Heterogeneity in the Impact of Privatizing Social Health Insurance: Evidence from California&Apos;S Medicaid Program

2021 ◽  
Author(s):  
Mark Duggan ◽  
Craig Garthwaite ◽  
Adelina Yanyue Wang
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health ◽  
Medicaid Program ◽  
The Impact

scholarly journals Impacts of the type of social health insurance on health service utilisation and expenditures: implications for a unified system in China

2018 ◽  
Vol 14 (4) ◽  
pp. 468-486 ◽  
Author(s):  
Si Ying Tan ◽  
Xun Wu ◽  
Wei Yang
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Rapid Expansion ◽  
Social Health ◽  
Service Utilisation ◽  
Provider Payment ◽  
Out Of Pocket Payments ◽  
The Impact

AbstractWhile moving towards unified social health insurance (SHI) is often a politically popular policy reform in countries where rapid expansion in health insurance coverage has given rise to the segmentation of SHI systems as different SHI schemes were rolled out to serve different populations, the potential impacts of reform on service utilisation and health costs have not been systematically studied. Using data from the Chinese Health and Retirement Longitudinal Study (CHARLS), we compared the mean costs incurred for both inpatient and outpatient care under different health insurance schemes, and the impact of different SHI schemes on treatment utilisation and health care costs using a two-part model. Our results show that Urban Employee Medical Insurance, which offers the most generous benefits, incurs the highest total costs prior to reimbursement when compared to other SHI schemes. Our analysis also shows that utilisation of SHI did not show significant reduction in out-of-pocket payments for outpatients. We argue that, unless effective measures are introduced to deal with perverse provider payment incentives, the move towards a unified system with more generous benefits may usher in a new wave of cost escalation for health care systems in China.

The Impact of Social Health Insurance on Household Fertility Decisions

2016 ◽  
Vol 25 (5) ◽  
pp. 699-717 ◽  
Author(s):  
Stephen O. Abrokwah ◽  
Christine M. Moser ◽  
Edward Norton
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health ◽  
Fertility Decisions ◽  
The Impact

scholarly journals The Impact of Social Health Insurance on Diabetes and Hypertension Process Indicators among Older Adults in Mexico

2016 ◽  
Vol 51 (4) ◽  
pp. 1323-1346 ◽  
Author(s):  
Maricruz Rivera-Hernandez ◽  
Momotazur Rahman ◽  
Vincent Mor ◽  
Omar Galarraga
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health ◽  
Process Indicators ◽  
The Impact

scholarly journals The Impacts Of A Free Health Insurance Policy In Vietnam

2021 ◽  
Author(s):  
◽  
Khoa Nguyen
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Outcomes ◽  
Social Health Insurance ◽  
Health Care Use ◽  
Social Health ◽  
Insurance Policy ◽  
Education Outcomes ◽  
Positive Effects ◽  
The Impact

<p>Social Health Insurance (SHI) is promoted as a policy that tackles the impoverishing effects of catastrophic spending that results from unexpected health shocks. This thesis contributes to the literature on the impact of social health insurance by examining the impact of a policy introduced in Vietnam in 2005. The new policy provided free health insurance for all children under six years. Using a difference-in-difference estimation strategy and eight national household surveys conducted between 2002 and 2016, I examine a variety of direct, indirect, and spill over effects of the policy. The direct effects of the policy are on insurance coverage, health care use, health care expenses, and self-reported morbidity of targeted children. The indirect effects are the persistent effects of the policy on the same set of health outcomes (and education outcomes) beyond the period of exposure to the policy. A third set of impacts cover spill over effects of the policy - on the health and education outcomes of older children living with targeted children, and a variety of household-level outcomes that reflect various dimensions of the wellbeing of household members. The results show that a free health insurance policy for young children has significant impacts on the health outcomes of children while they are covered by the policy and these persist, and also extend to educational outcomes beyond the age of eligibility. The policy also has positive spill over effects on older (untargeted) children living in targeted households, and positive effects on household wage income, and income per capita. On the other hand, the policy has no effects on the standard of living, household health expenditure, caloric consumption, and the likelihood of household spending on catastrophic healthcare.</p>

scholarly journals Evolution of Public Health Expenditure Financed by the Romanian Social Health Insurance Scheme From 1999 to 2019

2021 ◽  
Vol 9 ◽  
Author(s):  
Ciprian-Paul Radu ◽  
Bogdan Cristian Pana ◽  
Daniel Traian Pele ◽  
Radu Virgil Costea
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Health System ◽  
Structural Changes ◽  
Emergency Services ◽  
Health Sector ◽  
Social Health Insurance ◽  
Social Health ◽  
State And Local ◽  
The Impact

The Romanian health system is mainly public financed (80.45%) through the following sources: Social Health Insurance (65%), State and Local Authorities Budget (15.45%), while the private sources (voluntary health insurance and out of pocket) adds an additional 19.55% to the public funds. The shares of the types of expenditure reflect the importance of each sector in the overall health system, and trends in expenditure show the impact of financing on the health sector's structural changes. We analyzed the 20-year trend of the Social Health Insurance budget, from 1999 to 2019. The influences of the different allocations, subcategories, and new budget categories appearing over time were adjusted to reveal relevant trends. Of the 14 medical service categories and the stand-alone Administrative expenditure category, six expenditure categories including Hospital services, Total drugs, and Primary care showed stationary 20-year trends; five including Medical devices, Dialysis, and Homecare services showed ascendant trends; and four including Dentistry and Emergency services showed descendant trends. Stationary trends imply no structural changes in the health sector of relevant magnitude to impact the financing shares of major categories: hospitals, drugs, or primary care. Emerging trends related to the impact of different reforms were revealed only in the low share of expenditures categories. The allocation methodology and statistical analysis of the trends reveal a new perspective on the evolution of health sector in Romania.

scholarly journals The impact of social health insurance on rural populations

2021 ◽  
Author(s):  
Colin Green ◽  
Bruce Hollingsworth ◽  
Miaoqing Yang
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Social Health Insurance ◽  
Social Health ◽  
Rural Populations ◽  
Access To Health Services ◽  
Access To Health ◽  
The Impact

AbstractImproving health outcomes of rural populations in low- and middle-income countries represents a significant challenge. A key part of this is ensuring access to health services and protecting households from financial risk caused by unaffordable medical care. In 2003, China introduced a heavily subsidised voluntary social health insurance programme that aimed to provide 800 million rural residents with access to health services and curb medical impoverishment. This paper provides new evidence on the impact of the scheme on health care utilisation and medical expenditure. Given the voluntary nature of the insurance enrolment, we exploit the uneven roll-out of the programme across rural counties as a natural experiment to explore causal inference. We find little effect of the insurance on the use of formal medical care and out-of-pocket health payments. However, there is evidence that it directed people away from informal health care towards village clinics, especially among patients with lower income. The insurance has also led to a reduction in the use of city hospitals among the rich. The shift to village clinics from informal care and higher-level hospitals suggests that the NRCMS has the potential to improve efficiency within the health care system and help patients to obtain less costly primary care. However, the poor quality of primary care and insufficient insurance coverage for outpatient services remains a concern.

scholarly journals The Impacts Of A Free Health Insurance Policy In Vietnam

2021 ◽  
Author(s):  
◽  
Khoa Nguyen
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Outcomes ◽  
Social Health Insurance ◽  
Health Care Use ◽  
Social Health ◽  
Insurance Policy ◽  
Education Outcomes ◽  
Positive Effects ◽  
The Impact

<p>Social Health Insurance (SHI) is promoted as a policy that tackles the impoverishing effects of catastrophic spending that results from unexpected health shocks. This thesis contributes to the literature on the impact of social health insurance by examining the impact of a policy introduced in Vietnam in 2005. The new policy provided free health insurance for all children under six years. Using a difference-in-difference estimation strategy and eight national household surveys conducted between 2002 and 2016, I examine a variety of direct, indirect, and spill over effects of the policy. The direct effects of the policy are on insurance coverage, health care use, health care expenses, and self-reported morbidity of targeted children. The indirect effects are the persistent effects of the policy on the same set of health outcomes (and education outcomes) beyond the period of exposure to the policy. A third set of impacts cover spill over effects of the policy - on the health and education outcomes of older children living with targeted children, and a variety of household-level outcomes that reflect various dimensions of the wellbeing of household members. The results show that a free health insurance policy for young children has significant impacts on the health outcomes of children while they are covered by the policy and these persist, and also extend to educational outcomes beyond the age of eligibility. The policy also has positive spill over effects on older (untargeted) children living in targeted households, and positive effects on household wage income, and income per capita. On the other hand, the policy has no effects on the standard of living, household health expenditure, caloric consumption, and the likelihood of household spending on catastrophic healthcare.</p>

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