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Research Areas & Themes ( 2017 ): Social Issues

International comparative research on healthcare reform

Project Leader
Research Objective We will search for useful hints for Japan's healthcare reform by studying specific approaches to healthcare reforms taken by other countries. Under the amended Medical Care Act and Medical Insurance Act, which were enacted in 2014 and 2015, a regional healthcare scheme has been established in each prefecture, and Japan has seen accelerated activities toward 2025, the target year of the healthcare reform. The healthcare community has begun to experience confusion because the reform will inevitably lead to a large reduction in the number of hospitals and bring a downward revision of medical fees in 2018 or beyond. To address these issues, this project analyzes key points of controversy on the healthcare reform and makes recommendations.
Project Overview (1) Collect and analyze FY 2016 financial statements of all social healthcare corporations to pose a question to the medical fee revision in April 2018.
(2) Give specific shape to the proposal for a two-tier public medical insurance system, which was presented at the December 2016 symposium, titled "Discussion Points on Fiscal Risk and Options for the Public," through re-examination of systems in other countries.
(3) Based on the identified issues for discussion on the consolidated accounting system for the formation of an integrated non-profit healthcare network of medical, nursing and welfare service providers, exchange views on ways to implement the system with those concerned and seek to realize it. Conduct research while exchanging opinions with experts in the Japanese Institute of Certified Public Accountants.

Research on reform of the social welfare service corporation system

Project Leader
Research Objective The amended Social Welfare Act, which came into force in March 2016, provides for the construction of a financial database of approximately 20,000 social welfare corporations (SWCs). Meanwhile, ways to secure nursing care and child care workers (i.e. revenue source to raise their salaries) have become a major political concern. The project continues to focus on making policy recommendations on a desirable model for SWCs.
Project Overview (1) Having being reappointed as a member of the Welfare Working Group, Social Security Council, for the term ending around August 2018, the project leader has secured an opportunity to make policy recommendations publicly.
(2) The project will collect and analyze FY 2015 financial statements of SWCs by April 2017 in order to submit opinions on the issue of the revenue source to raise the salaries of nursing care and child care workers and the 2018 revision of nursing care fees.

Research on population health

Project Leader
Research Objective Lowering healthcare costs through disease prevention is an important theme of the healthcare reform in Abenomics. This is also the case with other countries' healthcare reforms. However, Japan lags behind in accumulating know-how in population health, which uses specific preventive techniques based on healthcare databases. We will examine the situation outside Japan and provide helpful information.
Project Overview Population health is characterized by the concept of curbing healthcare expenses, while improving the health of the entire population, not just by healthcare systems but also through broader approaches that address such social systems as relief for the poor and education. In other words, inequality has attracted the attention of even developed countries as a key impediment to improving the health of the overall population. This project focuses on inequality issues from the viewpoint of population health.

Policy-driven introduction of health technology assessment: Japan's choice and global strategy

Project Leader
Collaborator(s) Makoto KOBAYASHI (Director and Chief Operating Officer, Crecon Medical Assessment Inc.), etc.
Research Objective In a new approach to health technology assessment (HTA), the Ministry of Health, Labour and Welfare's Central Social Insurance Medical Council introduced in April 2016 a drug pricing system that considers cost-effectiveness on a trial basis. The Abe Cabinet has already stated in the 2014 revision of the Japan Revitalization Strategy that the approach of HTA for cost-effectiveness evaluation should be further explored for the new system as being a set policy line of the government.
Therefore, this project will critically appraisee the new HTA system, identify the issues for challenge, and conduct research and education to address them from international perspectives. In particular, our annual international HTA symposium will be expanded and enhanced to take the form of HTA training seminars in Japan and abroad.
The Asia-Pacific Conference of ISPOR, an international society that leads the world in research on cost effectiveness, will come to Tokyo in September 2018. To prepare for this event, we will conduct research on "value-based" policy and system building, and also boost network formation in HTA in collaboration with the international communities, especially with Asian countries.
Project Overview Specific projects are planned as follows:
(1) Research and analysis: Cost-effectiveness analysis and innovation assessment for new drugs, etc.
(2) Publication of papers and books: We report our research findings in HTA-related journals in Japan and abroad, and publish technical books on HTA in English. We also publish a paperback book for general readers to clarify the myth and crisis of Japanese healthcare , and further suggest the need for value-based approach.
(3) Domestic/international HTA training programs: The program will be co-hosted with the University of Tokyo. One-year training program is held as a domestic one for about 30 working adults as participants, and aims to develop certified HTA experts. International one will be short and intensive workshop for about 20 professionals from industry, government or academia in Japan and elsewhere in Asia, which aims to build a global network.
(4) The CIGS-HTA Research Interest Group to be continued: The Group will discuss practical and real-world issues with which the HTA specialists in charge of economic evaluations would face under the new HTA system of MHLW introduced in FY 2016 on a trial basis.

Research on the rebuilding of local government finances and potential factors for their future deterioration

Project Leader
Research Objective Under the current economic circumstances, local governments need to be increasingly independent in their administration. The project aims to acquire insights for the future through a survey of local governments that experienced financial difficulties and found a way out of them.
Project Overview The project has identified typical processes for these local governments to fall into financial difficulty and has related them to national policies. We will focus on factors and deepen the studies. The project will also study public assistance, which can be a factor of future deterioration of public finances. We develop a new form of fiscal discipline with public accounting.

Research on tax administration reform

Project Leader
Research Objective Japan and other advanced nations are searching for efficient and streamlined tax administration. The aim of our research is to understand efforts made by other countries (e.g., information technologies used and regulations imposed) and help Japan incorporate them into its tax system.
Project Overview The project will obtain the latest information through the international conferences. We will make proposals on innovative tax administration.

Research on Japan's healthcare and welfare finances and the UK's healthcare finances

Project Leader
Research Objective Healthcare expenses are a major fiscal challenge for Japan. We will study facts about Japan's and UK’s healthcare finances. With an awareness of the need to research the financial aspects of welfare, the situation of welfare in Japan will be studied as well.
Project Overview The research on the UK's healthcare focuses on healthcare finances under the current Conservative Party administration. For Japan's healthcare finances, municipal government officers will be interviewed to study how to prepare for the incorporation of clerical work for the National Health Insurance into prefectural governments with attention to the National Health Insurance tax and fee.

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