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Health Insurance (health + insurance)
Kinds of Health Insurance Terms modified by Health Insurance Selected AbstractsRISK ATTITUDES AND THE DEMAND FOR PRIVATE HEALTH INSURANCE: THE IMPORTANCE OF ,CAPTIVE PREFERENCES'ANNALS OF PUBLIC AND COOPERATIVE ECONOMICS, Issue 4 2009Joan Costa-Font ABSTRACT,:,Captivity to a mainstream public insurer, is hypothesized to constrain the choice of purchasing private health insurance, by influencing risk attitudes. Namely, risk averse individuals are more likely to stay captive to the National Health System (NHS). To empirically test this hypothesis we use a small scale database from Catalonia to explore the determinants of private health insurance (PHI) purchase under different forms of captivity along with a measure of risk attitudes. Our results confirm that the captivity corrections are significant and can potentially bias the estimates of the demand for PHI. Risk aversion increases the probability of an individual being captive to the NHS. The latter suggests a potential behavioural (or cultural) mechanism to isolate the influence of risk attitudes on the demand for PHI in publicly financed health systems. [source] Is it possible to identify early predictors of the future cost of chronic arthritis?FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 1 2009The VErA project Abstract This study was conducted to identify early predictors of the total cost of inflammatory arthritis (IA). One hundred and eighty patients affected by undifferentiated arthritis (UA) or rheumatoid arthritis (RA) were included in the French Very Early rheumatoid Arthritis (VErA) cohort between 1998 and 2001. Health economic data for 2003 were collected using a patient self-questionnaire. Results were analysed in terms of direct, indirect and total costs in 2003 euros (2003,) for the population as a whole and in diagnostic subgroups. A payor perspective (the French National Health Insurance, in this case) was adopted. Multiple linear regression models were used to identify predictors of total cost from among the criteria assessed on recruitment. Results of the study showed that for the study population as a whole, the mean total cost was ,4700 per patient. The costs attributable to the RA and UA sub-groups were ,5928 and ,2424 per patient, respectively. In a univariate analysis, certain parameters were significantly correlated with a higher cost of illness. In the multivariate analysis, some of these parameters were further identified as being predictive of higher cost. Two strong significant, early predictors of total cost were identified: higher pain (P = 0.002) and the presence of rheumatoid factor (P = 0.004). In the RA sub-group, lower grip strength of the dominant hand (P = 0.039) was another predictor of the illness's subsequent economic impact. In conclusion, our data show that simple clinical and laboratory parameters can be used early in the course of IA to predict the condition's impact on healthcare budgets. [source] Assessing horizontal equity in medication treatment among elderly Mexicans: which socioeconomic determinants matter most?HEALTH ECONOMICS, Issue 10 2008Jürgen Maurer Abstract Many low- and middle-income countries are currently undergoing a dramatic epidemiological transition, with an increasing disease burden due to degenerative noncommunicable diseases. Inexpensive medication treatment often represents a cost-effective means to prevent, control or cure many of these health conditions. Using micro-data from the 2001 Mexican Health and Aging Study, we assess horizontal inequity in medication treatment among older Mexicans before the introduction of Popular Health Insurance in Mexico. In doing so, we investigate the role of various dimensions of socioeconomic status for obtaining indicated medication treatment within a comparatively fragmented health-care system that features relatively high out-of-pocket expenditures. Our empirical analysis suggests health insurance coverage as a key socioeconomic determinant of indicated medication use with large and statistically significant positive effects on take-up. The effects of insurance status thereby clearly dominate any other possible effects of socioeconomic status on medication treatment. Our results thus highlight the importance of access to reliable health care and comprehensive coverage for rational medication use in the management of degenerative diseases. In light of this evidence, we expect that recent Mexican health-care reforms, which expand health insurance coverage to the previously uninsured population, will alleviate socioeconomic gradients in medication treatment among older people in need. Copyright © 2007 John Wiley & Sons, Ltd. [source] The effects of Taiwan's National Health Insurance on access and health status of the elderlyHEALTH ECONOMICS, Issue 3 2007Likwang Chen Abstract The primary objective of this paper is to evaluate the impact of Taiwan's National Health Insurance program (NHI), established in 1995, on improving elderly access to care and health status. Further, we estimate the extent to which NHI reduces gaps in access and health across income groups. Using data from a longitudinal survey, we adopt a difference-in-difference methodology to estimate the causal effect of Taiwan's NHI. Our results show that Taiwan's NHI has significantly increased utilization of both outpatient and inpatient care among the elderly, and such effects were more salient for people in the low- or middle-income groups. Our findings also reveal that although Taiwan's NHI greatly increased the utilization of both outpatient and inpatient services, this increased utilization of health services did not reduce mortality or lead to better self-perceived general health status for Taiwanese elderly. Measures more sensitive than mortality and self-perceived general health may be necessary for discerning the health effects of NHI. Alternatively, the lack of NHI effects on health may reflect other quality and efficiency problems inherent in the system not yet addressed by NHI. Copyright © 2006 John Wiley & Sons, Ltd. [source] Health insurance and treatment seeking behaviour: evidence from a low-income countryHEALTH ECONOMICS, Issue 9 2004Matthew Jowett Abstract This paper analyses the effect of being insured under the voluntary component of Vietnamese Health Insurance, on patterns of treatment seeking behaviour. A multinomial logit model is estimated using household survey data from three provinces in Vietnam. Decisions regarding both the type of provider sought and type of care received are analysed. Insurance status is treated as both exogenous and endogenous to account for potential selection bias. The results indicate that, overall, insured patients are more likely to use outpatient facilities, and public providers, an effect that is particularly strong at lower income levels. Copyright © 2004 John Wiley & Sons, Ltd. [source] Commentary: What Is the Right Price of Health Insurance?HEALTH SERVICES RESEARCH, Issue 6p1 2007A Rejoinder No abstract is available for this article. [source] Welfare Reform and Health Insurance of ImmigrantsHEALTH SERVICES RESEARCH, Issue 3 2005Neeraj Kaushal Objective. To investigate the effect of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) on the health insurance coverage of foreign- and U.S.-born families headed by low-educated women. Data Source. Secondary data from the March series of the Current Population Surveys for 1994,2001. Study Design. Multivariate regression methods and a pre- and post-test with comparison group research design (difference-in-differences) are used to estimate the effect of welfare reform on the health insurance coverage of low-educated, foreign- and U.S.-born unmarried women and their children. Heterogenous responses by states to create substitute Temporary Aid to Needy Families or Medicaid programs for newly arrived immigrants are used to investigate whether the estimated effect of PRWORA on newly arrived immigrants is related to the actual provisions of the law, or the result of fears engendered by the law. Principal Findings. PRWORA increased the proportion of uninsured among low-educated, foreign-born, unmarried women by 9.9,10.7 percentage points. In contrast, the effect of PRWORA on the health insurance coverage of similar U.S.-born women is negligible. PRWORA also increased the proportion of uninsured among foreign-born children living with low-educated, single mothers by 13.5 percentage points. Again, the policy had little effect on the health insurance coverage of the children of U.S.-born, low-educated single mothers. There is some evidence that the fear and uncertainty engendered by the law had an effect on immigrant health insurance coverage. Conclusions. This research demonstrates that PRWORA adversely affected the health insurance of low-educated, unmarried, immigrant women and their children. In the case of unmarried women, it may be partly because the jobs that they obtained in response to PRWORA were less likely to provide health insurance. The research also suggests that PRWORA may have engendered fear among immigrants and dampened their enrollment in safety net programs. [source] Older Married Workers and Nonstandard Jobs: The Effects of Health and Health InsuranceINDUSTRIAL RELATIONS, Issue 3 2009JEFFREY B. WENGER We examine the effects of health and health insurance coverage on older married workers' decisions to work in temporary, contract, part-time, self-employment, and regular full-time jobs. We model the behavior of older married workers as interdependent, showing that one spouse's health and insurance status affects the employment of the other. In general, we find that men and women are less likely to be employed in regular full-time jobs when they are in fair or poor health and are more likely to be in regular full-time employment when their spouses are in poor health. [source] Regulated Competition in Social Health Insurance: A Three-Country ComparisonINTERNATIONAL SOCIAL SECURITY REVIEW, Issue 3 2006Stefan Gre The objectives guiding healthcare reforms in Germany, Switzerland and the Netherlands were to increase efficiency and consumer satisfaction in the provision of healthcare services. This paper reviews the incentives for and instruments of competition for consumers, sickness funds and healthcare providers in these three countries which are necessary to fulfil these objectives. Incentives for risk selection of sickness funds are high in Germany and Switzerland while they are low in the Netherlands. Incentives for consumer choice are also highest in Germany and Switzerland. In all three countries sickness funds have only a few instruments of competition. The effects of competition have been disappointing so far. The objectives of competitive healthcare reforms can be achieved only if incentives for and instruments of competition consistently support competitive behaviour on the part of market actors. [source] Social Health Insurance: Key Factors Affecting the Transition Towards Universal CoverageINTERNATIONAL SOCIAL SECURITY REVIEW, Issue 1 2005Guy Carrin Several low- and middle-income countries are interested in extending their existing health insurance for specific groups to eventually cover their entire populations. For those countries interested in such an extension, it is important to understand the factors that affect the transition from incomplete to universal coverage. This paper analyses the experience of eight countries in the implementation of social health insurance. It highlights the importance of the socioeconomic and political context, particularly in relation to the level of income, structure of the economy, distribution of the population, ability to administer and level of solidarity within the country, but also stresses the important stewardship role government can play in facilitating the transition to universal coverage via social health insurance. [source] Welfare reform and future challenges in the Republic of Korea: Beyond the developmental welfare state?INTERNATIONAL SOCIAL SECURITY REVIEW, Issue 4 2002ju Kwon Since the economic crisis of 1997,98, the Republic of Korea has carried out vigorous social policy initiatives including the reform of the National Pension Programme and National Health Insurance. This paper seeks to answer whether the country's welfare state has moved beyond welfare developmentalism, by examining the cases of those two programmes. By the reform, the coverage of the National Pension Programme was extended to the whole population; and its financial sustainability and accountability were enhanced. Regarding National Health Insurance, efficiency reform was carried out on the management structure, while reform regarding financing was put on hold. These reforms were in clear contrast to the welfare developmentalism that used to place overwhelming emphasis on economic considerations. Despite these reforms, however, the Republic of Korea's welfare state faces the issues of ineffectual implementation and lack of financial sustainability of social policy. The National Pension Programme has failed to cover the majority of irregular workers, whose numbers are on the increase, and National Health Insurance needs to find a way to meet increasing health expenditure. [source] Interview with a Quality Leader,Karen Davis, Executive Director of The Commonwealth FundJOURNAL FOR HEALTHCARE QUALITY, Issue 2 2009Lecia A. Albright Dr. Davis is a nationally recognized economist, with a distinguished career in public policy and research. Before joining the Fund, she served as chairman of the Department of Health Policy and Management at The Johns Hopkins School of Public Health, where she also held an appointment as professor of economics. She served as deputy assistant secretary for health policy in the Department of Health and Human Services from 1977 to 1980, and was the first woman to head a U.S. Public Health Service agency. Before her government career, Ms. Davis was a senior fellow at the Brookings Institution in Washington, DC; a visiting lecturer at Harvard University; and an assistant professor of economics at Rice University. A native of Oklahoma, she received her PhD in economics from Rice University, which recognized her achievements with a Distinguished Alumna Award in 1991. Ms. Davis is the recipient of the 2000 Baxter-Allegiance Foundation Prize for Health Services Research. In the spring of 2001, Ms. Davis received an honorary doctorate in human letters from John Hopkins University. In 2006, she was selected for the Academy Health Distinguished Investigator Award for significant and lasting contributions to the field of health services research in addition to the Picker Award for Excellence in the Advancement of Patient Centered Care. Ms. Davis has published a number of significant books, monographs, and articles on health and social policy issues, including the landmark books HealthCare Cost Containment, Medicare Policy, National Health Insurance: Benefits, Costs, and Consequences, and Health and the War on Poverty. She serves on the Board of Visitors of Columbia University, School of Nursing, and is on the Board of Directors of the Geisinger Health System. She was elected to the Institute of Medicine (IOM) in 1975; has served two terms on the IOM governing Council (1986,90 and 1997,2000); was a member of the IOM Committee on Redesigning Health Insurance Benefits, Payment and Performance Improvement Programs; and was awarded the Adam Yarmolinsky medal in 2007 for her contributions to the mission of the Institute of Medicine. She is a past president of the Academy Health (formerly AHSRHP) and an Academy Health distinguished fellow, a member of the Kaiser Commission on Medicaid and the Uninsured, and a former member of the Agency for Healthcare Quality and Research National Advisory Committee. She also serves on the Panel of Health Advisors for the Congressional Budget Office. [source] Health insurance and savings over the life cycle,a semiparametric smooth coefficient estimationJOURNAL OF APPLIED ECONOMETRICS, Issue 3 2004Prof. Shin-Yi Chou Individuals save for future uncertain health care expenses. This is less efficient than pooling health risk through insurance. The provision of comprehensive health insurance may raise welfare by providing the missing market to smooth out consumption through the life cycle. We employ a semiparametric smooth coefficient model to examine the effects of the introduction of the National Health Insurance in Taiwan in 1995 on savings and consumption over the life cycle. The idea is to estimate the coefficients of health insurance which vary with age. Our results suggest that younger households are more sensitive to the risk reductions, and that they demonstrate a greater response in the reduction of their precautionary saving. Copyright © 2004 John Wiley & Sons, Ltd. [source] Health Insurance, Moral Hazard, and Managed CareJOURNAL OF ECONOMICS & MANAGEMENT STRATEGY, Issue 1 2002Ching-To Albert Ma If an illness is not contractible, then even partially insured consumers demand treatment for it when the benefit is less than the cost, a condition known as moral hazard. Traditional health insurance, which controls moral hazard with copayments (demand management), can result in either a deficient or an excessive provision of treatment relative to ideal insurance. In particular, treatment for a low-probability illness is deficient if illness per se has little effect on the consumer's marginal utility of income and if the consumer's price elasticity of expected demand for treatment is large relative to the risk-spreading distortion when these are evaluated at a copayment that brings forth the ideal provision of treatment. Managed care, which controls moral hazard with physician incentives, can either increase or decrease treatment delivery relative to traditional insurance, depending on whether demand management results in deficient or excessive treatment. [source] Universal Health Insurance and the Effect of Cost Containment on Mortality Rates: Strokes and Heart Attacks in JapanJOURNAL OF EMPIRICAL LEGAL STUDIES, Issue 2 2009J. Mark Ramseyer For more than four decades, Japan has offered universal health insurance. Despite the demand subsidy entailed, it has kept costs low by regulatorily capping the amounts it pays doctors, particularly for the most modern and sophisticated procedures. Facing subsidized demand but stringently capped prices on complex procedures, Japanese physicians have had little incentive to invest in specialized expertise. Instead, they have invested in small private clinics and hospitals. The resulting proliferation of primitive clinics and hospitals has cut both the number of complex modern medical procedures performed, and the number of hospitals with any substantial experience in those procedures. With a quarter of the heart disease in the United States, Japan performs less than 3 percent as many coronary bypass operations and less than 6 percent as many angioplasties. Of the 855 cities and regions in Japan, 77 percent lack any hospital with substantial experience in the sophisticated modern treatment (defined below) of cerebrovascular disease, and 89 percent lack much experience in angioplasties. In this article, I estimate one of the costs of this regulatorily-driven lack of expertise. Toward that end, I combine mortality data from 855 cities with information on local hospital expertise and local demographic composition. In the typical city, I find that the addition of one hospital with substantial experience in modern stroke treatment would cut annual stroke mortality by 7 to 16 deaths. The addition of one hospital with substantial experience in angioplasties would cut the annual deaths from heart attacks in the city by over 19. [source] Introduction to the 2010 Special Issue of JRI on Health InsuranceJOURNAL OF RISK AND INSURANCE, Issue 1 2010Georges Dionne No abstract is available for this article. [source] The Effects of Uncertainty on the Demand for Health InsuranceJOURNAL OF RISK AND INSURANCE, Issue 1 2004atay Koç This article analyzes the effects of uncertainty and increases in risk aversion on the demand for health insurance using a theoretical model that highlights the interdependence between insurance and health care demand decisions. Two types of uncertainty faced by the individuals are examined. The first one is the uncertainty in the consumer's pretreatment health and the second is the uncertainty surrounding the productivity of health care. Comparative statics results are reported indicating the impact on the demand for insurance of shifts in the distributions of pretreatment health and productivity of health care in the form of first-order stochastic dominance, Rothschild,Stiglitz mean-preserving spreads, and second-order stochastic dominance. The demand for insurance increases in response to a Rothschild,Stiglitz increase in risk in the distribution of the pretreatment health provided that the health production function is in a special class and the price elasticity of health care is nondecreasing in the pretreatment health. Provided also that the demand for health care is own-price inelastic, the same conclusion is obtained when the uncertainty is about the productivity of health care. [source] Social and medical impact, sleep quality and the pharmaceutical costs of heartburn in TaiwanALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2005C.-L. LU Summary Background :,Little is known about the social and medical burdens of heartburn in Asia. Aim :,To assess the impact of heartburn in Taiwan. Methods :,We applied a questionnaire to 2018 apparently healthy adult Chinese receiving a routine health maintenance programme. Costs of heartburn-related prescriptions were obtained from the Bureau of National Health Insurance of Taiwan. Results :,Heartburn prevalence (>1 episode/week) was 7%. Smoking and increased body mass index were associated with heartburn occurrence. Heartburn sufferers reported more atypical gastro-oesophageal reflux disease symptoms, e.g. chest pain, dysphagia and globus. They were more likely to consult physicians, and have an increased frequency and number of days of absenteeism, irrespective of upper gastrointestinal or nongastrointestinal-related illnesses. They experienced sleep disturbances more frequently. The 62 heartburn consulters (48%) were more likely to have co-existing globus, visited physicians more, had more absenteeism, suffered from more sleep disturbances and had higher costs for antacids, proton pump inhibitors, hypnotic/sedatives, tranquilizers and antidepressants than nonconsulters. Conclusions :,Heartburn prevalence in Taiwan is lower than in Western countries. Nevertheless, heartburn in Taiwanese creates a significant burden in terms of social impact, health resource utilization, sleep quality and pharmaceutical costs. The increased costs of psychoactive drugs in consulters suggest that anxiety/depression affects their health-seeking behaviour. [source] Influence of overweight and obesity on physician costs in adolescents and adults in Ontario, CanadaOBESITY REVIEWS, Issue 1 2009I. Janssen Summary The study purpose was to perform an obesity cost-of-illness analysis for individuals living in the province of Ontario, Canada. The participants consisted of a representative sample of 25 038 adults and 2440 adolescents (aged 12,17 years) who participated in the 2000/2001 Canadian Community Health Survey (CCHS). The CCHS data set includes measures of body mass index (BMI) (classified as normal weight, overweight or obese) and relevant covariates (age, income, smoking, alcohol, physical activity). The CCHS data set was linked to the Ontario Health Insurance Plan providers' database to obtain physician costs for 2002,2003. A two-part modelling approach was used to calculate and compare the average annual physician cost according to BMI. After adjusting for the covariates, physician costs were not significantly higher in overweight men and women compared with those with a normal weight. Physician costs were 14.7% higher in obese men and 18.2% higher in obese women than in men and women with a normal weight. Average physician costs were comparable in normal-weight and overweight/obese adolescents ($233 per year in both groups). Because Ontario operates a publicly funded healthcare system, the findings of this study have relevance for other provinces/states and countries that operate similar healthcare systems. [source] Anreizkompatibilität als zentrales Element eines neu gestalteten GesundheitsmarktesPERSPEKTIVEN DER WIRTSCHAFTSPOLITIK, Issue 3 2004Thomas Gries Frequently, administrative rules defined by the government or private health (doctor) associations dominate the allocation mechanisms of the health system. These administrative rules along with asymmetric information often cause moral hazard problems leading to vast inefficiencies in the ,Physician-Patient-Market". Therefore, the discussion of efficient health systems should focus on the problem of compatible incentives within the allocation system of the health sector. Even more, without incentive consistency instruments recently suggested to cure the inefficiency of the German system like ,Managed Care", ,Disease Management" or ,Diagnosis Related Groups" will not be able to improve the efficiency of the health system. Introducing these instruments without a full incentive , compatible allocation system covering all segments of the health system will just shift the problem of asymmetric information and moral hazard to another sub-market of the system, the ,Health Insurance,Patient-Market". Therefore, the intention of the paper is to identify the major elements of a suitable incentive , compatible allocation scheme for the health market. Further, we propose an independent evaluation and information institution as a major tool to cure the problem of asymmetric information in the health market. [source] Analgesic use and the risk for progression of chronic kidney disease,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 7 2010Hsin-Wei Kuo Abstract Purpose The chronic effect of various analgesics on the progression of chronic kidney disease (CKD) is inconclusive. There is also lack of information on the renal safety of selective cyclooxygenase-2 (COX-2) inhibitors. This study aimed to clarify the renal risk of analgesic use in CKD patients. Methods A cohort study using a nationally representative database randomly sampled from National Health Insurance (NHI) enrollees was performed. The study population included a total of 19,163 newly diagnosed CKD patients. Clinical conditions were defined by diagnostic codes and exposure information on analgesics was derived from service claims. Cox proportional hazard model was used to assess the association between analgesic use and the risk of progression to end stage renal disease (ESRD). Results CKD patients using acetaminophen, aspirin, and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) had an increased risk for ESRD with multivariable-adjusted HRs (95%CIs) of 2.92 (2.47,3.45), 1.96 (1.62,2.36), and 1.56 (1.32,1.85), respectively. The trends toward higher risk with increasing exposure dose were significant for all classes of analgesics (all P for trend,<,0.001). Among COX-2 inhibitors, only rofecoxib, but not celecoxib, shows a significant risk association with ESRD (HR,=,1.98; 95%CI, 1.15,3.40). Conclusions Our data indicated exacerbating effects of acetaminophen, aspirin, and non-selective NSAIDs on CKD in a dose-dependent manner. For COX-2 inhibitors, only rofecoxib showed an increased risk for ESRD. Although the possibility of residual confounding cannot be completely ruled out, given the common use of analgesics, the possible relation suggested by this study warrants further investigation. Copyright © 2010 John Wiley & Sons, Ltd. [source] Will Subsidising Private Health Insurance Help the Public Health System?THE ECONOMIC RECORD, Issue 242 2002Rhema Vaithianathan This paper challenges the argument that expanding private health insurance coverage in Australia will reduce the demand for public hospitals. We construct a simple model to illustrate that although a premium subsidy might expand insurance coverage, it may not reduce the demand for public health services. The reason is that, under certain conditions, government subsidies only increase insurance coverage among self,insured consumers; that is, consumers who are uninsured but purchase private health care if they fall ill. We argue that subsidising private health care rather than insurance is a more effective way of reducing the demand for public health services. [source] Update: Health Insurance and Utilization of Care Among Rural AdolescentsTHE JOURNAL OF RURAL HEALTH, Issue 4 2005Janice C. Probst PhD ABSTRACT: Context: Adolescence is critical for the development of adult health habits. Disparities between rural and urban adolescents and between minority and white youth can have life-long consequences. Purpose: To compare health insurance coverage and ambulatory care contacts between rural minority adolescents and white and urban adolescents. Methods: Cross-sectional design using data from the 1999,2000 National Health Interview Survey, a nationally representative sample of US households. Analysis was restricted to white, black, and Hispanic children aged 12 through 17 (8,503 observations). Outcome measures included health insurance, ambulatory visit within past year, usual source of care (USOC), and well visit within past year. Independent variables included race, residence, demographics, facilitating/enabling characteristics, and need. Results: Across races, rural adolescents were as likely to have insurance (86.8% vs 87.7%) but less likely to report a preventive visit (60.1% vs 65.5%) than urban children; residence did not affect the likelihood of a visit or a USOC. Minority rural adolescents were less likely than whites to be insured, report a visit, or have a USOC. Most race-based differences were not significant in multivariate analysis holding constant living situation, caretaker education, income, and insurance. Low caretaker English fluency, limited almost exclusively to Hispanics, was an impediment to all outcomes. Conclusions: Most barriers to care among rural and minority youth are attributable to factors originating outside the health care system, such as language, living situation, caretaker education, and income. A combination of outreach activities and programs to enhance rural schools and economic opportunities will be needed to improve coverage and utilization among adolescents. [source] Employers' Benefits from Workers' Health InsuranceTHE MILBANK QUARTERLY, Issue 1 2003Ellen O'Brien Most nonelderly americans receive their health insurance coverage through their workplace. Almost all large firms offer a health insurance plan, and even though they face greater barriers to providing coverage, so do the majority of very small firms. These employment-based plans cover two-thirds of nonelderly Americans and pay most of working families' expenses for health care and about one-quarter of national health spending. Despite employers' role in the health insurance market, however, very little attention has been paid to employers' motivations for providing health insurance to workers. Why do employers offer health insurance to workers? Is it because workers want it? Because their unions demand it? Or do employers offer health benefits to workers because their productivity and profitability depend on it? The standard economic theory of the availability of employer-provided health insurance focuses on worker demand (Cutler 1997; Pauly 1997; Summers 1989). Even though many employers believe that health insurance and health affect employees' productivity and firms' performance, health economists typically overlook and rarely measure firms' returns on health-related investments. Some research, however, suggests that firms may benefit economically by providing health insurance coverage for workers and their families. For example, health coverage may help employers recruit and retain high-quality workers. Health may contribute to productivity by reducing the costs of absenteeism and turnover and by increasing workers' productivity. This article reviews the evidence and proposes an agenda for future research. A better understanding of the benefits to employers of offering health coverage to workers may help clarify employers' behavior and help private employers and public officials make appropriate investments in health. [source] Employer-Sponsored Health Insurance: Are Employers Good Agents for Their Employees?THE MILBANK QUARTERLY, Issue 1 2000Pamela B. Peele Employers in the United States provide many welfare-type benefits, such as life insurance, disability insurance, health insurance, and pensions, to their employees. Employers can be viewed as performing an agency role in purchasing pension, health, and other welfare benefits for their employees. An exploration of their competence in this role as agents for their employees indicates that large employers are very helpful to their employees in this arena. They seem to contribute to individual employees' welfare by providing them with valued services in purchasing health insurance. [source] The System of Health Insurance for Living Donors Is a Disincentive for Live DonationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2010E. S. Ommen The health insurance system for living donors is derived from insurance policies designed to cover accidental death or dismemberment. The system covers only the direct consequences of organ removal, and recoups the costs of related medical services from the transplant recipient's health insurance provider. The system forces transplant programs to differentiate between health services that are, or are not directly attributable to donation and may compromise the pretransplant evaluation, postoperative care and long-term care of living donors. The system is particularly problematic in the United States, where a significant proportion of donors do not have medical insurance. The requirement to assign donor costs to a particular recipient is poorly suited to facilitate advances in living donation such as the use of nondirected donors and living-donor paired exchange programs. We argue that given the current understanding regarding the long-term risks of living donation, the provision of basic medical insurance is a necessity for living donation and that the system of attributing donor costs to the recipient's insurance is inefficient, has the potential to undermine the care of living donors and is a disincentive to the expansion of living donation. [source] Political Feasibility Analysis of the New Financing Scheme for the National Health Insurance Reform in Taiwan: An Application of Stakeholder AnalysisASIAN SOCIAL WORK AND POLICY REVIEW, Issue 3 2010Chao-Yin Lin This study carries out in-depth political feasibility analysis of the prospective health financing reform currently taking place in Taiwan. The National Health Insurance (NHI) Program, which was established in Taiwan in 1995, covers virtually all of the island's citizens. Between the years 2001 and 2004, the Taiwanese Government organized a taskforce to carry out the wholesale reform of the NHI program into the so-called ,Second Generation NHI Program'. This study is part of the comprehensive review, focusing on the preferences and positions of key policy stakeholders with regard to the financial reform proposals, as well as their network relationships. The approach of stakeholder analysis was employed to conduct this empirical study. The results reveal that the new financing scheme has a certain degree of support from the policy stakeholders participating in this study, and that in particular, the measures concerning equity and sustainability were most welcome. However, controversy remains with regard to the issue of the equitable sharing of contributions. It is clear that there is much strong support for the new scheme amongst the administrative and legislative elite, although the same level of support is not evident amongst the social elite affiliated with employees' associations and welfare groups. [source] Financing Health Insurance in Asia Pacific CountriesASIAN-PACIFIC ECONOMIC LITERATURE, Issue 1 2007Alexandra A. Sidorenko The paper discusses models of health insurance, including compulsory (social) health insurance, voluntary insurance, and community-based financing schemes. It illustrates the features of these models in terms of coverage, funding, sustainability, payment mechanisms, public,private mix, risk protection, and cost-containment properties, and outlines some emerging challenges to health financing arrangements. Health financing systems used in Japan, Korea, Taiwan, ASEAN and China are discussed, and implications are drawn for the developing countries in the Asia Pacific contemplating health insurance reform. [source] Taiwan's High Rate of Cesarean Births: Impacts of National Health Insurance and Fetal Gender PreferenceBIRTH, Issue 2 2007Tsai-Ching Liu PhD ABSTRACT: Background: Taiwan has a high rate of cesarean section, approximately 33 percent in the past decade. This study investigates and discusses 2 possible factors that may encourage the practice, one of which is fetal gender difference and the other is Taiwan's recently implemented National Health Insurance (NHI). Methods: A logistic regression model was used with the 1989 and 1996 National Maternal and Infant Health Survey and with the 2001 to 2003 NHI Research Databases. Results: Using survey data, we found a statistically significant 0.3 percent gender difference in parental choice for cesarean section. However, no statistically significant difference was found in the rate of cesarean section before and after NHI implementation. Conclusions: Taiwan's high cesarean section rate is not directly related to financial incentives under NHI, indicating that adjusting policy to lower financial incentives from NHI would have only limited effect. Likewise, focusing effort on the small gender difference is unlikely to have much impact. Effective campaigns by health authorities might be conducted to educate the general population about risks associated with cesarean section and the benefits of vaginal birth to the child, mother, and society. (BIRTH 34:2 June 2007) [source] Health-Care Reform and ESI: Reconsidering the Relationship Between Employment and Health InsuranceBUSINESS AND SOCIETY REVIEW, Issue 3 2010PATRICIA C. FLYNN ABSTRACT The health-care reform promised by the Patient Protection and Affordable Care Act of March 2010 continues our dependence on a central feature of the American health-care system: employer-sponsored insurance (ESI). In this article I will criticize the assumptions regarding market and welfare concerns on which this dependence is based and argue that efforts to mandate ESI ignore both the dynamics of the employment relation and the nature of health-care needs. A comparison between investing in employee education and investing in employee health will reveal the pragmatic challenges to ESI and the covert appeal to employer beneficence on which ESI rests. This paper argues that relying on ESI to guarantee appropriate care for a significant segment of the population is undesirable and unsustainable from both market and moral perspectives. [source] | |||||||||||||||||||||||||||||||||||||||||||