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Standards of Health Insurance (Classic Reprint) I. M. Rubinow
In 1958, the 1938 law was revised to include the remaining 30 percent of the population not previously coveredBoth systems are financed by a large number of employer-based private insurance plans in addition to public insurance for the poor and the elderlyIn the early 1970s, financing and the impact of cost sharing took center stage in the national health care debateKeelerWould pairing some form of cost sharing and managed care allow us to exploit cost sharing’s benefits (reduced costs and unnecessary care, small overall health effects) while avoiding its negatives (reduction in needed care, some health effects for poorer and sicker patients)? The study suggested that cost sharing should be minimal or nonexistent for the poor, especially those with chronic disease6These figures are taken from documents provided by representatives of the Ministry of Health and Welfare in New York (JETRO)
Research conducted by RAND Health 1 ranking on health status at a cost that is among the lowest of wealthy industrialized nations?2 In addressing this question, we begin with a comparative analysis of health care resources and the use of medical care in Japan, the United States and other OECD countriesLearning from comparative experience Cand Were Admitted to Hospitals Less Often SOURCE: Newhouse and the Insurance Experiment Group, 1993, Tables 3.2 and 3.3The largest share of health care financing in Japan is raised by means of compulsory premiums levied on individual subscribers (34.6 percent) and employers (21.7 percent).3 This employment-based share of health care financing in Japan (56.4 percent) raised by means of voluntary employer, employee and individual subscriber premiums in the United States (Figure 1)Managed care has become more prominent, as has prescription drug use
The United States and Japan face similar problemsPREFACE Health care has emerged as perhaps the most urgent issue in America, and health care reform as the most ambitious initiative in domestic policy since the New DealAssociate Professor and Director Division of Health Economics International Leadership Center on Longevity and Society (U.S.) Mount Sinai Medical Center International study is gaining recognition as a useful method of inquiry into questions of how best to allocate national resources to improve healthCited by Kobayashi and Reich (1992)RAND PDFs are protected under copyright law22
(1992)Proposals for change will be evaluated in comparison to the base case8Cash benefit payments, although they vary between plans, are generally sufficient to cover the costs of childbirth4J8Ikegami (1992a)
With the economic growth of the 1960s came demands for the expansion of social benefits that could not be ignoredIncreasingly, the public perceives these facilities as preferred sites for receiving medical careThe United States is a federal system whose 50 states have significant autonomy on matters of health insurance and public health policiesFigure 1Finally, the experiment examined whether shouldering more of their own health care costs leads people to take better care of themselvesAlthough Japan has one of the lowest physician-to-population ratios among OECD countries (Appendix 1, Table 3), at 12.9, Japanese doctors have the highest number of physician contacts per capita, more than twice the American rate Lessons for the United States DOn the contrary, among OECD countries, Japan has the highest number of computerized axial tomography (CT) scanners per capita, the highest number of extra-corporal shock wave lithotriptors per capita, and the highest number of patients per million treated for end-stage renal disease failure.5 In addition, Japanese spend more than any other nation on drugs as a percent of total health expenditures, more than twice the American rate.6 Japanese doctors' clear preference for non-invasive procedures is demonstrated by the kinds of medical technologies imported and exported 07f867cfac