Utilization of medical service coverage in low-income households

Abstract

Purpose of the Study
The present study aims to clarify the actual situation of utilization of both contributions and benefits of our social security system, focusing on what we call as the pitfall households. We define “pitfall households” as low-income households who do not pay social insurance premiums, but not low enough to qualify for welfare benefits. When a member of the household is sick, they cannot rely on public medical service coverage. If the proportion of pitfall households has increased in recent years, possible countermeasures for this problem should be discussed.
Methodology
To determine the number of such “pitfall households”, we had access to the micro data of the Survey of Redistribution of Income by the Ministry of Health, Labor and Welfare of Japan. Specifically, we identified the pitfall households in the sample in two steps; first we identified the households that had not paid public health insurance premiums, and then identified those that were not receiving welfare benefits. We then compared basic statistics of the pitfall households with the other households. We also conducted probit analysis to identify factors contributing to a household becoming a pitfall household.
Results
According to the results, 12.7% of the sample households were classified as pitfall households. We considered this proportion to be reasonable compared with the results of previous studies. The results of the probit analysis confirmed our hypothesis that liquidity constraint is a factor influencing non-coverage of medical services. We also found that unstable employment increased the probability of a household becoming a pitfall household. Conversely, larger households and households led by single mothers had a lower probability of becoming pitfall households. In a sub-sample that included only households below the poverty line, the probability of being a pitfall household showed an inverse correlation with the age of the head of the household.