Japan: achieving UHC by regulating payment

Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries

When the Japanese government adopted Western medicine in the late nineteenth century, it left intact the infrastructure of primary care by giving licenses to the existing practitioners and by initially setting the hurdle for entry into medical school low. Public financing of hospitals was kept minimal so that almost all of their revenue came from patient charges. When social health insurance (S...

UHC Presents Universal Challenges

Achieving Budget-Balance with Vickrey-Based Payment Schemes in Exchanges

Generalized Vickrey mechanisms have received wide attention in the literature because they are efficient and strategyproof, i.e. truthful bidding is optimal whatever the bids of other agents. However it is well-known that it is impossible for an exchange, with multiple buyers and sellers, to be efficient and budget-balanced, even putting strategy-proofness to one side. A market-maker in an effi...

Approaches to Regulating Interchange Fees in Payment Systems

Significant attention worldwide has been paid to the regulation of credit card interchange fees. In part, this attention has followed concerns expressed about the level of these fees in Europe, the U.S. and Australia. The Reserve Bank of Australia recently conducted an extensive inquiry into the interchange fees associated with credit cards and has moved to regulate those fees. At the same time...

An analysis of the new medical payment system in Japan

Based on the report of the Central Social Insurance Medical Council concerning the 2002 Revision of the Medical Service Fee Schedule, a new inclusive payment system was introduced in 82 special functioning hospitals (university hospitals, National Cancer Center, National Cardiovascular Center) in Japan in April 2003. Beginning in April 2004, the system was gradually extended to general hospital...