Solvency II, the European Government of Insurance Industry and Private Health Insurance

2020 ◽  
pp. 55-82
Author(s):  
Cyril Benoît
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Solvency Ii

scholarly journals What Are the Determinants of the Decision to Purchase Private Health Insurance in China?

2020 ◽  
Vol 17 (15) ◽  
pp. 5348
Author(s):  
Guangsheng Wan ◽  
Zixuan Peng ◽  
Yufeng Shi ◽  
Peter C. Coyte
Keyword(s):  
Logistic Regression ◽  
Health Insurance ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Policy Decision ◽  
Medical Expense ◽  
Enabling Factors ◽  
Chi Square ◽  
Services Utilization ◽  
Nationally Representative

The objective of this study was to assess the determinants of the decision to purchase private health insurance (PHI) in China. Nationally representative data from the fourth wave of the China Household Finance Survey from 2017 were used, and the dataset comprised 105,691 individuals aged 18 years or older. The Andersen health services utilization model was used to inform the research. Chi-square tests and logistic regression analyses were used to estimate the decision to purchase PHI. The proportion of the sample that had PHI was small, at 5.06%, but coverage for social basic medical insurance (SBMI) was 90.64%. Among PHI holders, the overwhelming majority (87.40%) also had SBMI. Logistic regression analysis demonstrated that predisposing factors (age, education, marital status, household size), enabling factors (household income, SBMI status, geographical factors, household medical expense, and medical debt), and needs-based factors (health status) were statistically significant determinants of the decision to purchase PHI. This study suggests that the socio-economic circumstances of households play a crucial role in the decision to acquire PHI. The findings may be used by the insurance industry to inform actions to enhance PHI coverage and by policy decision-makers that seek to improve equality in access to PHI.

scholarly journals Policy change and private health insurance: did the cheapest policy do the trick?

2002 ◽  
Vol 25 (6) ◽  
pp. 33 ◽  
Author(s):  
James R G Butler
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Policy Change ◽  
Financial Incentives ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Government Expenditure ◽  
Policy Changes ◽  
Community Rating ◽  
Health Insurance Industry

From the introduction of Australia's national health insurance scheme (Medicare) in 1984 until recently, the proportion of the population covered by private health insurance declined steadily. Following an Industry Commission inquiry into the private health insurance industry in 1997,a number of policy changes were effected in an attempt to reverse this trend. The main policy changes were of two types: "carrots and sticks" financial incentives that provided subsidies for purchasing, or tax penalties for not purchasing, private health insurance; and lifetime community rating, which aimed to revise the community rating regulations governing private health insurance in Australia. This paper argues that the membership uptake that has occurred recently is largely attributable to the introduction of lifetime community rating which goes some way towards addressing the adverse selection associated with the previous community rating regulations. This policy change had virtually no cost to government. However, it was introduced after subsidies for private health insurance were already in place. The chronological sequencing of these policies has resulted in substantial increases in government expenditure on private health insurance subsidies, with such increases not being a cause but rather an effect of increased demand for private health insurance.The paper also considers whether the decline in membership that has occurred since the implementation of lifetime community rating presages the re-emergence of an adverse selection problem in private health insurance. Much of the decline to date may be attributable to failure on the part of some members to honour premium payments when they first fell due. However, the changing age composition of the insured pool since September 2000,resulting in an increasing average age of those insured, suggests the possible reappearance of an adverse selection dynamic. Thus the 'trick' delivered by lifetime community rating may not be maintained in the longer term.

The Compatibility of Private Health Insurance Schemes with EU Law: Applying the Health Insurance Exception beyond Substitutive Private Health Insurance

2020 ◽  
pp. 1-26
Author(s):  
Bruno NIKOLIĆ
Keyword(s):  
Health Insurance ◽  
Member State ◽  
Private Health Insurance ◽  
State Intervention ◽  
Solvency Ii ◽  
Alternative Interpretation ◽  
Social Market Economy ◽  
Eu Law ◽  
The European Union ◽  
Social Market

Abstract The lack of clarity as to the scope of the health insurance exception enshrined in Article 206 of the Solvency II Directive has created uncertainties surrounding the implications for government intervention in the private health insurance market. A contentious interpretation of the health insurance exception, offered by former EU Commissioner Bolkestein, and the approach subsequently taken by the Commission and the Court of Justice of the European Union in assessing the compatibility of Member State intervention in private health insurance have led to a divergence in the application of EU law, which further increases uncertainties around the legality of Member State intervention. This article proposes an alternative interpretation of the health insurance exception that draws on a contemporary understanding of private health insurance as a socio-economic institution aimed at achieving a highly competitive social market economy. This alternative interpretation extends the applicability of the health insurance exception from substitutive private health insurance to complementary private health insurance that covers statutory user charges and thus improves the compliance of national health insurance systems in several Member States with EU law and enhances the coherence of EU law.

scholarly journals Australia's private health insurance industry: structure, competition, regulation and role in a less than 'ideal world'

2011 ◽  
Vol 35 (1) ◽  
pp. 23 ◽  
Author(s):  
Ardel Shamsullah
Keyword(s):  
Health Insurance ◽  
Social Insurance ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Public Awareness ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Industry Structure ◽  
Funding Policy ◽  
Health Insurance Industry

Australia’s private health insurance funds have been prominent participants in the nation’s health system for 60 years. Yet there is relatively little public awareness of the distinctive origins of the health funds, the uncharacteristic organisational nature of these commercial enterprises and the peculiarly regulated nature of their industry. The conventional corporate responsibility to shareholders was, until recently, completely irrelevant, and remains marginal to the sector. However, their purported answerability to contributors, styled as ‘members’, was always doubtful for most health funds. After a long period of remarkable stability in the sector, despite significant shifts in health funding policy, recent years have brought notable changes, with mergers, acquisitions and exits from the industry. The research is based on the detailed study of the private health funds, covering their history, organisational character and industry structure. It argues that the funds have always been divorced from the disciplines of the competitive market and generally have operated complacently within a system of comprehensive regulation and generous subsidy. The prospect of the private health funds enjoying an expanded role under a form of ‘social insurance’, as suggested by the National Health and Hospitals Reform Commission, is not supported. What is known about the topic? Government policies promoting private health insurance have long been the subject of public debate and have received considerable academic analysis. The health funds have a high profile in the media and with the public, reflecting the extent of private health insurance coverage. What does this paper add? There is relatively little awareness of the unique nature of the private health insurance industry. This paper highlights the distinctive organisational origins of the health funds, the recent changes to the structure of the sector which have complicated their corporate identities and the complex role they play in an extraordinarily regulated private health insurance industry. What are the implications for practitioners? Awareness of the nature of the sector should take us beyond perennial concerns about premium rises and the level of private health insurance coverage to better appreciate the diverse nature of the industry, the constraints under which the funds operate and the potential they may have to deliver ‘social insurance’.

The Private Health Insurance Industry: The Real Barrier to Healthcare Access?

1994 ◽  
Vol 3 (1) ◽  
pp. 99-107
Author(s):  
Mark Yarborough
Keyword(s):  
Health Insurance ◽  
Healthcare System ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Healthcare Access ◽  
Access To Healthcare ◽  
The Real ◽  
Barriers To Access ◽  
Health Insurance Industry

Any humane society needs a just and compassionate way to care for those who are sick, and should be vigilant in identifying and eliminating barriers that frustrate efforts to adequately care for the sick. Some current insurance underwriting practices constitute effective barriers to access to healthcare and serve to diminish the place of freedom and justice in our healthcare system.

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