scholarly journals Private health insurance: the problem child faces adulthood

2002 ◽  
Vol 25 (2) ◽  
pp. 38 ◽  
Author(s):  
Mark Cormack
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Medical Profession ◽  
Public Hospitals ◽  
Reform Process ◽  
Private Hospitals ◽  
Policy Initiatives ◽  
Problem Child ◽  
Insurance Funds ◽  
Health Insurance Funds

Since its election to office in 1996, reform of Private Health Insurance (PHI) has been the most obvious health policy focus of the Howard Government. The reform process has focussed on price, product, promotion, legislation and regulation. It has resulted in one of thelargest new Commonwealth health outlays in recent memory. Health insurance funds have emerged as activepurchasers of care, not just passive reimbursers of costs. PHI fund reserves have moved from precarious liquidity tohealthy surplus. Private hospitals are busier than ever before, but margins are slim. Anecdotally, public hospitals report little benefit to date. Waiting lists have not been reduced, and their budgets are unchanged as a result of the $2 Bn allocated under the 30% Rebate scheme. The paper begins by describing the origins of the PHI reform. Its objectives, policy initiatives, results to date and criticisms are analysed. Criticisms include the actual and opportunity costs. Specific concerns remain as to its effectiveness to date in reducing pressure on public hospitals, and perceived lack of equity for certain client groups. Themost significant result is that much of the reform package is here to stay including the expensive and much criticised 30% rebate. Like Medicare before it, the PHI reforms have achieved bipartisan support. The paper concludes by describing future implications for Government, industry, consumers and the medical profession.

Gemeinsame Selbstverwaltung: Bedingungen der Aufgabenwahrnehmung

2019 ◽  
Vol 68 (6-7) ◽  
pp. 519-536
Author(s):  
Thomas Gerlinger
Keyword(s):  
Health Insurance ◽  
Medical Profession ◽  
Insurance Companies ◽  
Regulatory Change ◽  
Self Administration ◽  
Insurance Funds ◽  
Health Insurance Companies ◽  
Joint Federal Committee ◽  
Health Insurance Funds ◽  
Regulated Competition

Zusammenfassung Ein vielgestaltiger Wandel in Gesundheitssystem und Gesundheitspolitik erschwert den Verbänden der Ärzte und Krankenkassen die Wahrnehmung ihrer Aufgaben im Rahmen der gemeinsamen Selbstverwaltung. Erstens steigert die mit der Einrichtung des Gemeinsamen Bundesausschusses verbundene transsektorale Ausweitung der korporatistischen Verhandlungssystemen die Komplexität der Akteurs- und Interessenkonstellationen in der gemeinsamen Selbstverwaltung. Zweitens trägt der ordnungspolitische Wandel in Richtung auf einen regulierten Wettbewerb zu einer Binnendifferenzierung der Interessen in der Ärzteschaft und bei den Krankenkassen bei. Drittens erschwert auf der Seite der Ärzteschaft zusätzlich die Ausdifferenzierung von Disziplinen, Versorgungseinrichtungen und -formen sowie von beruflichen Identitäten die für das Funktionieren der gemeinsamen Selbstverwaltung erforderliche Aggregation von Interessen und die Kompromissfindung. Abstract A multi-faceted change in the health system and health policy makes it difficult for associations of doctors and health insurance companies to carry out their tasks within the framework of joint self-government. First, the transsectoral expansion of corporatist bargaining systems associated with the establishment of the Joint Federal Committee increases the complexity of stakeholder and stakeholder constellations in joint self-government. Second, regulatory change towards regulated competition contributes to an internal differentiation of interests in the medical profession and in the health insurance funds. Third, on the side of the medical profession, the differentiation of disciplines and care as well as of occupational identities further complicates the aggregation of interests and compromise-finding necessary for the functioning of joint self-administration.

scholarly journals The Effect of Increased Private Health Insurance Coverage on Victorian Public Hospitals

2003 ◽  
Vol 26 (2) ◽  
pp. 6 ◽  
Author(s):  
Neil Powers ◽  
Vijaya Sandararajan ◽  
Steve Gillett ◽  
Ric Marshall
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Elective Surgery ◽  
Low Cost ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Waiting Lists ◽  
Public Hospitals ◽  
Private Hospitals

It was anticipated that the recent reforms to private health insurance arrangements would reduce the demand pressureson Australian public hospitals. However, this has not been demonstrated by trends in elective surgery waiting lists inVictorian public hospitals. Moreover, it appears that the increased caseload assumed by Victorian private hospitals sincethe reforms took effect mainly reflects an increase in low cost same day episodes.

scholarly journals Effects of increased private health insurance on hospital utilisation in Victoria

2004 ◽  
Vol 28 (3) ◽  
pp. 320 ◽  
Author(s):  
Vijaya Sundararajan ◽  
Kaye Brown ◽  
Toni Henderson ◽  
Don Hindle
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Severe Disease ◽  
Public Hospitals ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Number Of Patients ◽  
Hospital Utilisation ◽  
Two Sectors

The proportion of Victorians and Australians generally with private health insurance (PHI) increased from 31% in 1998 to 45% in 2001. We analysed a dataset containing all hospital separations throughout Victoria to determine whether changes in the level of private health insurance have had any impact on patterns of public and private hospital utilisation in Victoria. Total utilisation of private hospitals grew by 31% from 1998?99 to 2002?03, whereas utilisation of public hospitals increased by 18%. Total bed-days have increased in both private hospitals and public hospitals by 12%. The proportion of all separations at private hospitals has remained relatively stable between these 2 years, with 33% of all separations being private patients in private hospitals in 1998? 99, increasing slightly to 35% by 2002?03. Analysis of a number of specific DRGs shows that patients with more severe disease are more likely to be seen at public hospitals; notably this trend has strengthened between 1998?99 and 2002?03. The number of patients treated in Victorian public hospitals has continued to grow, despite a rapid increase in the utilisation of private hospitals. Given the limited extent of the shift in caseload share between the two sectors, the effectiveness of the Commonwealth?s subsidy of private health insurance as a mechanism to reduce pressure on the public sector needs to be carefully examined.

Charter of the Kazan Society of Physicians for the provision of medical care to participants in the sickness funds established by law on June 3, 1912

1913 ◽  
Vol 13 (2) ◽  
pp. 91-110
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Medical Assistance ◽  
Medical Aid ◽  
Insurance Funds ◽  
The Law ◽  
Health Insurance Funds ◽  
The City

The Kazan Society of Physicians for the Provision of Medical Aid to the Participants of the Health Insurance Funds Established on the Basis of the Law of June 23, 1912 "has the goal of providing medical assistance to the participants of the Health Insurance Fund established on the basis of the Law of June 23, 1912 in the city of Kazan and its environs.

scholarly journals Information Needs of Patients Undergoing Bariatric Surgery in Germany: A Qualitative Interview Study

2021 ◽  
Author(s):  
Jessica Breuing ◽  
Nadja Könsgen ◽  
Katharina Doni ◽  
Annika Lena Neuhaus ◽  
Dawid Pieper
Keyword(s):  
Bariatric Surgery ◽  
Health Insurance ◽  
Support Groups ◽  
Information Needs ◽  
Information Dissemination ◽  
Information Provision ◽  
Nutritional Counseling ◽  
Qualitative Interview Study ◽  
Insurance Funds ◽  
Health Insurance Funds

Abstract BackgroundObesity is a worldwide problem with different treatment options. Bariatric surgery is an effective treatment for severe obesity; however, it leads to drastic changes (e.g., changes in everyday life and eating behavior) for patients, which may lead to information needs. Our aim was to identify the information needs of patients undergoing bariatric surgery and to explore the information provision within the healthcare process of bariatric surgery in Germany.MethodsWe conducted n=14 semi-structured telephone interviews between April 2018 and April 2019. The interview guide was designed prior to the interviews and consisted of 4 main sections (demographic information, pre- and postoperative healthcare provision, information needs). The audio-recorded interviews were transcribed verbatim and analyzed using qualitative content analysis with MAXQDA software.ResultsThere were unmet information needs with two factors (time: pre/postoperative and categories of information: general/specific) to be considered. Due to the patients’ description of information, we categorized information into general (different surgical procedures, general nutritional information) and specific (occurring simultaneously with a problem) information. Most patients felt well informed concerning general information. However, it was pointed out that it was not possible to provide complete information preoperatively, as the need for information only arises when there are postoperative (specific) problems. In addition, there seems to be a high demand for specific postoperative information regarding nutrition and nutrition-related problems. However, patients stated that postoperative nutritional counseling is not reimbursed by health insurance funds. The information conveyed in support groups and the exchange of experiences are highly valued by patients. However, some patients describe the information provided within the support groups as unfiltered, frightening or exaggerated.ConclusionOverall, there were unmet information needs. Reimbursement by health insurance funds could increase the use of postoperative nutritional counseling and thus serve existing information needs. Support groups enable an exchange of experiences and therefore offer low-barrier access to information. Cooperation between support groups and healthcare professionals in information provision could be an approach to improving existing information needs or to avoiding the development of information gaps. Furthermore, the development and implementation of a digital solution for (postoperative) information dissemination could be helpful.

scholarly journals Private health insurance and the Pharmaceutical Benefits Scheme: how effective has recent government policy been?

2004 ◽  
Vol 28 (1) ◽  
pp. 34 ◽  
Author(s):  
Jeff R J Richardson ◽  
Leonie Segal
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Public Hospitals ◽  
Common Element ◽  
Cost Shifting ◽  
The Public ◽  
Pharmaceutical Expenditures ◽  
The Government ◽  
The Cost ◽  
Pharmaceutical Benefits Scheme

The cost to government of the Pharmaceutical Benefits Scheme (PBS) is rising at over 10 percent per annum. The government subsidy to Private Health Insurance (PHI) is about $2.4 billion and rising. Despite this, the queues facing public patients ? which were the primary justification for the assistance to PHI ? do not appear to be shortening. Against this backdrop, we seek to evaluate recent policies. It is shown that the reason commonly given for the support of PHI ? the need to preserve the market share of private hospitals and relieve pressure upon public hospitals ? is based upon a factually incorrect analysis of the hospital sector in the last decade. It is similarly true that the ?problem? of rising pharmaceutical expenditures has been exaggerated. The common element in both sets of policies is that they result in cost shifting from the public to the private purse and have little to do with the quality or quantity of health services.

Back to the future: Polish health care reform

2003 ◽  
Vol 36 (4) ◽  
pp. 385-403 ◽  
Author(s):  
Rachel Filinson ◽  
Piotr Chmielewski ◽  
Darek Niklas
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Workers ◽  
Universal Health Insurance ◽  
Care Workers ◽  
Insurance Funds ◽  
Physician Resistance ◽  
Polish Government ◽  
Health Insurance Funds ◽  
Universal Health

In January 1999, the Polish government implemented a new law reorganizing the health care in the country. This paper includes an outline of the changes, the main impact of which consisted of introduction of universal health insurance administered by Health Insurance Funds (‘‘Kasy Chorych’’). In June 2001 and 2002, a survey of insurance administrators and health care workers provided data concerning the reception of the new system, the perceived inadequacies, and the postulated changes. The intended objective of privatization of health provisions appears as remote as it was before the changes. The major obstacles are identified as political hurdles, physician resistance, and continued dependence on state allocations.

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