Recent Changes in Dutch Health Insurance: Individual Mandate or Social Insurance?

2009 ◽  
Author(s):  
Kieke Okma
Keyword(s):  
Health Insurance ◽  
Social Insurance ◽  
Dutch Health ◽  
Individual Mandate

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.

Die Berücksichtigung von Kindern in den Sozialversicherungen: Reformvorschläge auf dem Prüfstand

2015 ◽  
Vol 64 (3) ◽  
Author(s):  
Susanna Kochskämper
Keyword(s):  
Health Insurance ◽  
Social Insurance ◽  
Statutory Health Insurance ◽  
Future Generations ◽  
Pension Scheme ◽  
Insurance Scheme ◽  
Number Of Children ◽  
Additional Burden

AbstractHow to treat families within the German pay-as-you-go financed social insurance systems - this question is repeatedly discussed. A closer look on the statutory pension scheme as well as the statutory health insurance and the care insurance scheme reveals indeed, that people without children are treated to generously within these systems. This will place an additional burden on future generations. Therefore, reforms are necessary. In the statutory pension scheme benefits can be related to the number of children a person raised. In the statutory health and in the statutory care insurance scheme a second, capital funded pillar can be introduced.

scholarly journals Fraud in Healthcare Service

2018 ◽  
Vol 54 ◽  
pp. 03015
Author(s):  
Dara Pustika Sukma ◽  
Adi Sulistiyono ◽  
Widodo Tresno Novianto
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
National Health Insurance ◽  
National Health ◽  
Healthcare Service ◽  
Social Insurance ◽  
Empirical Method ◽  
Professional Organization ◽  
Social Insurance System ◽  
Central Java

In Indonesia, the fraud of healthcare service implementation occurs widely in hospitals, thereby harming the participants of social insurance. The objectives of research were to find out, to analyze, and to give solution to the fraud in the healthcare service. This research was taken place in several hospitals in Central Java Indonesia using non-doctrinal or empirical method on stakeholders related to national health insurance. The result of research showed that the substance of the ratification of Health Minister’s Regulation Number 36 of 2015 about Fraud Prevention in National Health Insurance in National Social Insurance System becomes the government’s attempt in suppressing fraud in healthcare service. In its structure, healthcare service occurs due to the pressure of enacted costing system, limited supervision, and justification in committing fraud and the imbalance between health service system and burden among clinicians, service provider not giving adequate incentive, inadequate medical equipment supply, system inefficiency, less transparency in health facilities, and cultural factor. Those who are responsible for the attempt of eradicating fraud such as Health Ministry, Regency/City Health Service, Hospital’s Board of Directors, Hospital Supervision Agency and Council, Social Insurance Administration Organization, professional organization, and Social Insurance participants should walk in the cycle starting from building awareness, reporting, detecting, investigating, sanction imposing, to building awareness.

scholarly journals Oil and Water: Mixing Individual Mandates, Fragmented Markets, and Health Reform

2010 ◽  
Vol 36 (1) ◽  
pp. 7-78 ◽  
Author(s):  
Allison K. Hoffman
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Health Reform ◽  
Care Delivery ◽  
Market Competition ◽  
Insurance Market ◽  
Insurance Reform ◽  
Health Insurance Reform ◽  
Individual Mandate ◽  
Policy Objectives

AbstractThe 2010 federal health insurance reform act includes an individual mandate that will require Americans to carry health insurance. This article argues that even if the mandate were to catalyze universal health insurance coverage, it will fall short on some of the policy objectives many hope to achieve through a mandate if implemented in a fragmented insurance market. To uncover this problem, this article sets forth a novel framework that disentangles three different policy objectives the individual mandate can serve. Namely, supporters of the mandate might hope for it to: (1) facilitate greater health and financial security for the uninsured (“paternalism”); (2) eliminate inefficiencies in health care delivery and financing (“efficiency”); and/or (3) require the healthy to buy insurance to help fund medical care for the sick (“health redistribution”). Health redistribution — the primary focus of this article — is a shifting of wealth from the healthy to the sick through the mechanism of risk pooling. Many see health redistribution as a means to enable all Americans to more equitably access medical care on the basis of need, rather than on the basis of ability or willingness to pay.Drawing on evidence from the implementation of an individual mandate in Massachusetts's health reform in 2006, this article reveals that the fragmented American health insurance market will thwart the mandate's ability to achieve these objectives— in particular the goal of health redistribution. Fragmentation is an atomization of the insurance market into numerous risk pools that has been driven by market competition and regulation. It prevents Americans from sharing broadly in the risk of poor health and, in doing so, entrenches a system where access to medical care remains tied to ability to pay and individualized characteristics. The final section of this article examines how various policies, including some in the new law (e.g., insurance regulation and exchanges) and others not (e.g., expanded public insurance), can reduce fragmentation so that the mandate can successfully serve all desired objectives and in the process gain greater legitimacy over time.

The Individual Health Insurance Mandate and Veterans Health Coverage

2019 ◽  
pp. 0095327X1987887 ◽  
Author(s):  
Dongjin Oh ◽  
Frances Stokes Berry
Keyword(s):  
Health Insurance ◽  
Safety Net ◽  
Veterans Health ◽  
Health Coverage ◽  
Health Administration ◽  
Social Safety Net ◽  
Individual Mandate ◽  
Insurance Mandate ◽  
The Individual ◽  
Veteran Health Care

In December 2017, Congress repealed the individual insurance mandate penalty. Given the poor health status of veterans, their higher demands for health insurance, and the substantial number of uninsured veterans, the repeal of the individual mandate should have a significant impact on the veterans. This article investigates how the repeal of the individual mandate effective in January 2019 is likely to affect the number of uninsured veterans and their enrollments in Veterans Affairs (VA) insurance. By analyzing 52,692 nonelderly veterans in Florida and California from 2008 to 2017, the findings suggest that the repeal will lead to a considerable increase in the number of uninsured veterans. Veterans who are unemployed, poor, and suffering disabilities are more likely to sign up for the VA insurance than better-off veterans. Thus, one of the important functions of veteran health care is to serve as a social safety net for vulnerable veterans. Thus, the Veterans Health Administration should establish a policy to minimize the expected negative repercussions of the repeal.

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