[The experience of Japan: the application of the intersectoral balance methodology to control health care costs as a factor of mobilization readiness of health care to COVID-19 pandemic].

ABSTRACT

One of possible reasons for success of Japan in confronting the COVID-19 pandemic (low mortality rates, refusal of hard lock-downs and relatively low fall in economy) is seen in record high (3-4 times higher than in most other developed countries) provision of hospital beds. Its financing was supported during first 2 decades of the XXI century by the policy of relative to GDP advanced growth of public health public expenditures based on assessment of multiplier impact of these expenditures on demand, production and employment in other sectors of the economy using the intersectoral balance method based on "input-output" tables.Purpose of the study is to analyze Japan's economic policy in managing budgetary health care costs.The comprehensive statistical, comparative and retrospective analysis of available data was applied.The study results permit to suggest that high provision of the Japan population with hospital care resources and low mortality rates in 2022 prior to development of vaccines and effective treatment schemes for COVID-19 can be explained, among other things, by long-term policy of managing health care costs using assessment of their effect on production growth, demand and employment in other economy sectors using intersectoral balance method based on regular compilation of "input-output" tables.The data obtained permits to characterize as promising approach of the Japanese government to management of health care costs using assessment of their effect on production growth, demand and employment in other sectors of the economy using intersectoral balance method based on the regular compilation of "input-output" tables. This approach permitted to increase up to 1.5 times health care costs during 2005-2018 in situation of chronic stagnation of the national economy and thus to avoid world-wide trend towards reduction of hospital bed stock and after the start of pandemic severe shortage of hospital beds. The positive experience of Japan is confirmed by encouraging results of 2 pilot projects in the EU countries on applying the intersectoral balance method to assess the multiplier effect of health care costs in 2017-2018. It is considered that using the experience of Japan in managing budgetary health care expenditures through intersectoral balance method is challenging.