Succession and Change of the Ideas in Health Insurance Policy

Abstract

Hospitalization Preliminary Review Program (HPRP) is the Germany’s Health Insurance System that examines the necessity of hospital treatment in advance. In Japan, HPRP used to be known before WW II that was later abolished. However, lately there have been some discussions on adapting HPRP to Japan in terms of reducing inappropriate hospitalization. This paper aims to analyze the policy decision-making process involving Japan’s HPRP including reference of undisclosed documents. The main findings are as the followings: (1) The Japan’s HPRP was abolished for simplifying administrative business during wartime. (2) Policy-makers in Ministry of Health and Welfare have considered internally adapting HPRP again until 1980s. (3) Due to lesson-drawing in the early of 1990s, Idea (2) has fundamentally been changed. As a result, those who tried to adapt HPRP in 1994 were not existing, therefore Insurer Function Reinforcement still hasn’t achieved.