An Introduction of Capitation in Medical Care for the Elderly and the Effects on the Medical Sector in a Macro System

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This project was initially started in 1993 under the name, "A Comparative Analysis of Medical Systems between Japan and the U.S." The first phase, the first three years, was the project entitled, "Inefficiency in the Medical Sector in Japan and their Causes: An Econometric Analysis" (The Ministry of Education, Culture, Sports, Science and Technology (MEXT) : Grant No. 05630023). The second three-year phase extended the previous project : "Synthesis and Health Economics Approach to Aging Population.and Medical Care : an Empirical analysis" (MEXT : Grant No. 08630035). The third phase, from 1999 through 2001, was the study, "An Introduction of Capitation into Medical Care for the Elderly and its effects on Medical Sector in Macro System, " (MEXT : Grant No. 11630034).With respect to the third phase of the project, we obtained a number of empirical findings with regard to the Japanese elderly in terms of their demand for medidal care by using different sets of micro data. Further, the medical health check-up system in Japan was also evaluated in terms of cost-containment perspectives. The results | show that there exist quite a number of differentials among the Japanese population in their health check-up demand, and this study also shows what adequate policy targeting at specific groups in occupation, age category and insurance type may be adopted. All research results from, the project were presented at various international conferences held in Canada, England, Sweden, Taiwan, Japan and the U.S. While cultivating rich results from this project for the last three years, the period was to short to complete constructing an economic macro system to study the effects of capitation in the medical sector with regard to the costs of elderly medical care. We will continue this project to meet the current demand for policies to cope with the sharp increase in medical care costs in Japan as well as to improve social welfare.