The Effect of Programs to Reduce Health Care Cost for Children on Parental Behavior

Abstract

The paper analyzes the parental behavior of refraining from using health care services for children in Japan. Using parent-answered questionnaire which asked “in the past year, have you ever refrained from seeking health care for children in times of sickness?” from three prefectures, the paper analyzes the association of health cost reduction programs and health service usage. In Japan, the co-payment of health care cost by public health insurance is 30％, but some municipalities provide entire amount of co-payment for children, making the health cost virtually free, while others charge only nominal amount（200-500 yen）, and some others do not provide any. In some municipalities, parents have to pay 30％ at doctor’s office and later the amount is reimbursed from municipality, and in others, they do not have to pay up front. The analysis was conducted for two-parent households with Grade 5 and Grade 8 children. The results show that parents of Grade 8 children living in municipalities with no financial help or municipalities that reimburses the cost later are twice likely to refrain from using health care services compared to those living in municipalities which provide free, up front, health care for children. The results are stronger for households with low economic status. For parents of Grade 5 children, only those with low economic standing exhibited signs of effects from municipalities’ programs on health care costs for children.