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.

scholarly journals Impact on public hospitals if private health insurance rates in Victoria declined

2004 ◽  
Vol 28 (3) ◽  
pp. 330 ◽  
Author(s):  
Brian W T Hanning
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Health Insurance ◽  
Operating Cost ◽  
Public Hospitals ◽  
Income Loss ◽  
The Public ◽  
Capital Costs ◽  
Recurrent Cost ◽  
Insurance Rates

The additional cost of treating acute care type Victorian private patients as public patients in Victorian public hospitals based on the current public sector payment model and rates was calculated, as was the loss of health fund income to public hospitals. If all private cases became public the net recurrent cost would be $1.05 billion assuming all patients were still treated. If private health insurance (PHI) uptake had declined to 23.3% as was projected without Lifetime Health Cover and the 30% rebate, the additional operating cost and income loss would be $385 million. This compares to the Victorian cost of the 30% rebate for acute hospital cases of $383 million. This takes no account of capital costs and possible public sector access problems. The analysis suggests that 31 extra operating theatres would be needed in the public sector (had the transfer of surgical patients from the public sector to the private sector not occurred). This analysis suggests that without the PHI rebate the current stresses on Victorian public hospitals would be increased, not decreased.

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.

scholarly journals Kepercayaan Publik (Public Trust) Terhadap E-Government : Studi Kasus Penggunaan E-Mobile BPJS Kesehatan Di Kota Makassar

2020 ◽  
Vol 9 (1) ◽  
pp. 80
Author(s):  
Sitti Mirsa Sirajuddin ◽  
A . Atrianingsi
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Mobile Applications ◽  
Mobile Application ◽  
Public Trust ◽  
The Public ◽  
The Government ◽  
Quantitative Descriptive ◽  
High Level

The general objective of the study was to analyze the level of public trust (citizen trust) of e-government based health insurance services, namely the e-mobile National Health Insurance (JKN) BPJS in Makassar City.The design of this research is a quantitative descriptive type. The population in this study were people who used the National Health Insurance (JKN) e-mobile application with 167 respondents. Data collection was carried out using a questionnaire instrument. Data analysis uses multiple linear regression.The results showed that first there was a high level of public trust in JKN e-mobile applications. This means that the application gives satisfaction to the community and is considered beneficial for them. Secondly, the level of public trust is high in the government, where the public considers the government to be serious in providing health insurance services.Tujuan umum penelitian adalah untuk menganalisis tingkat kepercayaan publik (citizen trust) terhadap pelayanan jaminan kesehatan berbasis e-government yaitu e-mobile Jaminan Kesehatan Nasional (JKN) BPJS Kesehatan di Kota Makassar. Desain penelitian ini adalah kuantitatif tipe deskriptif. Populasi dalam penelitian ini adalah masyarakat yang menggunakan aplikasi e-mobile Jaminan Kesehatan Nasional (JKN) dengan jumlah responden sebanyak 383 orang. Pengumpulan data dilakukan dengan menggunakan instrument kuesioner. Analisis data menggunakan regresi linear berganda. Hasil penelitian menunjukkan bahwa, pertama terdapat tingkat kepercayaan tinggi masyarakat terhadap aplikasi e-mobile JKN. Hal ini berarti aplikasi memberi kepuasan kepada masyarakat dan dianggap bermanfaat bagi mereka. Kedua tingkat kepercayaan publik tinggi terhadap pemerintah tinggi, dimana masyarakat menilai pemerintah serius dalam memberikan pelayanan jaminan kesehatan.

scholarly journals Economic Implications of Coronary Arterial Revascularization from Bangladesh Perspective

2020 ◽  
Vol 13 (1) ◽  
pp. 56-61
Author(s):  
Refaya Rashmin ◽  
Nazmul Hosain
Keyword(s):  
Heart Diseases ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
Public Hospitals ◽  
Economic Implications ◽  
The Public ◽  
Percutaneous Coronary ◽  
Health Event ◽  
The Cost

Background: There has been a radical improvement lately both for coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) in Bangladesh. Besides the clinical goals, the economic impact of these procedures is very important as well. Out of pocket spending is the major payment strategy for healthcare in Bangladesh. It is estimated that the poverty headcount increased by 3.5% due to out of pocket healthcare payments. Methods: Data on patients’ expenditure for CABG and PCI in seven Bangladeshi hospitals were collected between 16th and 30th August, 2020. Several models were created, where the cost of CABG was compared with that of PCI in each of these hospital settings. Results: In the two public hospitals CABG is much cheaper than PCI. However, in mid-level expensive hospitals the cost of PCI with 2 stents is comparable with that of CABG, but with 3 or more stents, PCI becomes more expensive. In the big corporate hospitals, CABG tends to be relatively more expensive. The basic treatment expenditure of a patient suffering from triple vessel ischemic heart diseases may range from Taka 50000 to Taka 415000. Conclusion: In Bangladesh CABG is much cheaper than multi-stent PCI in the public and medium range private hospitals. CABG in corporate hospitals may be equal or even more expensive than PCI. IHD may contribute to national poverty as it may turn into a catastrophic health event for the patient’s family. Cardiovasc. j. 2020; 13(1): 56-61

scholarly journals Has the increase in private health insurance uptake affected the Victorian public hospital surgical waiting list?

2002 ◽  
Vol 25 (6) ◽  
pp. 64 ◽  
Author(s):  
Brian Hanning
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Uptake Rate ◽  
Public Hospital ◽  
Private Health Insurance ◽  
Elective Surgery ◽  
Waiting List ◽  
Limited Data ◽  
The Public

It was anticipated that increased uptake of Private Health Insurance (PHI) would reduce demand on public sector surgical waiting lists. The best measure of changed demand is the comparison of the actual cases added to that projected given previous trends in PHI uptake. Detailed Victorian data is available up to 2000-1.The total waiting list has varied little, reflecting significant decreases in both in patients added to and removed. There was a marked increase in private sector elective surgery cases coinciding with the fall in additions to the public sector waiting list and in public sector elective surgical cases. The June 2001 Victorian surgical waiting list would have been 69,599 not 41,838 if the PHI uptake rate had continued to fall in line with pre-1999 trends, and that of June 2002 about 100,000 compared to 40,458 in March 2002.Limited data from other states suggests the Victorian trends are representative of all Australia.

scholarly journals Costs of bariatric surgery in a teaching hospital and the financing provided by the Public Unified Health System

2010 ◽  
Vol 25 (2) ◽  
pp. 201-205 ◽  
Author(s):  
Wilson Salgado Júnior ◽  
Karoline Calfa Pitanga ◽  
José Sebastião dos Santos ◽  
Ajith Kumar Sankarankutty ◽  
Orlando de Castro e Silva Jr ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health System ◽  
Perioperative Period ◽  
University Hospital ◽  
Retrospective Evaluation ◽  
The Public ◽  
Unified Health System ◽  
The Government ◽  
The Cost ◽  
The University

PURPOSE: Analyze the effect of some measures on the costs of bariatric surgery, adopting as reference the remuneration of the procedure provided by the Unified Health System (SUS). METHODS: A retrospective evaluation conducted in the Costs Section of the University Hospital of Ribeirão Preto, of the costs involved in the perioperative period for patients submitted to bariatric surgery from 2004 to 2007. Changes in the routines and protocols of the service aiming at the reduction of these costs during the study period were also analyzed. RESULTS: Nine patients in 2004 and seven in 2007 submitted to conventional vertical banded "Roux-en-Y" gastric bypass were studied. All patients presented good postoperative evolution. The average cost with these patients was R$ 6,845.17 in 2004. Even though an effort was made to contain expenditures, the cost in 2007 was of R$ 7,525.64 because of the increase in the price of materials and medicines. The Government remuneration of the procedure in the two years was R$ 3,259.72. CONCLUSION: Despite the adoption of diverse measures to reduce the expenditures of bariatric surgery, in fact there was an increase in the costs, a fact supporting the necessity of permanent evaluation of the financing of public health.

scholarly journals EVALUATION OF THE COST-EFFECTIVENESS OF THE PUBLIC SECTOR SERVICES: VARIABILITY OF THE METHODOLOGICAL TOOLS

2019 ◽  
Vol 8 (4) ◽  
pp. 34-48
Author(s):  
Oksana Yurievna Dyagel
Keyword(s):  
Health Insurance ◽  
Cost Effectiveness ◽  
Public Sector ◽  
Economic Effects ◽  
The Public ◽  
Medical Institutions ◽  
Compulsory Health Insurance ◽  
Definition Of ◽  
The Cost ◽  
Analytical Tools

The purpose of the article was to reveal the analytical tools for evaluating the effectiveness of the allocated financing funds for the provision of the services provided in the public sector of the economy, the application of which does not have a uniform methodology today. The possibility to solve this issue is shown with regard to the compulsory health insurance system. To achieve the goal, the study reveals the definition of such categories as “effect” and “efficiency” of the medical institutions activities, “efficiency of spending” of the Territorial Fund for Compulsory Health Insurance. There is revealed the analytical significance of the existing methodological approaches to assessing the effectiveness of health care costs; their comparative analysis is carried out. Based on the results, the alternative is proposed, based on the system of the cost-effectiveness indices to achieve the health, social and economic effects of medical institutions; the analytical advantages of the alternative proposed are justified.

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