scholarly journals The price of choice: private health insurance in Australia

2002 ◽  
Vol 25 (6) ◽  
pp. 42 ◽  
Author(s):  
Johannes U. Stoelwinder
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Private Health Insurance ◽  
Political Support ◽  
Progressive Decline ◽  
Australian Health ◽  
The Past ◽  
Commonwealth Government ◽  
Care System

Private Health Insurance (PHI) is an integral part of the financing of the Australian health care system. PHI is popular and has strong political support because it is perceived to give choice of access and responsiveness. However, in the past increasing premiums have led to a progressive decline in membership. A package of reforms by the Commonwealth Government in support of the private health insurance has reinvigorated the industry over the last three years. Some strategies for achieving a sustainable PHI industry are described. The key challenge is to control claims cost to maintain affordable premiums. Many techniques to do this compromise choice and challenge the very rationale for purchasing the product. Funds and providers will have to establish a new level of relationship to meet this challenge.

A European late starter: lessons from the history of reform in Irish health care

2017 ◽  
Vol 14 (03) ◽  
pp. 355-373 ◽  
Author(s):  
Maev-Ann Wren ◽  
Sheelah Connolly
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Hospital Care ◽  
Political Support ◽  
Universal Health Care ◽  
Universal Health Care System ◽  
Universal Health ◽  
Late Starter ◽  
Care System

AbstractThe Irish health care system is unusual within Europe in not providing universal, equitable access to either primary or acute hospital care. The majority of the population pays out-of-pocket fees to access primary health care. Due to long waits for public hospital care, many purchase private health insurance, which facilitates faster access to public and private hospital services. The system has been the subject of much criticism and repeated reform attempts. Proposals in 2011 to develop a universal health care system, funded by Universal Health Insurance, were abandoned in 2015 largely due to cost concerns. Despite this experience, there remains strong political support for developing a universal health care system. By applying an historical institutionalist approach, the paper develops an understanding of why Ireland has been a European outlier. The aim of the paper is to identify and discuss issues that may arise in introducing a universal healthcare system to Ireland informed by an understanding of previous unsuccessful reform proposals. Challenges in system design faced by a late-starter country like Ireland, including overcoming stakeholder resistance, achieving clarity in the definition of universality and avoiding barriers to access, may be shared by countries whose universal systems have been compromised in the period of austerity.

scholarly journals Are persons with a limited health literacy less satisfied with the German health care system?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Achstetter ◽  
J Köppen ◽  
M Blümel ◽  
R Busse
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Literacy ◽  
Health Care System ◽  
Medical Errors ◽  
Private Health Insurance ◽  
Perceived Discrimination ◽  
German Health Care System ◽  
German Health ◽  
Care System

Abstract Background Health literacy (HL) is the ability to find, understand, appraise and apply health information with the aim of using this information to make decisions affecting the own health. Previous studies showed limited HL in around 50% of the German population. The assessment of the German health care system from the perspective of persons with limited HL is subject of this study. Methods In 2018, a survey was conducted among 20,000 persons with private health insurance in Germany. Survey items were based on the intermediate and final goals of the WHO Health Systems Framework. Questions comprised, for example, satisfaction with the health care system, responsiveness (e.g. perceived discrimination), access (e.g. off-hour care), and safety (e.g. medical errors). HL was assessed with the HLS-EU-Q16 questionnaire. Descriptive statistics and Chi-square test were used to analyze the data and group differences. Results Overall, 3,601 participants (18.0%) completed the survey (58.6 years ± 14.6; 64.6% male). Limited HL was seen with 44.6% (8.5% inadequate & 36.1% problematic), whereas 55.4% did not report limited HL (43.4% sufficient & 12.0% excellent). Very satisfied with the German health care system were 6.5% of the persons with limited HL (vs. 14.3%). Perceived discrimination within the last 12 months was reported by 11.0% of the persons with limited HL (vs. 5.1%). To get medical care on weekends, holidays or evenings outside hospitals was rated as “very hard” by 34.6% of the persons with limited HL (vs. 23.6%). The feeling that they experienced medical errors was reported by 18.7% with limited HL (vs. 11.5%) and 5.9% were unsure (vs. 2.2%). All results were statistically significant (p < 0.001). Conclusions Persons with limited HL were less satisfied with the overall German health care system in comparison to persons with not limited HL and reported more often perceived discrimination. Strengthening HL could help to improve satisfaction with the health care system. Key messages Limited HL among persons with private health insurance in Germany was found in 44.6% of the survey’s participants. Persons with limited HL indicated to be less satisfied with the German health care system and perceived more often discrimination in their health care.

scholarly journals THE DRIVERS OF VOLUNTARY PRIVATE HEALTH INSURANCE DEMAND IN EUROPEAN COUNTRIES

2021 ◽  
Vol 30 (2) ◽  
pp. 457-474
Author(s):  
Marijana Ćurak ◽  
◽  
Dujam Kovač ◽  
Klime Poposki
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Risk Aversion ◽  
Health Care System ◽  
Private Health Insurance ◽  
European Countries ◽  
Public Health Care ◽  
System Quality ◽  
Economic Level ◽  
Care System

During the pandemic, health care services have gained in importance. One of the ways used to finance these services is through voluntary private health insurance. Existing studies on the demand for voluntary private health insurance are based predominantly on the micro-economic level. Therefore, the aim of this paper is to analyse the factors of demand at the macro-economic level. The analysis covers economic and demographic factors, the quality of the public health care system, risk aversion and the status of the population’s health. The empirical research is based on the databases of 29 European countries in the period from 2013 to 2017 and on the dynamic panel model. The results of the empirical analysis revealed that income, price, urbanization, health care system quality, risk aversion/education and self-perceived health are important determinants of demand for voluntary private health insurance in European countries.

scholarly journals Section 3 Introduction: System Change

2003 ◽  
Vol 9 (3) ◽  
pp. 101
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Institutional Change ◽  
Health Care System ◽  
Guest Editorial ◽  
System Change ◽  
Self Management ◽  
Australian Health ◽  
Commonwealth Government ◽  
Care System

Institutional change is required if the Australian health care system is to systematically provide support for chronic disease self-management. This section is introduced by a Guest Editorial (Frendin) in which the Commonwealth Government?s strategy to bring about change is discussed.

scholarly journals Why it is time to review the role of private health insurance in Australia

2004 ◽  
Vol 27 (1) ◽  
pp. 3 ◽  
Author(s):  
Leonie Segal
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Private Health Insurance ◽  
Private Provider ◽  
Private Hospitals ◽  
The Public ◽  
Universal Health ◽  
Care System

The role of private health insurance (PHI) within the Australian health-care system is urgently in need ofcomprehensive review. Two decades of universal health cover under Medicare have meant a change in the function ofPHI, which is not reflected in policies to support PHI nor in the public debate around PHI. There is increasingevidence that the series of policy adjustments introduced to support PHI have served to undermine rather than promotethe efficiency and equity of Australia's health care system. While support for PHI has been justified to 'take pressure offthe public hospital system' and to 'facilitate choice of insurer and private provider', and the incentives have indeedincreased PHI membership, this increase comes at a high cost relative to benefits achieved. The redirection of hospitaladmissions from the public to private hospitals is small, with a value considerably less than 25% of the cost of thepolicies. The Commonwealth share of the health care budget has increased and the relative contribution from privatehealth insurance is lower in 2001-02, despite an increase in PHI membership to nearly 45% of the population,compared with the 30% coverage in 1998. The policies have largely directed subsidies to those on higher incomes whoare more likely to take out PHI, and to private insurance companies, private hospitals and medical specialists. Ad hocpolicy adjustments need to be replaced by a coherent policy towards PHI, one that recognises the fundamental changein its role and significance in the context of universal health coverage.

scholarly journals Determinants of employment-based private health insurance coverage in Denmark

2011 ◽  
Vol 1 (1) ◽  
Author(s):  
Astrid Kiil
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Private Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Actual Choice ◽  
Fair Poor ◽  
Self Assessed Health ◽  
Care System

This study estimates the determinants of having employment-based private health insurance (EPHI) based on data from a survey of the Danish workforce conducted in 2009. The study contributes to the literature by exploring the role of satisfaction with the tax-financed health care system as a potential determinant of EPHI ownership and by taking into account that some employees receive EPHI free of charge, while others pay the premium out of their pre-tax income and thus make an actual choice. The results indicate that the probability of having EPHI is positively affected by private sector employment, size of the workplace, whether the workplace has a health scheme, income, being employed as a white-collar worker, and age until the age of 49, while the presence of subordinates, gender, education level, membership of 'denmark' and living in the capital region are not significantly associated with EPHI coverage. As expected, the characteristics related to the workplace are by far the quantitatively most important determinants. The association between EPHI and self-assessed health is found to be quadratic such that individuals in good self-assessed health are more likely to be covered by EPHI than those in excellent and fair, poor or very poor self-assessed health, respectively. Finally, the probability of having EPHI is found to be negatively related to the level of satisfaction with the tax-financed health care system. The findings of the study are not affected notably by distinguishing empirically between employees who receive EPHI free of charge and those who pay the premium out of their pre-tax income. Link to Appendix

scholarly journals Some pain, no gain: experiences with the no-claim rebate in the Dutch health care system

2009 ◽  
Vol 4 (4) ◽  
pp. 405-424 ◽  
Author(s):  
J. HOLLAND ◽  
N.J.A. VAN EXEL ◽  
F.T. SCHUT ◽  
W.B.F. BROUWER
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Social Health Insurance ◽  
Convenience Sample ◽  
High Loss ◽  
Dutch Health ◽  
Dutch Health Care ◽  
Gp Visits ◽  
Care System

AbstractTo contain expenditures in an increasingly demand driven health care system, in 2005 a no-claim rebate was introduced in the Dutch health insurance system. Since demand-side cost sharing is a very controversial issue, the no-claim rebate was launched as a consumer friendly bonus system to reward prudent utilization of health services. Internationally, the introduction of a mandatory no-claim rebate in a social health insurance scheme is unprecedented. Consumers were entitled to an annual rebate of ₠ 255 if no claims were made. During the year, all health care expenses except for GP visits and maternity care were deducted from the rebate until the rebate became zero. In this article, we discuss the rationale of the no-claim rebate and the available evidence of its effect. Using a questionnaire in a convenience sample, we examined people’s knowledge, attitudes, and sensitivity to the incentive scheme. We find that only 4% of respondents stated that they would reduce consumption because of the no-claim rebate. Respondents also indicated that they were willing to accept a high loss of rebate in order to use a medical treatment. However, during the last month of the year many respondents seemed willing to postpone consumption until the next year in order to keep the rebate of the current year intact. A small majority of respondents considered the no-claim rebate to be unfair. Finally, we briefly discuss why in 2008 the no-claim rebate was replaced by a mandatory deductible.

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