Research Paper Series 2004

(No.21:July 2004)

Public Expenditures for Equal Access to Health Care

Hisao Endo*, Naoya Fujihara and Takahito Kushi

  The public health insurance system not only reduces the risk of disease but also assures equality of access to medical treatment even for high-risk and low-income groups by keeping the level of co-payment low. The purpose of this study was to examine how the public health insurance system influences equality of access to medical treatment. Specifically, the system's association with healthcare expenditure per GDP and regressiveness of co-payment was analyzed.

  In this study, empirical analyses of OECD countries suggest that a public health insurance system is effective in reducing healthcare expenditure per GDP. Moreover, in seven countries (other than Germany and the Netherlands, where high-income groups are either not allowed or not required to participate in the public health insurance system), public health insurance reduces the regressiveness of the citizens' economic burden and enhances the low-income group's access to medical treatment .

*Faculty of Economics, Gakushuin University

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