Research On The Social Medical Insurance Of Japan

Medical insurance originated in Europe, it is the inevitable result of the social development and civilization. It plays a significant role in maintaining the social stability, reducing the losses of diseases and ensuring healthy economical operation. Medical insurance includes social medical insurance and commercial medical insurance. Now most countries are operating the social medical insurance which are managed by the government. The social medical insurance of Japan started in 1922 and achieved universal in 1961.It has been 88 years by now. The social medical insurance of Japan is complex, it has good system construction and the insurance coverage is high, especially the elderly medical insurance in Japan is creative. Plus Japan and China are neighbor so that they have many similarities in culture and social background, and thus China can learn a lot from the social medical insurance to improve its reform in medical insurance.The paper studies the social insurance system of Japan, past and present, and evaluates its performance, pointes out its problems and reforms, then summarizes China's current situation and problems of medical insurance, at last, by comparing the medical insurance in Japan and in China puts forward reform suggestions in our country.This article is divided into six chapters:The first chapter of introduction part introduces the background and the significance of the article, the research technique as well as the domestic and foreign research present situation and so on.The second chapter of introduction medical insurance basic concept, function and related economic theory foundation. The medical insurance is a kind of insurance, it collects the fund which are from the insured payment's insurance premium, and provides the insured people with the economical rescue or the medical services when they fall ill, occur accidents and so on. The medical insurance including the social medical insurance and the commercial medical insurance, the two most main difference lies in the social medical insurance is compulsive implemented by the Official organization; while the commercial medical insurance has the other business insurance general characteristic: The citizen participates voluntarily, and the safeguard level is high. The medical insurance have the positive function in regarding the economic development, the social stability and the civilization . The related medical insurance's economic theory involves the welfare economics theory, the government intervention theory, the public product theory and the information economics theory.The third chapter inspects the Japanese social medical insurance's production and the developing process. According to the insurance's practice and development, I divides it into three stages: the establishment time (early in 20 century -the Second World War), the development time (end of the Second World War - the 1970s) as well as reform time (from the 1980s until now).The fourth chapter is the Japanese social medical insurance's operating mechanism and the achievements appraisal. Japan established the social medical insurance in 1922, and then developed it unceasingly, to 1961 it had realized"all the people are covered by the health insurance". The employee health insurance and the national health insurance compose the whole social medical insurance of Japan, the two parts have covered nearly all citizens (including the foreigners who are living in the Japan). Japanese medical insurance's management system is complex and the division is detailed. The central authorities makes the policies, and each kind of insurance system manages themselves independently. The social medical insurance premium is generally burdened by individual, the enterprise and the government, and the premium rate ranges because the medical insurance is different. Let's look at the payment of the insurance money, the payment content of the insurance money covers widespread, according to different kind of insurances, the payment proportion ranges from 70%-90%; Being different to the ways that our country's insurance payment, Japan's insurance money is directly carries on the relay payment through the special examination payment organization as the third party. Japan's medical service system consists the hospital and the clinic. The hospital divided into the Public hospital and the Private hospital, the overwhelming majority hospital has joined the system of medical insurance, provides the hospitalization and the clinic service for the patients.Regarding the Japanese social medical insurance's achievements appraisal, the article carries on the appraisal from the population life expectancy, the hygienic service resources, the hygienic funds and the health grade of service , and obtains the following results: First, the Japanese population life expectancy ranks No.1 in the world, it can reflect that Japan has high level of medical services; Second, the human resources of hygienic services in Japan are higher than the world average level, but the doctor numbers are insufficient comparing with other developed countries; Third, the government invests much money in the hygienic field, but from the other side, the oversized government expenditure's proportion will also form certain pressure to the government finance. Finally, the Japanese content with the medical service quality as a whole. All in all, the social medical insurance of Japan successful safeguard national's basic health life.The fifth chapter further studies the problems and the reform measures of the social medical insurance of Japan. The aging of populations in Japan is serious, the medical expense rises unceasingly; On the other hand, the economy had been murky in Japan since the bubble economy, and the economic growth rate sometimes even is a negative value, but medical expense's rate of increment has been actually high, the phenomenon results in the medical expense's rise speed surpasses the economical development speed, so creating the huge financial pressure to the government; The Japanese medical insurance system is complex, and various systems are closed operated, thus the financial resource burden is uneven. In view of the above question, Japanese government took a series of measures to carry on deals. Such as establishes the nursing insurance for the senior; Reforms the medical insurance diagnosing and treating reward way, replacing the post payment system by the impress system to control the medical expense; Value prevention health care. These measures have made certain progress. The sixth chapter introduces the medical insurance of China and analyzes its existence problems: The insurance coverage area is small, the safe level is low, the design of the insurance system is unfair. Then, according to the similarities and differences in the medical insurance of Japan and of China, I give some advices on the reform direction of our country's medical insurance by comparative analysis's method. They range from preventing the influence of the aging population on the system, the safe coverage, the government support to the innovation of medical institutions.