Understanding the distributional impacts of health insurance reform: Evidence from a consumer cost‐sharing program

2021 ◽  
Author(s):  
Marion Aouad ◽  
Timothy T. Brown ◽  
Christopher M. Whaley
Author(s):  
Hosung Shin ◽  
Han-A Cho ◽  
Bo-Ra Kim

Since 2009, the National Health Insurance in Korea (NHI) has been implementing a series of policies to expand the scope of dental benefits. This study reviewed the changes in co-payments and dental use patterns before (2008 to 2012) and after (2013 to 2017) the NHI’s dental health insurance reform. The study used Korea Health Panel data of 7681 households (16,493 household members) from a 10-year period (2008–2017). Dental expenditures and equivalent income using square root of household size were analyzed. Dental services were categorized into 13 types and a concentration index and 95% confidence interval using the delta method was calculated to identify income-related inequalities by a dental service. Dental expenditures and the number of dental services used increased significantly, while the proportion of out-of-pocket spending by the elderly decreased. The expenditure ratio for implant services to total dental expenditures increased substantially in all age groups, but the ratio of expenditures for dentures and fixed bridges decreased relatively. The concentration index of implant services was basically in favor of the rich, but there was no longer a significant bias favoring the better-off after the reforms. The dental health insurance reform in Korea appears to contribute not only to lowering the ratio of out-of-pocket to total dental expenses per episode in the elderly but also to improving the inequality of dental expenses.


2004 ◽  
Vol 177 ◽  
pp. 155-173 ◽  
Author(s):  
Jane Duckett

Since 1998, the central government has focused its attention on social security. Among other things, it has created a ministry for social security, pressed for the extension of health and unemployment insurance to larger numbers of the urban working population, and increased spending. Does this mean that the party-state is rebuilding the eroded urban social security system and re-asserting its role in ensuring collective provision? Do recent initiatives repair or damage the interests of urban workers? This article examines these questions through a study of urban health insurance reform. It argues the state has taken over from work units the responsibility for health insurance, that collectivism has been partially preserved through redistributory “risk-pooling” systems, and that the party-state is moving away from its traditional state enterprise-centred working-class base and widening participation to include workers in the private and rural industrial sectors. However, continued prioritization of economic growth means that the party-state's role is limited, while collectivist provision is restricted to the non-agricultural working population. In practice, government officials and workers in successful state enterprises are still the most likely to be insured.


2020 ◽  
Vol 8 (9S) ◽  
pp. 45-45
Author(s):  
Ledibabari M. Ngaage ◽  
Shan Xue ◽  
Mimi R. Borrelli ◽  
Bauback Safa ◽  
Jens U. Berli ◽  
...  

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