Interest Groups and Medical Officers

Author:
Yukio Sakurai
Publication Date:
01-2025
Content Type:
Journal Article
Journal:
The Rest: Journal of Politics and Development
Institution:
Centre for Strategic Research and Analysis (CESRAN)
Abstract:
Japan’s healthcare policy is defined by a universal health insurance system that guarantees affordable healthcare for all citizens at any time and in any location. The system was established in 1961 and has since undergone a process of evolution through the implementation of national healthcare policies. Despite the existence of conflicts and issues, the mechanism of the Central Social Insurance Medical Council (“Chuikyo”) has continued to advance national healthcare interests. Nevertheless, this resulted in the commencement of criminal proceedings in 2004. The current demographic shifts present a challenge to the long-term sustainability of the national health insurance system, the long-term care insurance system, and the public pension system. This is occurring against a backdrop of rising costs associated with healthcare and long-term care, as well as an unsustainable national budget. The Chuikyo system is confronted with a multitude of challenges. This paper analyses the roles of three key actors in the Japanese national healthcare policy-making process. These actors include advisory councils such as Chuikyo, interest groups such as the Japan Medical Agency, and medical officers of the Ministry of Health, Labour and Welfare, who play a pivotal role in the policy-making process. The incremental improvements that Chuikyo produces are insufficient to address the long-term challenges facing the national healthcare policy. Japan’s healthcare model requires reconstruction to align it with the needs of an ageing society with a declining birthrate. Prior to embarking on this important policy work, it is essential to determine who should lead it. It is recommended that the Prime Minister and the Cabinet Office spearhead a study on radical reform, with strong political leadership and a capable technocrat team to facilitate collaboration with the National Diet and the public. Furthermore, it would be crucial to achieve a consensus through national forums on the fundamental concepts that citizens, as consumers, desire and are prepared to forego from a bottom-up approach. It is essential that the governance structure of the national healthcare system is changed to a decentralised structure so that citizens can be proactively involved in healthcare issues and make autonomous decisions.
Topic:
Politics, Insurance, and Healthcare System
Political Geography:
Japan and Asia

2. How Well Does Korea's Employment Insurance System Support Workers Facing Trade Shocks?

Author:
Kyong Hyun Koo
Publication Date:
05-2023
Content Type:
Working Paper
Institution:
Korea Institute for International Economic Policy (KIEP)
Abstract:
This study uses worker-level longitudinal panel data and trade data to conduct an analysis of the performance of Korea's employment insurance system in supporting trade-affected workers. We find that the rapid economic growth of China and Vietnam since the 2000s has subjected some Korean industries to heightened import competition. The Korean workers who were employed in these industries in their earlier careers tended to experience a long-term (10-year) decline in the growth rate of labor income and a relative deterioration in their employment security as the probability of involuntary job separation increased. With an increased probability of involuntary job separation, workers in import-competing industries were more likely to receive unemployment benefits. This implies that the unemployment benefit system in Korea was relatively effective in the short term to alleviate employment shocks triggered by trade shocks. Nevertheless, the trade adjustment support function of the unemployment benefit system had certain limitations in that the receipt of unemployment benefits could not ultimately counteract the downward trend in long-term labor income for workers in import-competing industries. In contrast to unemployment benefits, government-supported vocational training holds the potential to increase the long-term earnings of workers more exposed to import competition. However, workers employed in import-competing industries were not more likely to participate in government-supported vocational training; on the contrary, workers in export-expanding industries were more likely to participate in government-supported vocational training. This finding implies that the jobs of workers in import-intensive industries were less likely to be covered by employment insurance than those in export-intensive industries. Consequently, workers in import-intensive industries, who are at greater risk of trade shocks, may be less safeguarded than their counterparts in export-growing industries under the prevailing employment insurance system.
Topic:
Economics, Employment, Trade, and Insurance
Political Geography:
Asia and South Korea

3. Networks and Misallocation: Insurance, Migration, and the Rural-Urban Wage Gap

Author:
Kaivan Munshi and Mark Rosenzweig
Publication Date:
09-2015
Content Type:
Working Paper
Institution:
Institute for New Economic Thinking (INET)
Abstract:
We provide an explanation for the large spatial wage disparities and low male migration in India based on the trade-off between consumption-smoothing, provided by caste-based rural insurance networks, and the income-gains from migration. We provide an explanation for the large spatial wage disparities and low male migration in India based on the trade-off between consumption-smoothing, provided by caste-based rural insurance networks, and the income-gains from migration. Our theory generates two key empirically-verified predictions: (i) males in relatively wealthy households within a caste who benefit less from the redistributive (surplus- maximizing) network will be more likely to migrate, and (ii) males in households facing greater rural income-risk (who benefit more from the insurance network) migrate less. Structural estimates show that small improvements in formal insurance decrease the spatial misallocation of labor by substantially increasing migration.
Topic:
Migration, Income Inequality, Urban, Rural, Caste, Insurance, Redistribution, Wage Growth, and Wealth
Political Geography:
India and Asia