Private Health Insurance

The above figure focuses on the sources of awareness of the private health insurance companies. Totally out of 120 respondents 42 % of male and 23 % of female respondents come know from the agents. Independent insurance agents typically represent a number of insurance companies, or "carriers", and sell the products that most appropriately meet the needs of their clients. Independent agents typically are very well trained and knowledgeable of the complexities of the insurance market and insurance law. Their expertise allows them to advise their clients about appropriate amounts of insurance and insurance coverage for their particular needs. Oftentimes, independent insurance agents will work with insurance intermediaries, which obtains quotes from multiple insurance providers and passes them off to the independent agent. Working with an insurance intermediary service allows the independent agent to review many quotes and offer their clients the best policy options available. For their efforts, independent agents are paid a commission (remuneration).

Abstract: This study investigates the determinants of demand for private health insurance among formal sector employees in Malawi, a poor country with heavy pressure on under-funded free government health services. The study is based on membership in the Medical Aid Society of Malawi’s (MASM), three schemes, namely: the VIP, the best; the Executive, the intermediate; and the Econoplan, the minimum. The results indicate that formal sector employees prefer to receive medical treatment from private fee-charging health facilities, where health insurance would be relevant. The study finds that the probability of enrolling in any of MASM’s schemes increases with income and with age for the top and minimum schemes. More children and good health status reduce the probability of enrolling into the two lower schemes. The results suggest the potentially important roles that can be played by information and interventions that address the affordability factor such as through employer contributions that take into consideration income and family size.

Background: Information on risk selection is important for the regulation and development of supplemental private health insurance (PHI). The research on risk selection into supplemental PHI has been documented in several developed countries where the regulation of the PHI markets was relatively mature. However, evidence on this important aspect of the supplemental PHI market in China is still absent in the literature. The private insurers in China were not prohibited from discrimination against pre-existing conditions and did not guarantee ongoing enrolment. Therefore, the direction and degree of risk selection could not be inferred using the evidence from the other countries. To provide evidence on risk selection into supplemental PHI in China, we conducted a cross- sectional analysis using data from the 2015 wave of China Health and Retirement Longitudinal Study (CHARLS). Results: Using probit models, we found that individuals having better self-reported general health were more likely to enrol in PHI in China, suggesting advantageous selection. This result was confirmed by an alternative analysis using an instrumental variable. We also adjusted the realized occurrence of hospitalization by excluding potential moral hazard effect and showed that the adjusted hospitalization risk was negatively associated with PHI

the propensity score histogram of the control group (w = 0) and below, the treatment one (w = 1). The histo- gram shows how many treated and control units are matched within each propensity score stratum. As long as there are at least as many untreated units as there are treated units, we can match both using neighbor algo- rithm. Moreover, another point of interest is the one re- lated with potential endogeneity problems. These issues may arise by the way in which the relevant health status is observed in social surveys. However, we have assumed exogeneity of health indicators based on the results ob- tained by Urbanos et al. [10], Kreider [31] and Linde- boom et al. [32]. In fact, it is assumed that the effect of taking out private health insurance on health status is a gradual process rather than an instantaneous effect. Table 5 Matching and regression estimates of the effect of private health insurance on general practitioner and specialist visits

Data were collected concerning private health insurance coverage of services needed by chronically ill children, including basic medical care services, ancillary therapies, mental health[r]

The Spanish Insurance Law defines PHI – so called ‘Seguro de Asistencia Sanitaria’ - as an insurance that “provides to the insured with the medical, hospital and surgery care, with own staff of doctors whereby the insurer takes care of its own enrolees in exchange of a premium”. Unlike in other EU countries, insurance policies are mainly individually (rather than corporately) purchased and, typically, benefits are received in kind rather than reimbursed to the patient. Normally, to control ex-ante moral hazard after purchasing PHI there is at least a 6-month period by which no claims can be satisfied with the exception of urgent care. 5 Contracts have an undetermined duration and can be cancelled by both insurer and insured. The majority of insurance policies purchased are for medical care, usually under the form of indemnity. 6 Previous research using data from Catalonia (Costa-Font and García, 2003, Costa-Font and García 2002, and Costa-Font and Font-Vilalta, 2004) indicates that demographic variables are important determinants in the purchase of PHI, and for instance, the share of PHI increases up until the age of 30. The largest share of the Catalan private health insurance market is concentrated in Barcelona (78.6 percent of the insured), which represents around 23 percent of the total population in Barcelona. In Tarragona, Girona and Lleida 17 percent, 22 percent and 22 percent of the population buys PHI, respectively.

Literature on private health insurance or health insurance in the Caribbean, and in particular Jamaica, has been substantially on 1) population density–i.e. coverage, 2) coverage offerings, 3) cost of care–i.e. health economics, and 4) acceptance (or lack of) by health service provid- ers of certain insurance coverage. Having extensively perused the literature review on private health insurance and health care reform in Jamaica, it is obvious that no study has been conducted identifying the different fac- tors that explain health insurance coverage in this nation. The individual utilization pattern of health insurance coverage is highly associated over time with older adults [1,2] as they prepare for the degeneration of the body; but, what else do we know about those who have private health insurance in Jamaica? Do insurers attract healthy patients, and are high risk individuals more likely to become insured as against their low risk (i.e. less health conditions) counterparts? Health insurance is a con- stituent of health seeking behaviour, suggesting that it is equally important in any study of health, quality of life, and wellbeing. In this study the researchers will criti- cally examine factors that can be used to predict private health insurance coverage by using a logistic regression technique to explain the independent effect; and in the process the researchers will investigate the lives of re- spondents in order to understand those who reported having private health insurance coverage.

Permanent repository link: http://openaccess.city.ac.uk/5401/ Link to published version: Copyright and reuse: City Research Online aims to make research outputs of City, University of Lo[r]

Additionally, we analyzed the effect of cost-sharing on health care utilization by type of health insurance (Medical Aid, NHI). The utilization of outpatient visits declined for both Medical Aid and NHI benefi- ciaries after the introduction of cost-sharing. However, the magnitude of the cost-sharing effect was stronger for Medical Aid. This result may indicate that low- income patients are more sensitive to cost-sharing. Other studies reported similar differences in the effect size of cost-sharing by economic status. A study in Japan showed that utilization of outpatient care was most sensitive to the copayment rate [16]. Per-capita income stratification models revealed that the greatest copayment effect on inpatient care was for the lowest income group in the National Health Insurance sys- tem. A Korean study also showed that the magnitude of the impact of copayment on the number of phys- ician visits varied depending on income level. Increas- ing cost-sharing rates affected health care utilization by individuals with relatively low income [28]. These results indicated that increasing copayment rates may raise problems by discouraging access to medical care services for the poor.

Scholars are eager to evaluate the effects of health policy on health, but they often neglect that policies are intricately connected to marriage, family structure, and social standing. The three chapters of this dissertation study unintended consequences of health insurance policies in the United States. How people gain private health insurance is connected to divorce (chapter 1) and availability of a public insurance program at birth is associated with lower mortality not only in infanthood but also in adulthood (chapter 2). US health policies that tie health insurance coverage to socioeconomic status add dimensions to racial and ethnic inequality. Minorities spend more years without insurance due to their greater probabilities of losing coverage (chapter 3). These chapters provide national landscapes of health insurance coverage and inequality in the years prior to the Patient Protection and Affordable Care Act of 2010 setting the baseline for post-reform comparisons. In Chapter 1, I apply hazard models to the nationally representative longitudinal Survey of Income and Program Participation (2004 panel) to find lower divorce rates among people who are enrolled in their spouses’ health insurance policies. Women who depend on their husbands for health insurance had the lowest rates of divorce. This chapter highlights how family- and employment-based insurance coverage could create inequalities between families and between men and women.

health care has long fallen on lower- and mid- dle-income payers of private health insurance premiums.' One increasingly recognized problem is that health care prices[r]

This paper aims to investigate impacts of public provision of universal health in- surance (UHI) in an environment with household heterogeneity and financial mar- ket incompleteness. Various UHI polices with both distortionary (payroll-tax) and non-distortionary (lump-sum tax) financing methods are compared to address the trade-off between risk reduction and tax distortion as well as corresponding welfare implications. We undertake a dynamic equilibrium model with endogenous insur- ance choice and labor supply decisions to perform quantitative analyses. The results suggest that the UHI expenditure coverage rate would be too high in most OECD countries when the distortion effect is considered. We find a clear crowding out effect on asset holdings. Implications for private health insurance (PHI) purchases when UHI is introduced depend on the pricing and the design of coverage. We find the rich are sensitive to the price of PHI, and would prefer a supplemental plan when UHI is introduced.

The influence of health insurance on access to the private health care facilities has an important policy implication. For the last three decades, Malaysia is considering on restructuring its health care financing system to ensure integrated health care delivery system. The evidence from this study suggests that promoting health insurance ownership may shift the demand of health care to the private health institutions thus reducing the crowd-out at the public health facilities. A key policy priority is therefore to increase health insurance ownership either through subsidizing private health insurance premium or developing an affordable social insurance program. However, insurance ownership reduces out of pocket payment in private facilities and it could be associated with moral hazard problem. The presence of moral hazard may crippled the role of health insurance as over utilization will result in higher than average insurance claims. Thus, regulating utilization is needed to avoid unnecessary demand which will later influence health insurance and health care prices. Cost containment measures such as co-insurance may need to be a compulsory feature in health insurance program to control utilization as insured also has to share health care cost with the insurance company.

The choice between public health financing or private insurance is hardly available to countries like India because of their governments’ limited ability to marshal sufficient resources to finance health spending, and also because the nature of employment (where majority of workers are self-employed, or do not have a formal employer or steady employment) is such as to provide little scope for payroll taxes[13]. Given this, heavy reliance on private spending is necessary for financial reasons, notwithstanding the declared policy of the state to provide universal, comprehensive primary health services to the entire population. Private spending may also be desirable on efficiency grounds[14]. But the form that bulk of private spending takes need to change from out-of-pocket payments to private insurance. Conceptually, a society can be thought of as consisting of two groups of individuals, those who can afford to buy health insurance that promises certain “minimum” level of benefit, and those who cannot afford to buy the “minimum” benefit on their own and need some public subsidy[15]. As mentioned above, development of private health insurance may take care of those who can afford to buy insurance. For those who cannot afford, alternate approaches with some public subsidy are suggested.

Private health insurance is generally expensive, and thus, is undertaken mostly by people with higher income rather than the poor (Gertler & Sturm, 1997; Sekhri & Savedoff, 2005). Therefore, the significant effects of the financial variables Income and Gov on insurance expenditure should be unquestionable. However, the observation of a negatively significant effect of IQ on health insurance was surprising. When the oil-rich Persian Gulf countries were excluded from our analysis, IQ became more significant (p<.01) than Gov (p<.05). The fitness of the model with the adjusted R 2 value was greater than .70, which was good enough to verify that the negative effect of IQ on Insurance really exists. If a model were to be employed efficiently for predictive function, an R 2 greater than .70 would be ideal, given that it is difficult to obtain a high R 2 using cross-sectional data rather than time-series data (Doran, 1989, pp. 85–86). This finding refutes our earlier postulation that IQ may be associated positively with expenditure on health insurance based on the facts that high IQ individuals have healthier lifestyles and are more patient and perceptive to gaining better rewards in the future. Hence, one may question why high IQ societies have spent less on private health insurance.

Abstract: The provisions of the law of the Latvian Republic related to health care are not on basis on competition law, offering it as public services only. On the other hand, health insurance provided by private insurance undertakings covers significant part of health care services and mostly used by state entities and municipalities. The private health insurance ensures also a significant part of medical expenses for individuals. At the same time, the European Union regime for the non- life insurance including health insurance (in a number of directives and regulations) limits the ability of Member States of the European Union to intervene in insurance conditions and prices, except for schemes of a social security. These conditions reflects the necessity of compliance between compulsory insurance coverage in the health insurance if it has been created (Latvia still has no it) and bringing of the risk to private insurance undertakings that characterizes the increasing importance of health insurance the Latvian Republic as part of the policy mix. There is also opportunity for Latvia to apply some mentioned policy mix to problems of funding and guaranteeing the provision of health care. However, it is still difficult to find the necessary balance for two mentioned parts of the main process.

The independent variables included children charac- teristics such as current weight and birth weight (stan- dardized by mean deviation), number of hospitalizations after delivery, child health status reported by the mother (children were considered healthy when they reported either “good,” “very good,” or “excellent” health), and having private health insurance; household characteris- tics such as number of people living in the household, family income (the natural log of the sum of incomes of all household members); head of household (father or mother); maternal characteristics including age (with a quadratic term to accommodate for possible nonlinear changes); maternal self-reported health status (healthy when they reported either “good,” “very good,” or “excel- lent”), and maternal level of education at the time of the child birth.

Another barrier to integrated and people‐centred health services in Australia is the lack of accountability of private hospitals, private specialists and private insurance funds for the quality of private hospital care and the efficiency with which public funds are used. Conservative govern- ments have legislated for huge government subsidies to keep the price of private health insurance (for private inpatient care) affordable while public hospitals are seri- ously stretched. Significant financial penalties (linked to Medicare premiums) have been put in place to encourage (or force) people to buy private hospital insurance. 11

I prefer the UK Cochrane Centre to competitive insurance as a means of securing greater efficiency, public purchasing health authorities to private health insurers as a means of revealin[r]

One of the equity concerns relating to the NHIS is how it has affected the non-insured. When a new Diagnosis- Related Group (DRG) tariff was introduced in 2008 it increased 'cash and carry' prices as much as those paid by the DMHIS. For the non-insured, who are commonly the less well off, this will have increased existing financial bar- riers to health care. Assessing to what extent the non- insured have been 'squeezed out' of the market is not straightforward, but at the fact that two-thirds of 'inter- nally generated revenue' (IGF – income generated by facil- ities from user fees and the NHIS) is now generated by the NHIS (see below), while membership is 45% of the pop- ulation, suggests that the non-insured are using fewer services and/or less expensive services. Whether they are using fewer services than they did prior to the tariff increases would require more in-depth study, but it seems intuitively likely, given rises in user fees.