The Global Financial Crisis and Healthcare Inequality in Japan

The aim of this study is to clarify whether health-care inequality in Japan widens during a depression, even though Japan has a universal health-care system. To this end, we investigate the time-series fluctuations in health-care expenditure inequalities in Japan for the period 2008–2017, which includes the period during which the global financial crisis affected Japan. We construct an economy-wide inequality index comparing the actual health-care expenditure at various income levels (low, middle and high) against the estimated health-care needs. The findings of the study are as follows. First, the rich (the top 20% income class) spend far more than their estimated needs on health care, whereas the poor (bottom 20%) spend far less. Second, during the global financial crisis, health-care inequality especially among the working generation became greater in Japan, mainly because not only the low-income class but also the middle-income class (the bottom 30–60%) was unable to pay for health care.