Health Care Financing and Insurance (eBook)

Options for Design

Francesco Paolucci (Autor)

eBook Download: PDF

2010 | 2011
XI, 115 Seiten
Springer Berlin (Verlag)
978-3-642-10794-8 (ISBN)

Infos

As a contribution to the search for suitable and sustainable solutions to finance rising medical care expenditures, the book proposes a typology of healthcare financing and insurance schemes, based on the dimensions of basic vs. supplementary services and mandatory vs. voluntary coverage, to analyse the design and the complex interactions between various financing and insurance arrangements in several OECD countries. This study provides a better understanding of the strengths and weaknesses of the financial and organisational structures of different countries' healthcare financing and insurance schemes. Its main contributions are the development of a novel and rigorous theoretical framework analysing the economic rationales for the optimal design of healthcare financing and insurance schemes, and an empirical and institutional analysis investigating the consequences for efficiency and affordability of the complex interactions between basic and supplementary sources of financing.

Inhalt

Preface 8
Contents 10
Chapter 1: General Introduction 14
1.1 Introduction 14
1.1.1 Many Definitions of Health Care Financing Schemes 15
1.1.2 Classifying Health Care Financing Schemes 16
1.1.3 Trends 19
1.1.4 Implications for Efficiency and Affordability 20
1.2 Aim and Contribution of This Study 22
1.3 Research Questions 23
Chapter 2: Economic Rationales for the Design of Health Care Financing Schemes 25
2.1 Introduction 25
2.2 Mandatory Cross-Subsidies 26
2.2.1 Externalities 26
2.2.1.1 Altruistic Preferences 27
Cost-Effectiveness of Services 28
Initial Health Status of the Beneficiary 29
The Expected Cost of Services per Consumer 31
Consumer´s Responsibility for the Incidence of the Disease 32
2.2.1.2 Egoistic Preferences 32
2.2.2 The Financial Risk of Becoming a High Risk 34
2.2.3 Moral Hazard 35
2.2.4 Summary 36
2.3 Mandatory Coverage 37
2.3.1 Economic Rationales for Mandatory Coverage 37
2.3.1.1 Free Riding 37
2.3.1.2 Lack of Foresight 38
2.3.1.3 Transaction Costs of Organising a System of Cross-Subsidies 40
2.3.1.4 Summary 40
2.3.2 Fine-Tuning Mandatory Coverage 41
2.3.2.1 High and Low Option Schemes 42
2.3.2.2 Single-Option Scheme with Income-Related Deductibles 43
2.4 Summary and Conclusions 43
Chapter 3: The Design of Health Care Financing Schemes in Different Countries 45
3.1 Introduction 45
3.2 Mandatory Cross-Subsidies in Different Countries 46
3.3 Mandatory Coverage in Different Countries 52
3.4 Conclusions 57
Chapter 4: The Potential for Risk Rating in Competitive Markets for Supplementary Health Insurance: An Empirical Analysis 59
4.1 Introduction 59
4.2 The Solidarity and Equivalence Principles 60
4.3 The Determinants of the Level of Risk Rating 61
4.3.1 Level of Competition 61
4.3.2 Consumers´ Willingness to Switch 62
4.3.3 Regulatory Framework 62
4.3.4 Transaction Costs 63
4.3.5 Self-Regulation 63
4.3.6 Choice of Risk Adjusters 64
4.4 Methods 65
4.5 Data 67
4.6 Results 68
4.6.1 The Potential Gains of Risk Rating in Competitive Supplementary Health Insurance Markets 68
4.6.2 Will Insurers Risk-Rate in Practice? 72
4.7 Conclusions 74
Chapter 5: Competition and Solidarity in European Markets for Basic and Supplementary Health Insurance: Economic and Legal Analysis 76
5.1 Introduction 76
5.2 Combining Competition and Solidarity in Health Insurance Markets 77
5.2.1 Premium Rate Restrictions 77
5.2.2 Risk-Compensation Schemes 78
5.2.3 Premium- and Excess-Loss-Compensation Schemes 81
5.3 Analysis of the EC Legal Framework 81
5.3.1 Free Movement of Services: The Insurance Directives 81
5.3.2 Competition Law 83
5.4 Are the Four Regulatory Strategies in Conformity with the EC Legal Framework? 85
5.5 Conclusions and Discussion 87
Chapter 6: Risk-Selection via Supplementary Health Insurance in Universal Mandatory Health Insurance for Basic Services 89
6.1 Introduction 89
6.2 Conceptual Framework 89
6.3 Risk-Selection via Supplementary Health Insurance 91
6.3.1 SI Markets in Different Countries: Main Features 91
6.3.2 The Determinants for the Use of SI as a Selection Device 94
6.3.3 BI Markets in Different Countries: Incentives for Risk-Selection 97
6.3.4 Evidence of Risk-Selection via SI 98
6.4 Conclusions and Discussion 100
Chapter 7: Conclusions and Discussion 102
7.1 Introduction 102
7.2 The Design of Basic and Supplementary Health Care Financing Schemes 103
7.3 Implications for Efficiency and Affordability 106
7.4 Epilogue 110
References 112
About the Author 124

Produkt-Details

• Erscheint lt. Verlag: 28.10.2010
• Reihe/Serie: Developments in Health Economics and Public Policy
• Reihe/Serie: Developments in Health Economics and Public Policy
• Zusatzinfo: XI, 115 p.
• Verlagsort: Berlin
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Studium ► 1. Studienabschnitt (Vorklinik) ► Biochemie / Molekularbiologie
• Themenwelt: Sozialwissenschaften ► Politik / Verwaltung
• Themenwelt: Wirtschaft ► Betriebswirtschaft / Management ► Finanzierung
• Schlagworte: Healthcare • Health Care • Healthcare Financing • Healthcare Insurance • Health Economics • Public Health
• ISBN-10: 3-642-10794-X / 364210794X
• ISBN-13: 978-3-642-10794-8 / 9783642107948