Health Care Systems in Japan and the United States

1 Overview.- 1.1 Decomposition of Health Care Expenditures.- 1.2 Related Literature.- 1.3 Objective of this Study.- 1.4 Organization of the Monograph.- 2 Demographic Changes in Japan and the United States.- 2.1 Decreasing Fertility Rates.- 2.2 Increasing Life Expectancy.- 2.3 Dependency Ratio.- 2.4 Per Capita Utilization of Health Care Services.- 3 Health Care Services Utilization Profiles Among the Elderly.- 3.1 A Behavior Model of Health Care Services Among the Elderly.- 3.2 The Impact of Need Factors in Services Utilization.- 3.3 Predisposing Factors in Services Utilization.- 3.4 Income of the Elderly as Enabling Factor in Health Care Services Utilization.- 4 Paternalism in Health Care for the Elderly.- 4.1 Case of the U.S. Government.- 4.2 Case of the Japanese Government.- 4.3 Paternalism in the Medical Community.- 5 Trends in Health Care Expenditures and Financing.- 5.1 Trends in Health Care Expenditures.- 5.2 Financing Health Care Expenditures.- 5.3 Financing Health Care for Elderly Japan.- 5.4 Financing Health Care for Elderly U.S.A..- 5.5 Health Care Price Inflation.- 5.6 Financing of Rising Health Care Prices.- 6 Our Approach to the Problem.- 6.1 Productivity and Wages.- 6.2 The Source of Health Care Inflation.- 6.3 Technological Improvements in the Medical Industry.- 6.4 Empirical Estimates of Productivity Growth Rates in the United States and Japan.- 7 The Simulation Model.- 7.1 Simplified Version of Model.- 7.2 Some Basic Concepts.- 7.3 Variables.- 7.4 General Assumptions.- 7.5 Data-specific Initial Conditions.- 8 Simulation Results.- 8.1 The Japanese Case Simulation 1.- 8.2 The Japanese Case Simulation 2.- 8.3 The United States Case Simulation 3.- 8.4 The United States Case Simulation 4.- 9 Alternate Set of Assumptions.- 9.1 Japan: Simulation 5.- 9.2 Japan:Simulation 6.- 9.3 The United States: Simulation 7.- 9.4 The United States: Simulation 8.- 10 Concluding Remarks and Policy Recommendations.- Appendix A Mathematical Specification of the Model.- 1.1

Ryuzo Sato is a C. V. Starr Professor Emeritus of Economics at the Stern School of Business, New York University. He was director of the Center for Japan U.S. Business and Economic Studies at the Stern School. Prior to becoming a Stern faculty member, he was a professor of economics at Brown University. Professor Sato also taught at Harvard University, The University of Tokyo, Kyoto University, and Bonn University. He was the founding chief editor of Japan and the World Economy, an international theory and policy journal. For more than 40 years, Professor Sato has divided his time between Japan and the United States, and he conducts research, gives lectures, and writes on the subject of Japan U.S. relations. Professor Sato, who was a Fulbright Scholar, received his B.A. in economics and his Dr. Economics from Hitotsubashi University in Tokyo, and his Ph.D. in economics from Johns Hopkins University. His principal areas of research interest are mathematical economics and economic growth.