2012 Volume 23 Issue 2 Pages 129-145
We identified the factors contributing to the non-payment of Japan’s National Health Insurance premiums, by taking into account the counterfactual willingness to pay if the insurance was made voluntary.
We found that, in general, income had little effect but low financial assets weakened the willingness of people to pay premiums. Also, unemployed and irregularly employed persons often fell into arrears with their health insurance premiums despite their high counterfactual willingness to pay. Thus unstable employment appears to increase the arrears by increasing the individual’s economic uncertainty. In addition, adverse selection was observed with respect to the subjective health and BMI; poor subjective health encourages the actual payment behaviors, by increasing the hypothetical willingness to pay. Finally, arrears in payment were found to be less for those who have the knowledge of the “Upper-Limit of the Individual Out-of-Pocket Payment in the National Health Insurance,” even though their hypothetical willingness to pay is low. Thus, it is expected that arrears in payment will decline when people are informed of the benefits of the upper-limits system in spite of the compulsory participation in Japan’s National Health Insurance.
