Immigrants' Experience with Publicly Funded Private Health Insurance

Despite various efforts introduced, private health insurance coverage is still low in Malaysia. The objective of this article is to find the factors associated with not having a private health insurance in Malaysia. We analyze data involving 19 959 respondents from the 2015 National Health Morbidity Survey. In this article, we describe the prevalence of not having health insurance and conducted binary logistic regression to identify determinants of uninsured status. A total of 56.6% of the study population was uninsured. After adjusting for other variables, the likelihood of being uninsured was higher among those aged 50 years and above, females, Malay/other Bumiputra ethnicities, rural, government/semigovernment, self-employed, unpaid workers and retirees, unemployed, lower education level, without home ownership and single/widowed/divorced, daily smoker, underweight body mass index, and current drinker. The likelihood of being uninsured also increased with increasing household size while the inversed trend was seen for household income. A substantial proportion of population in Malaysia did not have private health insurance, and these subgroups have limited preferential choices for provider, facility, and care.

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Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/00469580211028171 ◽

2021 ◽

Vol 58 ◽

pp. 004695802110281

Author(s):

Minsung Sohn ◽

Minsoo Jung ◽

Mankyu Choi

Keyword(s):

Socioeconomic Status ◽

Health Insurance ◽

Health Status ◽

Regression Models ◽

Private Health Insurance ◽

Public And Private ◽

Logistic Regression Models ◽

Self Rated Health ◽

Interaction Terms ◽

Healthcare Coverage

To investigate the effects of public and private health insurance on self-rated health (SRH) status within the National Health Insurance (NHI) system based on socioeconomic status in South Korea. The data were obtained from 10 867 respondents of the Korea Health Panel (2008-2011). We used hierarchical panel logistic regression models to assess the SRH status. We also added the interaction terms of socioeconomic status and type of health insurance as moderators. Medical aid (MA) recipients were 2.10 times more likely to have a low SRH status than those who were covered only by the NHI, even though the healthcare utilization was higher. When the interaction terms were included, those not covered by the NHI and had completed elementary school or less were 16.59 times more likely to have a low SRH status than those covered by the NHI and had earned a college degree or higher. Expanding healthcare coverage to reduce the burden of non-payment and unmet use to improve the health status of MA beneficiaries should be considered. Particularly, the vulnerability of less-educated groups should be focused on.

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A clinical update on managed care implications for Australian psychiatric practice

Australasian Psychiatry ◽

10.1177/10398562211030011 ◽

2021 ◽

pp. 103985622110300

Author(s):

Jeffrey CL Looi ◽

Stephen R Kisely ◽

Tarun Bastiampillai ◽

William Pring ◽

Stephen Allison

Keyword(s):

Health Insurance ◽

Managed Care ◽

Private Health Insurance ◽

Psychiatric Treatment ◽

Patient Choice ◽

Insurance Sector ◽

Cost Cutting ◽

Appropriate Treatment ◽

The Us ◽

Limit Access

Objective: To provide a clinical update on private health insurance in Australia and outline developments in US-style managed care that are likely to affect psychiatric and other specialist healthcare. We explain aspects of the US health system, which has resulted in a powerful and profitable private health insurance sector, and one of the most expensive and inefficient health systems in the world, with limited patient choice in psychiatric treatment. Conclusions: Australian psychiatrists should be aware of changes to private health insurance that emphasise aspects of managed care such as selective contracting, cost-cutting or capitation of services. These approaches may limit access to private hospital care and diminish the autonomy of patients and practitioners in choosing the most appropriate treatment. Australian patients, carers and practitioners need to be informed about the potential impact of private managed care on patient-centred evidence-based treatment.

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Identifying Risk Profiles of Malignant Prostate Cancer Surgical Delay Using a Person-Centered Approach to Understand Prostate Cancer Disparities: The Constellation of Health Determinants Using Latent Class Analysis on Cancer Registry Data

American Journal of Men s Health ◽

10.1177/1557988320984282 ◽

2020 ◽

Vol 14 (6) ◽

pp. 155798832098428

Author(s):

Francisco A. Montiel Ishino ◽

Claire Rowan ◽

Rina Das ◽

Janani Thapa ◽

Ewan Cobran ◽

...

Keyword(s):

Prostate Cancer ◽

Health Insurance ◽

Latent Class Analysis ◽

Cancer Registry ◽

High Probability ◽

Private Health Insurance ◽

Latent Class ◽

Class Analysis ◽

Risk Profiles ◽

Surgical Delay

Surgical prostate cancer (PCa) treatment delay (TD) may increase the likelihood of recurrence of disease, and influence quality of life as well as survival disparities between Black and White men. We used latent class analysis (LCA) to identify risk profiles in localized, malignant PCa surgical treatment delays while assessing co-occurring social determinants of health. Profiles were identified by age, marital status, race, county of residence (non-Appalachian or Appalachian), and health insurance type (none/self-pay, public, or private) reported in the Tennessee Department of Health cancer registry from 2005 to 2015 for adults ≥18 years ( N = 18,088). We identified three risk profiles. The highest surgical delay profile (11% of the sample) with a 30% likelihood of delaying surgery >90 days were young Black men, <55 years old, living in a non-Appalachian county, and single/never married, with a high probability of having private health insurance. The medium surgical delay profile (46% of the sample) with a 21% likelihood of delay were 55–69 years old, White, married, and having private health insurance. The lowest surgical delay profile (42% of the sample) with a 14% likelihood of delay were ≥70 years with public health insurance as well as had a high probability of being White and married. We identified that even with health insurance coverage, Blacks living in non-Appalachian counties had the highest surgical delay, which was almost double that of Whites in the lowest delay profile. These disparities in PCa surgical delay may explain differences in health outcomes in Blacks who are most at-risk.

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Changes in the activity levels and financing sources of Israel’s private for-profit hospitals in the wake of reforms to the public-private divide

Israel Journal of Health Policy Research ◽

10.1186/s13584-021-00455-z ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Royi Barnea ◽

Adi Niv-Yagoda ◽

Yossi Weiss

Keyword(s):

Health Insurance ◽

Surgical Procedures ◽

Health Expenditure ◽

Medical Center ◽

Waiting Times ◽

Publicly Funded ◽

Private Hospitals ◽

The Public ◽

For Profit ◽

Elective Surgical Procedures

Abstract Background The Israeli National Health Insurance Law provides permanent residents with a basket of healthcare services through non-profit public health insurance plans, independently of the individual’s ability to pay. Since 2015, several reforms and programs have been initiated that were aimed at reinforcing public healthcare and redressing negative aspects of the health system, and specifically the constant rise in private health expenditure. These include the “From Reimbursement-to-Networks Arrangement”, the “Cooling-off Period” program and the program to shorten waiting times. The objectives of this study were to identify, describe, and analyze changes in private hospitals in 1) the volume of publicly and privately funded elective surgical procedures; and 2) private health expenditure on surgical procedures. Methods Data on the volume and funding of surgical procedures during 2013–2018 were obtained from Assuta Medical Center, Hertzelia Medical Center, the Israeli Ministry of Health and the Central Bureau of Statistics. The changes in the volume and financing sources of surgical activities in private hospitals, in the wake of the reforms were analyzed using aggregate descriptive statistics. Results Between 2013 and 2018 the volume of surgical activities in private for-profit hospitals increased by 7%. Between 2013 and 2017, the distribution of financing sources of surgical procedures in private hospitals remained stable, with most surgical procedures (75–77%) financed by the voluntary health insurance programs of the health plans (HP-VHI). In 2018, following the regulatory reforms, a significant change in the distribution of financing sources was observed: there was a sharp decline in the volume of HP-VHI-funded surgical procedures to 26%. Concurrently, the share of publicly-funded surgical procedures performed in private hospitals increased to 56% in 2018.,. During the study period, private spending on elective surgical procedures in private hospitals declined by 53% while public funding for them increased by 51%. Conclusions and policy implications In the wake of the reforms, there was a substantial shift from private to public financing of elective surgical activity in private hospitals. Private for-profit hospitals have become important providers of publicly-funded procedures. It is likely that the reforms affected the public-private mix in the financing of elective surgical procedures in those hospitals, but due to the absence of a control group, causality cannot be proven. It is also unclear whether waiting times were shortened. Health reforms must be accompanied by a clear and comprehensive set of indicators for measuring their success.

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