It is generally observed that the physical capability tapers off according to aging among the elderly people. We can describe this process by the application of the concept of health capital. We assume that the health capital of the elderly continues to depreciate at the rate of δ. Thus the health capital of the elderly at time t is written as below.
H_t=(1−δ) H_o
where H_o stands for the level of health capital when people are healthy.
When people get older，some of them need physical cares as well as health care. In this paper the demand for health care and elderly care is derived by the maximization of utility function of the elderly that incorporates the rate of depreciation of health capital. This enables us to analyse how the ratio of health care expenditure to the elderly care expenditure will change according to the future aging under the regime of the elderly care insurance system introduced in 2000.

Moving elderly inpatients needing nursing care from hospitals to long-term care facilities is of great policy concern in Japan. We analyzed whether the introduction of public long-term care insurance in 2000 had any effect on these elderly inpatients. A log-logistic hazards model is used to estimate the conditional probability of hospital discharges for elderly inpatients between 1998 and 2003. Our empirical宣ndingsindicate that increases in the number of beds in long-term care facilities significantly increased the hazard of discharges of these elderly inpatients from hospitals. This effect was accelerated by the revision of medical service fee schedules in 2002 in which hospitals were charged a 15% penalty for inpatients hospitalized for 180 days or more.

This paper examines the style of the competition on hospital market in Japan and to submit one of the backgrounds for the judgment on the reformation of policies for promoting competition. The paper examined whether it is a “quality competition” or“quasi-price competition” on Japanese hospital market. This paper would be a first empirical analysis of Japanese hospital markets from the view point of Industrial Organization Paradigm.
We constructed unique micro database of Japanese private hospitals by questionnaire survey. According to the micro data analysis by 2SLS in this paper，we find that the results of this analysis show a clear inverse correlation between profit margin and competitiveness of the market. This would imply that standard Industrial Organization paradigm，the hypothesis “competition lowers prices”，would not be applicable for the private hospitals in Japan.
We think that hospitals compete by mainly quality level of hospital service and try to attract patients with high sensitivity of the quality (or amenity). We think private hospitals can get higher profit margin by providing high quality (or amenity) and density service. In short, more competitive hospital market would induce higher quality of hospital service rather than lower cost of the service.
These findings imply that policies for promoting competition in Japanese hospital market would cause both quality improvement and medical cost inflation.

The long-term care (LTC) insurance was introduced in 2000 as the element of fifth social insurance. Seven years have passed after the introduction, but little attention has been paid for the distributional aspects of the LTC insurance. In this paper, we investigated the equity of access to the LTC, controlling for the need for the LTC and especially focusing on whether the system favors high-income groups.
LTC is not necessarily as vital as service as health care. A certain portion of LTC services constitute light housekeeping services, and the policy makers have concerned about a possibility of these being overused, particularly by people from higher-income groups.
The LTC insurance system has increased people’s ability to purchase services, since requires a co-payment of only 10% subject to a cap on overall cost which is, itself determined by the needs of the person concerned. However, for people with low incomes, this co-payment might be still expensive and might reduce their demand for LTC services.
In our analysis, we used the micro data set the “Comprehensive Survey of the Living Condition of the People on Health and Welfare (2001)” that was collected by the Ministry of Health, Labor, and Welfare. This captured about 3,500 people entitled to the LTC services. Based on probit model and concentration curve analysis of the data, we have three findings:
1. The gap between “needs” and “actual usage” of the LTC is quite small between the income groups, and it means that the LTC insurance achieves a horizontal equity of access care services.
2. Although the “need” or“actual usage” as a percentage of income is higher for people with lower incomes than for people with higher incomes, as a whole, LTC insurance succeeded in boosting the ability of low-income people to purchase or access care services. This is because, when account is taken of in-kind assistance as cash transfers, it contributed to an equalization of the income distribution among older disabled people.
3. The upper limit of the LTC service provision is appropriately designed in terms of excess usage, except the limit for care required level 1. For those who are entitled to care required level 1, the limit is too high. Additionally, excess usage was observed amongst the people with cognitive impairment, and it would be desirable to take account of their special needs, when the limit was set.

The purpose of this paper is the analysis on the following two hypotheses; the first one is whether individuals whose fathers are private medical practitioners succeed their father’s status，and the second one is whether individuals who are private medical practitioners have the expectation that they want their child to succeed their status.
The results obtained from the current study can be summarized as follows. The first one is supported significantly. Individuals whose fathers are private medical practitioners and individuals who are the eldest son of the private medical practitioners are significantly more likely than others to choose the same medical practitioners as their fathers. But the second one is not supported significantly. Individuals who are private medical practitioners have the expectation that they want their sons to follow their footsteps significantly，but do not have the expectation that they want their daughters to follow their footsteps.