HITOTSUBASHI UNIVERSITYJSPS BILATERAL JOINT SEMINAR

Bilateral Joint Seminar Program

Sustainability of Health,Environment and Development

Date: 10, 11 MARCH 2022
Venue: Online - Webex

EventProgram

We aim to establish international
research networks of healtheconomics.

Lunch*Presentation Language
English : EN
Chinese : CN

DAY 1 THURSDAY, 10 MARCH 2022

OPENING REMARKS
Motohiro Sato

10:00 – 10:10 (JST)
09:00 – 09:10 (CST)

Director of HIAS HealthProfessor, Hitotsubashi University

KEYNOTE SESSION : Health, Inequality, and Sustainable Growth

10:10 – 12:20 (JST)09:10 – 11:20 (CST)

Keynote 1: Exploring the health-relevant poverty line in Japan (EN)

10:10 – 10:40 (JST)09:10 – 09:40 (CST)

Takashi Oshio

Professor, Hitotsubashi University

Keynote 2: The Growth–Poverty–Inequality Triangle in China (EN)Guanghua Wan

10:40 – 11:10 (JST)09:40 – 10:10 (CST)

Professor/Director, Fudan University

Page 1

Keynote 3: Modernization of Medical Insurance Supervision and Governance System
and Governance Capacity (CN)Qunhong Wu

Professor, Harbin Medical University

Keynote 4: Theories and Cases of Integrated Medical and Health Service System (CN)Jun Wang

11:10 – 11:40 (JST)10:10 – 10:40 (CST)

Professor, Renmin University

Discussion and Group Photo

11:40– 12:10 (JST)10:40 – 11:10 (CST)

12:10– 12:20 (JST)11:10 – 11:20 (CST)

Lunch BreakSESSION 1 : Development and Social Welfare

Ryota Nakamura

Session Chair
Professor, Hitotsubashi University

Paper 1: The Income Inequality-CO2 Emissions Nexus: Transmission Mechanisms (EN)Jinxian Wang

Wrap-up

14:40 – 15:20 (JST)13:40 – 14:20 (CST)PhD Candidate, National Graduate Institute for Policy Studies

Paper 3: Promoting Better Integration of Healthcare in China:
Policy Evolution and Theoretical Framework (EN)Xueyao Wang

14:00 - 14:40 (JST)
13:00 – 13:40 (CST)

Lecturer, Central South University

Paper 2: Prosumers’ Investment Decisions and Social Welfare underDifferent Pricing Schemes (EN)Kazuya Ito

14:00 – 16:10 (JST)
13:00 –15:10 (CST)

15:20 – 16:00 (JST)
14:20 – 15:00 (CST)

Research Associate, Renmin University

16:00 – 16:10 (JST)
15:00 – 15:10 (CST)

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DAY 2 FRIDAY, 11 MARCH 2022
SESSION 2 : Health Policy
Ayako Honda

Session Chair
Professor, Hitotsubashi University

Paper 4: Reducing Inequality While Improving Health: The Long-Run Impacts
from the Onset of Universal Health Insurance in Japan (EN)
Hongming Wang

11:10 – 11:50 (JST)10:10 – 10:50 (CST)

Research Associate (Specially Appointed ), Hitotsubashi University

Paper 7: Research on perfecting financial transfer payment policy in the field of
medical and health care (EN)
Shengjie Zhang

10:30 –11:10 (JST)09:30 – 10:00 (CST)

Assistant Professor, Waseda University

Paper 6: Increasing physical activity and reducing sedentary behavior at the workplace:an umbrella review (EN)Thomas Rouyard

09:50 – 10:30 (JST)08:50 – 09:30 (CST)

Research Associate (Specially Appointed), Hitotsubashi University

Paper 5: The impact of contracting formal care benefits on informal careprovision and caregiver well-being: evidence from Japan (EN)
Rong Fu

09:50 – 12:30 (JST)08:50– 11:20 (CST)

11:50 – 12:30 (JST)
10:50 – 11:30 (CST)

Research Associate, Renmin University

Lunch BreakSESSION 3 : Sustainability of Health Care System
Makoto Tanaka

Session Chair
Professor, National Graduate Institute for Policy Studies

Paper 8: Association Between Social Integration, Social Exclusion and Vaccination
Behavior Among Migrants in China (EN)Yang Bai

15:20 – 16:00 (JST)
14:20 – 15:00 (CST)PhD Candidate, Renmin University

16:00 – 16:10 (JST)
15:00 – 15:10 (CST)

CLOSING REMARKS
Ying Yao

14:40 – 15:20 (JST)13:40 – 14:20 (CST)

Assistant Professor (Specially Appointed), Hitotsubashi University

Paper 10: Analysis on main features and regulatory strategies of the new healthservice industry (EN)Fukang Zhang

14:00 – 14:40 (JST)
13:00 – 13:40 (CST)

Research Associate, Renmin University

Paper 9: Global, regional, and national progress in financial risk protection
towards universal health coverage, 2000-2030 (EN)
Mizanur Rahman

14:00 – 16:00 (JST)
13:00 – 15:00 (CST)

Assistant Professor (Specially Appointed), Hitotsubashi University

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BIOGRAPHIESandABSTRACTS

Page 4

Keynote Session : Health, Inequality and Sustainable Growth

Takashi Oshio
Professor,
Institute of Economic Research, Hitotsubashi University
After working for eleven years as a researcher and economist in theJapanese government and at J.P. Morgan, Takashi Oshio started hisacademic career from 1994 and has been serving at Hitostubashi
University since 2009 as a professor at the Institute of Economic
Research. He obtained a Ph. D. in international public policy from Osaka
University in 2002. His research has largely focused on social security,
income distribution, education policy, and other issues related to publicfinance. His interests are in public health, social epidemiology, andoccupational health. He has published several journal articles in thesefields and has published more than ten books in Japanese.

Keynote 1: Exploring the health-relevant poverty line in Japan

Abstract
Income poverty is known to be associated with poor health outcomes. However, the poverty line, which is used
to calculate the poverty rate, is arbitrarily set without specific reference to health. This study explored thehealth- relevant poverty line to understand poverty in terms of population health. Using repeated crosssectional data from approximately 663,000 individuals obtained from the nationwide population surveys
conducted in Japan from 1986 to 2016, we calculated a health-relevant poverty line. We showed that thehealth-relevant poverty line should be drawn, respectively, at 72–86% and 67–69% of median income. Theselevels were somewhat higher than the conventional 50% or 60%, suggesting that the conventionally definedpoverty line may underestimate poverty in terms of population health.

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Keynote Session : Health, Inequality and Sustainable Growth

Guanghua Wan
Professor/Director,
Institute of World Economy, Fudan University
Guanghua Wan is Director of the Institute of World Economy at Fudan
University (IWEFU). Before joining the IWEFU, he was Principal Economist
at the Asian Development Bank (ADB), Project Director at UNU-WIDER, andtaught in several universities in Australia and China. Trained indevelopment economics and econometrics, he has an outstanding
publication record of over 150 professional papers and reports, over 60 ininternational and refereed economic journals, and a dozen books, including
two by Oxford University Press. In addition, he was the Guest editor of 11
special issues of leading journals in development economics or Asian
economies and a guest speaker in more than 30 countries. He has also
directed the productions of multiple ADB flagship reports, which attracted
the attention of the global development community and various national
governments, including the State Department of the USA.

Keynote 2: The Growth–Poverty– Inequality Triangle in China

Abstract
Since the 1990s, China's absolute poverty rate has fallen dramatically, while wealth inequality has increased.
To investigate the causes of this paradox, we use poverty decomposition and panel-VAR modelling to assessand compare the roles of income growth and income inequality in affecting absolute and relative poverty rates.
The results show that miracle reduction in absolute poverty is completely attributable to fast growth, while
income inequality played a small aggravating role. Moreover, relative poverty is largely driven by fast growthand, to a moderate extent, by income inequality. It is suggested that in the short- and medium-run, China shallcontinue to target absolute poverty with a higher poverty line rather than shifting policy direction to focus on
relative poverty.

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Keynote Session : Health, Inequality and Sustainable Growth

Qunhong Wu
Professor,
Harbin Medical University
Qunhong Wu is the dean of School of health management, Harbin Medical
University. She distinguished professor of the "Changjiang Scholar" of the
Ministry of education, winner of the 863 project of the Ministry of scienceand technology, key projects of the National Natural Science Foundationand key projects of the National Social Science Foundation. She is theleader of social medicine and health management in key disciplines in
Heilongjiang Province, the leader of talent echelon in Heilongjiang
Province, and the chief expert of provincial key high-end think tanks.
She is engaged in research on health emergency management, healthpolicies and systems, population and health, and medical and healthservices. She has published more than 300 papers at home and abroad,including more than 80 SCI papers, 16 textbooks and monographs plannedby the chief editor / deputy chief editor, and has won 9 national patents andcomputer software copyrights, the second prize of scientific andtechnological progress of the Ministry of education, the health management
award of Science and technology award of the Chinese Medical Association,
the first prize of provincial outstanding achievements in Social Sciences, 3second prizes of provincial scientific and technological progress and 6 otherawards. She presided over the national excellent teaching team, national
excellent resource sharing courses, national bilingual demonstration
courses, national open video courses and national first-class courses ofvirtual simulation experiment teaching, and won the second prize of national
teaching achievement, national excellent scientific and technologicalworkers, middle-aged and young experts with outstanding contributions
from the Ministry of health, provincial famous teachers, provincial excellent
middle-aged and young experts, provincial excellent teachers CMB
distinguished professor and other honorary titles.

Keynote 3: Modernization of Medical Insurance Supervision and Governance System
and Governance Capacity

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Keynote Session : Health, Inequality and Sustainable Growth

Jun Wang
Professor,
School of Public Administration and policy, Renmin University
Director,
Health Policy Research and Evaluation Center, Renmin University
Jun Wang is a professor at the School of Public Administration and policyof Renmin University of China; director of the Health Policy Research and
Evaluation Center of Renmin University of China.His honors include: "FourGroups" of National Cultural Masters, National "Ten Thousand Talents
Program" Philosophy and Social Science Leaders, National "Ten Thousand
Talents Program" Young Top Talents, Ministry of Education "New Century
Talents", Beijing the young and middle-aged philosophy and social
science theoretical talents are selected as the "Hundred Talents Project".
In the international academic field, he served as a visiting professor at the
University of Paris, France, a visiting professor at the University ofBirmingham in the United Kingdom, a financial and economic expert of theWorld Health Organization (WHO), a research partner of the World Bank
(WB), and a UNICEF (UNICEF) medical and health project evaluation
Expert and senior research partner of the French Embassy in China insocial and health affairs.He has long been engaged in research in thefields of health economics, health management, health policy, aging andsocial security. Currently, he leads the team to concentrate on medical
and health policy formulation and mechanism design and other related
academic and policy decision-making research work.

Keynote 4: Theories and Cases of Integrated Medical and Health Service System

Page 8Session 1 : Development and Social Welfare

Jinxian Wang
Lecturer,Business School, Central South University
Jinxian Wang is a lecturer at the Business School of Central South
University, China. She got Ph.D. in Economics in 2016 from Leiden
University, the Netherlands. Her research interests include income
distribution, environmental protection, and public health. She has
published papers in Ecological Economics, Energy Economics, China
Economic Review, Cambridge Journal of Economics, Journal of the Asian
Pacific Economy, and The Singapore Economic Review.

Paper 1 : The Income Inequality-CO2 Emissions Nexus: Transmission Mechanisms

Abstract
Income distribution and environmental degradation represent two of the most important goals in the
SDGs (Sustainable Development Goals). However, the linkage between income inequality and carbon
emissions remains controversial. Relying on a large set of cross-country panel data (217 countries from1960 to the latest), this paper contributes to the literature by using the instrumental variable approachto estimate the causal impact of income inequality on carbon emissions and exploring the underlying
transmission mechanisms. Our modelling results indicate that there is a trade-off between income
inequality and CO2 emissions. And the underlying mechanisms include (1) diminishing marginal
propensity to emit (DMPE) coupled with the economic law of diminishing marginal propensity to consume(DMPC); (2) high income inequality induces increases in R&D expenditure, leading to reductions in CO2emissions; (3) political freedom does not significantly affect the relationship between income inequality
and CO2 emissions.

Page 9Session 1 : Development and Social Welfare

Kazuya Ito
PhD Candidate,
National Graduate Institute for Policy Studies (GRIPS)
Completion of PhD at the National Graduate Institute for Policy Studies(GRIPS) in 2022. Research Keywords: Investment decision-making inelectricity market, Optimization, Renewable energy policy.

Paper 2: Prosumers’ Investment Decisions and Social Welfare underDifferent Pricing Schemes

Abstract

The emergence of prosumers who own renewable distributed energy resources has brought about aparadigm shift in the electricity market. In this study, we formulate complementarity problems for all market
participants (i.e., prosumers, consumers, producers, and independent system operators), focusing on
prosumer investments in photovoltaics (PVs) with and without battery operations. Specifically, this study
compares the equilibrium outcomes under two different pricing schemes, namely, net metering and net
billing. First, we discuss that the capacity of PVs invested in by prosumers and the total social surplus
increase as the capital costs of PVs decrease under both pricing schemes without considering battery
operation. Next, we show that battery operation increases the capacity of prosumer investment in PV underboth pricing schemes. Furthermore, the total social surplus under net billing is larger than that under net
metering, with and without battery operation. This suggests that net billing could be a better regulatory
scheme in the future, especially when the capital cost of PVs falls sufficiently.

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Session 1 : Development and Social Welfare

Xueyao Wang
Doctoral candidate,Renmin University
Xueyao Wang is an assistant researcher at the Health Policy Research and
Evaluation Center of Renmin University of China and a doctoral student in
the School of Public Administration and Policy of Renmin University of
China. The main research field is health policy, and the research direction
mainly includes the construction of an integrated medical and healthservice system and the integration of medical and prevention. In recent
years, he has participated in nearly ten National Natural Science
Foundation projects and commissioned research projects at the national,
provincial and ministerial levels. The research reports and internalreferences that he participated in writing have been submitted to the
National Health Commission, Beijing Municipal Health Commission andother relevant departments.

Paper 3: Promoting Better Integration of Healthcare in China:
Policy Evolution and Theoretical Framework
Abstract
To build regional integrated healthcare systems(IHS) has been an important policy objectives of China’s
government. Since the new medical reform in 2009, China has issued many policies aiming at promoting the
integration and collaboration between health organizations. The policy evolution of IHS in China mainly
involve three stages, including the policy design, policy making and policy diffusion, and it’s a process ofinteraction between central government and local governments. With the practices of HIS, different modelsof IHS emerged. The choice of integration model should take overall economic development level, healthresource density, funds available for health system, transportation convenience and degree of government
power transfer into account, or else the building of IHS can hardly promote the accessibility of health care.

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Session 2 : Health Policy

Hongming Wang
Research Associate (Specially Appointed),
Hitotsubashi Institute for Advanced Study, Hitotsubashi University
Hongming Wang is a HIAS research associate (Specially Appointed) at
Hitotsubashi Institute of Advanced Studies. He holds a BA in Finance and a
BS in Math from Shanghai Jiao Tong University and a MA and Ph.D. in
Economics from the University of Southern California. His researchinterests include health insurance systems and health policy reforms. His
recent studies include the long-run impacts of universal health insurance inJapan and a modelling study of the optimal targeting of age and risk groups
for COVID-19 vaccines in Japan.

Paper 4: Reducing Inequality While Improving Health:
The Long-Run Impacts from the Onset of Universal Health Insurance in Japan

Abstract

Health insurance provides an important safety net to individuals in the distress of illness and financial hardships.
Providing universal insurance is pursued by many governments to ensure the access to healthcare and to reduce
the health and economic inequalities facing less advantaged populations. Exploiting the historic onset ofuniversal insurance in Japan in 1956-1961, this paper examines the long-run impacts of universal insurance on
population health and economic outcomes as well as the inequalities across gender. I find that exposure to
universal insurance early in life led to lower mortality and chronic disease burdens in prime age. For women,
universal insurance increased college enrollment and the probability of marrying a college-educated spouse.
Within households, the homemaker’s role shifted from women to men whereas employment and earnings
increased for women relative to men. The results indicate that, in addition to improving population health in thelong run, universal insurance could reduce the gender inequality in socio-economic status by increasing the
education and earnings of women.

Page 12Session 2 : Health Policy

Rong Fu
Assistant Professor,
School of Commerce, Waseda University
Rong FU is an assistant Professor at School of Commerce of Waseda
University. Her recent studies focus on the influence of demographic
and socioeconomic factors on health statuses and various spillover
effects of Japanese public health and long-term care policies. She
received her PhD in Economics from Waseda University.

Paper 5 : The impact of contracting formal care benefits on informal care provisionand caregiver well-being: evidence from Japan

Abstract

The rapid demographic transition has resulted in an ever-increasing demand for both formal and informal longterm care. This study investigated how changes in formal care availability affect informal caregiver well-being,
which adds to the heated discussion on what constitutes an appropriate level of formal care that is bothsustainable and adequate. We leveraged a reform of Japan’s public long-term care insurance in 2006, which
contracted formal care benefits among a group of recipients. By applying a difference-in-difference approachwith fixed effects to a nationally representative sample of informal caregivers, we found that informal
caregivers took on care duties when formal care benefits were reduced, which was detrimental to their wellbeing. The negative impact on well-being was reflected in decreased mobility and stability, as well as increased
stress from financial strains and domestic work. We also found that the impact of contracting formal care was
not always detrimental. Caregivers who are female, working, or low-income are particularly vulnerable to thenegative effects of a lack of formal care, whereas male and non-working caregivers benefit from it in terms of
reduced stress levels. The results suggest that policymakers should consider the diverse well-being impact ofproviding informal care for future reforms on long-term care systems.

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Session 2 : Health Policy

Thomas Rouyard
Research Associate (Specially Appointed),
Hitotsubashi Institute for Advanced Study, Hitotsubashi University
Thomas Rouyard holds an M.Sc. in Economics from the Paris School of
Economics, France, and a Ph.D. in Population Health from the University of
Oxford, UK. His research interests lie in the area of global health, including
theoretical and empirical work to inform the design of health-related
interventions and policies. In particular, he is interested in using insightsfrom behavioural economics to explore new approaches to improve theprevention and management of lifestyle-related diseases. Before joining
HIAS in June 2019, Thomas was a Doctoral Transition Fellow supported by
the European Institute for Innovation and Technology (EIT) at the
University of Oxford.

Paper 6 : Increasing physical activity and reducing sedentary behavior
at the workplace: an umbrella review
Abstract
Background:
Increasing rates of urbanization have been accompanied by higher levels of sedentary behaviour (SB) andreduced physical activity (PA) worldwide. While physical inactivity has long been identified as a major risk factor
for morbidity and mortality, increased concerns about the detrimental associations between SB and health has
led to the development of many interventions aimed at reducing SB and/or promoting PA. Due to theprominence of sedentary time spent at work, the workplace has been identified as a key setting to implement
such interventions. While many systematic reviews (SR) have evaluated the effects of SB and PA workplaceinterventions, most of them have focused on specific interventions types or populations, making it difficult todraw a conclusive picture of the existing evidence.

Objective:
The objective of this umbrella review is to identify all SRs investigating the effects of PA and SB workplaceinterventions, and to evaluate and synthesize evidence based on intervention level.

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Methods:
Systematic searches for relevant SRs published between January 2000 and June 2021 were conducted in six
databases (Cochrane Systematic Review Database, CINAHL, EMBASE, MEDLINE, Scopus, and Web of
Science). Backward citation tracking complemented the search. SRs with or without meta-analysis were
included if they reported SB and/or PA outcomes in the occupational domain and if intervention level ofprimary studies could be identified. Two independent reviewers screened the identified articles by title,
abstract, and full-texts for inclusion. Two independent reviewers also systematically extracted data andevaluated the risk of bias of included SRs using the AMSTAR2 tool. To analyze the data, we extracted therelevant primary studies identified in each SR and grouped them by intervention level (individual, social,environmental, organizational, multi-component), intervention type (e.g., self-monitoring intervention within
individual level interventions), and outcome. For each PA and SB outcome of interest, we will synthesize
evidence by performing meta-analyses of primary studies considered to be at low risk of bias, when possible.
Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE)
method to rate the quality of evidence for each outcome and at each intervention level.

Results:
The database search identified 6,444 items, of which 22 were included in the umbrella review. Additional searchstrategies identified 5 new studies, bringing the total of included SRs to 27. We identified 136 primary studies
published on or after 2000, of which 31 were randomized trials reporting objective measures of behaviourchange. These primary studies, covering a total of 54 interventions, will be included in the meta- analyses
provided that all necessary quantitative information can be obtained (i.e., effect sizes, standard deviations, andsample size). We expect to complete the meta-analyses and the GRADE assessment process by the end of April
2022.

Conclusion:
Building an evidence base of effective strategies to reduce SB and/or promote PA at work is needed to help
reduce the health risks faced by many sedentary employees. This umbrella review will provide guidance topolicy makers and employers concerned with implementing such strategies in the workplace. This will also
allow potential research gaps to be identified, so that the design of future studies can be better informed.
Registration: This study has been registered with the PROSPERO International Prospective Register ofSystematic Reviews (registration number CRD42020171774).

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Session 2 : Health Policy

Shengjie Zhang
Doctoral candidate,Renmin University
Shengjie Zhang is an assistant researcher at the Health Policy Researchand Evaluation Center of Renmin University of China and a doctoral
student in the School of Public Administration and Policy of Renmin
University of China, a double bachelor of science and law, and a master of
medicine in the Peking University School of Medicine. The current
research focuses on public health policy research, research on improving
the service capacity of primary medical institutions, and population healtheducation and health promotion.

Paper 7 : Research on perfecting financial transfer payment
policy in the field of medical and health care
Abstract

The purpose of transfer payment is to eliminate the horizontal imbalance between the amount of tax revenue
between local governments and the expenditure of basic public service demand, and strive to ensure theconsistency of social public service level in different regions. The empirical results of this paper show that
although the distribution of transfer payment funds in the health field is directly proportional to the local
financial gap, the existing five-tier distribution system is too rough and fails to take into account the ability of
medical service providers, the health needs of people in each region and the cost of service provision. Since thecapability of the provider and the server is not taken into account, the fund is only allocated from
theperspective of finance, and its promoting effect on the equalization of public services needs to be improved.

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Session 3 : Sustainability of Health Care System

Yang Bai
Doctoral candidate,
Health Policy Research and Evaluation Center, Renmin University
Yang Bai, an assistant researcher at the Health Policy Research and
Evaluation Center of Renmin University of China and a doctoral student in
the School of Public Administration and Policy of Renmin University of
China. In recent years, she has participated in a number of health policy
related projects, including the National Natural Science Foundation ofChina's New Coronary Pneumonia Governance Special Project "TheIntegration and Synergy Mechanism of the Public Health System, Medical
Services and Medical Security System", and the World Bank Project"Promoting the Sustainable Development of National Basic Public HealthServices——China’s Experiences and Cases, etc. She also have gone to
Hunan Province, Yunnan Province, Sichuan Province, Henan Province,
Fujian Province and other places to conduct research. In recent years,
she wrote and submitted seven research reports, internal reference andso on to World Bank, the National Health Commission. HealthCommission and other relevant departments.

Paper 8 : Association Between Social Integration, Social Exclusion and
Vaccination Behavior Among Migrants in China
Abstract
Cross-sectional studies about the association between social integration, social exclusion and vaccination
behaviour among migrants in China are extremely lacking. In this study, we aimed to explore the association
between the influenza vaccination behaviour and social integration as well as social exclusion in China based ona nationwide cross-sectional study. We included 12467 participants aged 15 years old or above from the 2017
Migrant Population Dynamic Monitoring Survey (MDMS). We used univariate analysis and logistic regression
models to access the association between social integration, exclusion status and influenza vaccination rates.
Results suggested that, although there was no negative association between social exclusion and influenza
vaccination rate, the association between social integration and the vaccination rate was significantly positive.
Significant association between influenza vaccination behaviour and education attainment, income status,
health record and the awareness of basic public health services program was reported. Therefore, in order toreduce the incidence of influenza disease and increase the vaccination rate, policymakers and the public should
promote social integration for migrants. Meanwhile, our finding also implies possible strategies to promote
COVID-19 vaccination.

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Session 3 : Sustainability of Health Care System

Mizanur Rahman
Assistant Professor (Specially Appointed),
Hitotsubashi Institute for Advanced Study, Hitotsubashi University
Mizanur Rahman is a specially appointed Assistant Professor in the
Hitotsubashi Institute for Advanced Study. He received his Bachelor andMaster's degree in Population Science in 2004 and 2005, respectively,from the University of Rajshahi, Bangladesh. He received a PhD in Global
Health in 2013 from the department of Global Health Policy, theUniversity of Tokyo, Japan. Before joining at the Hitotsubashi University in
2021, he worked as an Assistant Professor at the University of Tokyo and
Associate Professor at the University of Rajshahi, Bangladesh. Apart fromhis experiences of working with academies, Mr. Rahman has regularly
collaborated with national and international researchers from the
University of Tokyo, World Health Organization, St Luke International
University, and Global Public Health Research Foundation in Bangladesh.
His specialized knowledge in topics of universal health coverage (UHC),
SDG-related health indicators, health financing and policy evaluation,
equity in health, maternal and child health, and systematic review andmeta-analysis in global health, has resulted in several publications inprestigious peer-reviewed journals including The Lancet, JAMA, Bulletinof the World Health Organization, Diabetes Care, American Journal of
Clinical Nutrition, Obesity Reviews, and Ann New York Acad Sci. Much of
his current work relates to the development and implementation of
innovative approaches to public health, maternal and child health,healthcare financial risk management, and policy development.

Paper 9: Global, regional, and national progress in financial risk
protection towards universal health coverage, 2000-2030
Abstract
Background
Financial protection is a key dimension of universal health coverage (UHC) and conceptualized by two indicators:
catastrophic health expenditure (CHE) and impoverishment. Evidence-based estimates must be at the heart ofpolicy development for UHC, further research using updated data is essential to monitor, track, and compare
country progress up to 2030. We estimate global, regional, and country-level CHE and impoverishment during
2000-2030.

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Methods
We aggregated 626 data points from 140 countries for estimates, and constructed scenario-based projections
based on 5% GDP spending on health and per capita health expenditure (PCHE) of $86 with a Bayesianhierarchical model.
Results
Most countries fail to achieve financial protection targets by 2030, with the global incidence of CHE predicted topersist around 7%. CHE is predicted to increase in most of Asia (Southern: 8.1% in 2000 to 13.4% in 2030;
Central: 3.6% to 23.2%; Eastern: 8.3% to 14.4%; and Western: 7.3% to 20.2%), Northern Africa (12.4% to27.2%), Eastern (7.1% to 14.9%) and Northern Europe (6.6% to 13.2%). In contrast, a decrease is predicted in
Oceania, Latin America and the Caribbean, and Northern America. By 2030, incidence of impoverishment ispredicted to be 0% worldwide, however the highest impoverishment (≥5%) is observed in Cyprus, Niger,
Tanzania, Chad, Bangladesh, Central African Republic, Nepal, Georgia, Nigeria, Tajikistan, South Sudan,
Afghanistan and Guinea. Widening urban-rural disparities draw attention to efforts required to reduce inequality
in financial protection. The scenario-based analysis indicated that CHE and impoverishment is expected todecrease in 41 and 42 countries for GDP increase and 43 and 62 for PCHE increase respectively compared tocurrent spending on health.
Conclusion
To accelerate progress towards reducing financial protection, governments should carefully assess the country
context to determine how health can be prioritised through government spending to reduce out-of-pocket
payments.

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Session 3 : Sustainability of Health Care System

Fukang Zhang
PhD candidate,
Health Policy Research and Evaluation Center, Renmin University
PhD candidate in Social Medicine and Health Management, School of Public Administration, Renmin Universityof China as well as the assistant researcher of the Center for Health Policy Research and Evaluation. He is
engaged in the research of health policy and health management. He went to Sichuan province, Yunnan
province, Fujian province, Guangdong province and other places for research. The research reports and internalreference he once wrote was submitted to National Health Commission, Beijing Municipal Health Commission
and other relevant departments.

Paper 10: Analysis on main features and regulatory strategies of the newhealth service industry
Abstract

Analysis on main features and regulatory strategies of the new health service industry
Abstract: Compared with the traditional health service industry, the new health service industry tends to be
more comprehensive and integrated , and the various factors are in a dynamic change process, which ischaracterized by larger scale, intensive, agglomerative and special methods. Compared with the traditional
medical and health industry supervision, its regulatory content has greatly changed in the new system. Under
the new market relationship, the supply and the demand sides have put forward higher requirements forsupervision, and the emerging business forms are networked, fragmented and flexible. The service boundary
has broken through the traditional supervision mode ,and it simultaneously faces the challenge of defining thesupervision responsibilities, complexity, the current tax system management, the current supervision
mechanism hindrances, and the balance between the new health service industry and health quality accessregulation which are undergoing an exponential trend of development. Therefore, this paper puts forwards somesuggestion such as the establishment of a new health service industry supervision mechanism with information
supervision as the core, the realization of the transition from direct control to bottom-line supervision, theestablishment of multi-sectoral organic coordination, and a coordinated supervision mechanism which involves
the participation of all social subjects.

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Motohiro Sato
Professor, Graduate school of Economics and School of International and Public Policy,
Hitotsubashi University
Director, Research Center for Health Policy and Economics, Hitotsubashi Institute forAdvanced Study (HIAS Health)Motohiro SATO has been serving as a professor at the Graduate School of
Economics, Hitotsubashi University since 2009, after serving as an
assistant professor from 1999 and an associate professor from 2002 at
Hitotsubashi University. He is also a professor of the School ofInternational and Public Policy, Hitotsubashi University. He graduatedfrom Hitotsubashi University in 1992 with a BA and an MA in Economics
and obtained a Ph. D. in Economics from Queen’s University, Canada, in
1998. His areas of expertise are public finance, especially local publicfinance. In the field of health economics, he is studying dispensations ofhealthcare insurance systems and its theory and has been making policy
recommendations based on this research. His publications include books
that have been awarded prizes, such as Economics of Local Grant Tax,
Yuhikaku Publishing Co., Ltd., 2004

（in Japanese） awarded the 47th

Nikkei Prize for Excellent Books in Economic Science and Reformation of
Local Tax, Nikkei Inc., 2011
Economist Prize in 2011.

（in Japanese） awarded the 52nd Mainichi

Ryota Nakamura

Professor,
Hitotsubashi Institute for Advanced Study, Hitotsubashi University
Ryota Nakamura is a professor based in the Hitotsubashi Institute forAdvanced Study. He is an applied microeconomist specialising in health.
He holds a BA and an MA in Economics from Kyoto University and a PhD
in Economics from the University of York. Prior to joining Hitotsubashi
University in 2016, he held positions at the University of East Anglia andthe University of York. His research interests include empirical andtheoretical investigations of health-related behavior as well as healthcare
systems to inform national and international public health policies, usinga wide range of research methods including micro-econometric analysis
of observational data, economic experiment, modelling, and evidence
synthesis.

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Ayako Honda

Professor,
Hitotsubashi Institute for Advanced Study, Hitotsubashi University
Ayako Honda has extensive experience in research on health systems in
Africa and Asia. She previously worked in the Health Economics Unit at
the University of Cape Town, South Africa and has collaborated with
African and Asian researchers to address a range of health systems
issues in LMIC settings. She holds a PhD in health economics from theLondon School of Hygiene and Tropical Medicine (University of London).
Ayako is interested in understanding how different groups of actors
respond to the implementation of policy options, particularly health carefinancing policy that aims to progress toward universal health coverage.
She is also interested in the use of discrete choice experiment (DCE) in
LMIC settings as a method to understand the needs, preferences andvalues of people working in health systems in order to reflect people’s
opinions in policy.

Makoto Tanaka

Professor,
National Graduate Institute for Policy Studie
Makoto Tanaka is a professor at the National Graduate Institute for Policy
Studies (GRIPS) in Japan. He focuses on the interdisciplinary fields of
economic analysis and operations research. His interests include energy,
environment, and industry.

Ying Yao

Assistant Professor (Specially Appointed),
Hitotsubashi Institute for Advanced Study, Hitotsubashi University
Ying Yao joined Hitotsubashi Institute for Advanced Study (HIAS) in 2017
after working as a research associate at the Asian Development Bank
Institute (ADBI). She holds a PhD in public economics from the National
Graduate Research Institute for Policy Studies (GRIPS) in Japan. Her
research interests are health economics and industrial organization, witha focus on the pharmaceutical industry. She has worked on several
policy-oriented projects on income inequality and health, healthbehavior, trade finance, digitalization and inclusion. Currently, herresearch focuses on pharmaceutical procurement and listings andsmoking behavior.

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