Public Views of Health Insurance in Japan During the Era of Attaining Universal Health Coverage: A Secondary Analysis of an Opinion Poll on Health Insurance in 1967

摘要

While Japan's success in achieving universal health insurance over a short period with controlled healthcare costs has been studied from various perspectives, that of beneficiaries have been overlooked. We conducted a secondary analysis of an opinion poll on health insurance in 1967, immediately after reaching universal coverage. We found that people continued to face a slight barrier to healthcare access (26.8% felt medical expenses were a heavy burden) and had high expectations for health insurance (60.5% were satisfied with insured medical services and 82.4% were willing to pay a premium). In our study, younger age, having children before school age, lower living standards, and the health insurance scheme were factors that were associated with a willingness to pay premiums. Involving high-income groups in public insurance is considered to be the key to ensuring universal coverage of social insurance.Significance for public healthIn our best knowledge, this is the first study describing perspectives from beneficiary of health insurance in Japan when it reached universal population coverage. This secondary analysis of opinion poll on health insurance in 1967 found that people in Japan in the date still facing slight barrier to access medicine (26% felt medical-expense as heavy burden and 60% weren't willing to see doctor unless very severe illness) and high expectation for health insurance (60% satisfied with insured medical services and 80% were willing to pay premium). The strongest predictor for willingness to pay premium was scheme of insurance, probably due to difference of copayment. Japan reduced copayment for insured of National Health Insurance to make it equivalent to other scheme.