THE ASIAN WOMAN IN AMERICA

Both females and males, regardless of their racial ethnic group, are seriously limited in their information about Asian women. Far too often the system educates individuals about race and sex as two distinct and separate categories. Consequently, Asian women, as well as other women of color, are viewed either as members of their ethnic group or their sexual group, and rarely as members of both groups simultaneously. This paper presents an overview of the historical context and the present-day status of Asian women in America as well as implications for education and change

On Geographic Inequality in Japanese Regional Health Insurance

In Japan, economic stagnation due to the lack of aggregate demand has hit the regional health insurance system and this affects most retired pensioners. The fiscal state of insurers in rural areas deteriorated. This paper aims to investigate whether the regional disparities in medical levies per household make a contribution to income-related geographic inequalities in health care financing. Data of the central two regions of the Japanese National Health Insurance in 2005 were extracted. Their share of population was about 41.5 percent. Retired employees and self-employed individuals are covered by this insurance system. We conducted the geographic decomposition using the concentration index. The within-area inequality in medical levies mainly accounted for geographic inequality in medical levies per household. The hypothesis that there was no between-area inequality in medical levies was not rejected. We revealed the differences in the within-area inequality in medical levies in the central Kanto. This means such proportionality was not built into the NHI system through near constant contribution rates across the distribution of living standards. It can be considered that the differences in the within-area inequality were caused by the inequality in income per household and the multiplier of income levies. We found that income per household, the standard land price of residential districts and the size of an insurer are major determinants of the multiplier of income levies. The higher land price tends to greater the multiplier of income levies. The expansion of insurer's size increases the multiplier of income levies in most of districts. The inequality in the multiplier of income levies will reduce if local governments raise per-household levy in proportion to the size of an insurer and lower the multiplier of income levy.Decomposition, Inequality, Japan, Medical Levies, National Health Insurance

Introduction New Challenges in New Economic Geography

Developing countries, Developed countries, Economic geography, Econometric model

On the Long-Run Equilibrium Relationship among Health Care Expenditures, Public Pension and Social Insurance Burden Rate in Japan

Despite a decrease in the number of working generations supporting Japan's social security system, the relationship between public pension benefits and health care expenditures since the inception of universal health insurance system has not been explored. We obtained one stable long-run equilibrium relationship among those three variables over the period from 1966 to 2002. We employed the forecast error variance decomposition to examine the determination of social insurance burden rate. It is found that health care shock was important for the long-run determination of social insurance burden rate. Because it appears that a free health service system for the elderly (health care shock) caused the increase in the doctor's consultation, we estimated the health care function to analyze price policy in the health care sector. We finally accepted the dynamic OLS model with lead lags as an aggregated health care function. The price elasticity of health care has declined in absolute value since the universal health insurance system started, and it has been around 0.6 since the early 1980s. The policy which eliminated health care fees for the elderly in the 1970s was a mistake since the elderly increased their health care expenditures. The out-of-pocket expenses for health care of the elderly should have been raised in the 1970s.cointegration, dynamic OLS, price elasticity of health care, variance decomposition, vector error correction model

The Effect of Cost Containment on the Outpatient in Japan: A VAR Approach

This paper examined the effects of restrictions on both the demand and supply sides of the health sector in Japan over a certain time period. Because the effect of supply side restrictions could not be taken into account in previous studies, we employed econometric time series techniques to develop a four-variable VAR model of the health sector over a sample period from November 1999 to March 2004. We used a first-difference series regarding the number of general beds to capture productivity shock. By using impulse response functions and a forecast error variance decomposition, we found that a price shock dominated the behavior of both patient and physician at forecast horizons, although in the short run the rise in the intensity of treatment leads to a decrease in the rate of doctor consultations. By estimating the structural VAR model under a recursive constraint, it was found that all of the causal links in the model constituted an invalid specification. We concluded that the increase in the patient's coinsurance rate had the effect of restraining health care costs but that a labor productivity shock did not have a permanent effect on the doctor consultation. The supply side of the health sector might absorb the change that occurred in the demand side.Coinsurance rate, Government-managed health insurance, Japan, Labor productivity, Number of beds, Structural shock, Vector autoregressive model