scholarly journals The Uncertain and Differentiated Impact of EU Law on National (Private) Health Insurance Regulations

2020 ◽  
pp. 85-127
Author(s):  
Philippe Martin ◽  
Marion Del Sol
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Eu Law

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 EU law and regulation of private health insurance

2007 ◽  
Vol 2 (2) ◽  
pp. 117-124 ◽  
Author(s):  
SARAH THOMSON ◽  
ELIAS MOSSIALOS
Keyword(s):  
Health Insurance ◽  
Access To Health Care ◽  
Private Health Insurance ◽  
Good Time ◽  
Eu Law ◽  
Or Efficiency ◽  
Policy Makers ◽  
Policy Goals ◽  
Relative Neglect ◽  
Policy Direction

The influence of European Union (EU) law on private health insurance has not received as much attention as its impact on other parts of the health system (Hervey, 2007). Now is a good time to redress this relative neglect, as growing interest in private health insurance – in particular, its potential to relieve pressure on public budgets and enhance choice – raises questions about how best to create or expand and shape markets to achieve specific aims. There are no easy answers to these questions, but one thing seems clear: if policy makers intend to use private health insurance to achieve a particular objective, they must be able to direct market behaviour appropriately. Otherwise, the type of market most likely to emerge is one that simply provides access to acute care in the private sector for wealthier people. However, in newer markets lack of regulatory capacity often presents a barrier to effective policy direction (Thomson et al., 2007 forthcoming). In the established markets of the EU, many of the constraints facing policy makers come from single market legislation. Here we use the case of the Third Non-Life Insurance Directive to illustrate some of these constraints and to show how they can undermine the achievement of health policy goals such as financial protection, equity of access to health care and quality or efficiency in the organization, administration, and delivery of health services.

Constructing health consumers: Private health insurance discourses in Australia and the United Kingdom

2011 ◽  
Vol 20 (3) ◽  
pp. 306-320 ◽  
Author(s):  
Kirsten Harley ◽  
Karen Willis ◽  
Jonathan Gabe ◽  
Stephanie Doris Short ◽  
Fran Collyer ◽  
...  
Keyword(s):  
United Kingdom ◽  
Health Insurance ◽  
Private Health Insurance ◽  
The United Kingdom ◽  
Health Consumers

scholarly journals Private Health Insurance in Malaysia: Who Is Left Behind?

2021 ◽  
pp. 101053952110009
Author(s):  
Nur Zahirah Balqis-Ali ◽  
Jailani Anis-Syakira ◽  
Weng Hong Fun ◽  
Sondi Sararaks
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Home Ownership ◽  
Insurance Coverage ◽  
Binary Logistic Regression ◽  
Health Insurance Coverage ◽  
Rural Government ◽  
Lower Education Level ◽  
Current Drinker ◽  
Study Population

Despite various efforts introduced, private health insurance coverage is still low in Malaysia. The objective of this article is to find the factors associated with not having a private health insurance in Malaysia. We analyze data involving 19 959 respondents from the 2015 National Health Morbidity Survey. In this article, we describe the prevalence of not having health insurance and conducted binary logistic regression to identify determinants of uninsured status. A total of 56.6% of the study population was uninsured. After adjusting for other variables, the likelihood of being uninsured was higher among those aged 50 years and above, females, Malay/other Bumiputra ethnicities, rural, government/semigovernment, self-employed, unpaid workers and retirees, unemployed, lower education level, without home ownership and single/widowed/divorced, daily smoker, underweight body mass index, and current drinker. The likelihood of being uninsured also increased with increasing household size while the inversed trend was seen for household income. A substantial proportion of population in Malaysia did not have private health insurance, and these subgroups have limited preferential choices for provider, facility, and care.

scholarly journals Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Minsung Sohn ◽  
Minsoo Jung ◽  
Mankyu Choi
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Health Status ◽  
Regression Models ◽  
Private Health Insurance ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Self Rated Health ◽  
Interaction Terms ◽  
Healthcare Coverage

To investigate the effects of public and private health insurance on self-rated health (SRH) status within the National Health Insurance (NHI) system based on socioeconomic status in South Korea. The data were obtained from 10 867 respondents of the Korea Health Panel (2008-2011). We used hierarchical panel logistic regression models to assess the SRH status. We also added the interaction terms of socioeconomic status and type of health insurance as moderators. Medical aid (MA) recipients were 2.10 times more likely to have a low SRH status than those who were covered only by the NHI, even though the healthcare utilization was higher. When the interaction terms were included, those not covered by the NHI and had completed elementary school or less were 16.59 times more likely to have a low SRH status than those covered by the NHI and had earned a college degree or higher. Expanding healthcare coverage to reduce the burden of non-payment and unmet use to improve the health status of MA beneficiaries should be considered. Particularly, the vulnerability of less-educated groups should be focused on.

A clinical update on managed care implications for Australian psychiatric practice

2021 ◽  
pp. 103985622110300
Author(s):  
Jeffrey CL Looi ◽  
Stephen R Kisely ◽  
Tarun Bastiampillai ◽  
William Pring ◽  
Stephen Allison
Keyword(s):  
Health Insurance ◽  
Managed Care ◽  
Private Health Insurance ◽  
Psychiatric Treatment ◽  
Patient Choice ◽  
Insurance Sector ◽  
Cost Cutting ◽  
Appropriate Treatment ◽  
The Us ◽  
Limit Access

Objective: To provide a clinical update on private health insurance in Australia and outline developments in US-style managed care that are likely to affect psychiatric and other specialist healthcare. We explain aspects of the US health system, which has resulted in a powerful and profitable private health insurance sector, and one of the most expensive and inefficient health systems in the world, with limited patient choice in psychiatric treatment. Conclusions: Australian psychiatrists should be aware of changes to private health insurance that emphasise aspects of managed care such as selective contracting, cost-cutting or capitation of services. These approaches may limit access to private hospital care and diminish the autonomy of patients and practitioners in choosing the most appropriate treatment. Australian patients, carers and practitioners need to be informed about the potential impact of private managed care on patient-centred evidence-based treatment.

scholarly journals Identifying Risk Profiles of Malignant Prostate Cancer Surgical Delay Using a Person-Centered Approach to Understand Prostate Cancer Disparities: The Constellation of Health Determinants Using Latent Class Analysis on Cancer Registry Data

2020 ◽  
Vol 14 (6) ◽  
pp. 155798832098428
Author(s):  
Francisco A. Montiel Ishino ◽  
Claire Rowan ◽  
Rina Das ◽  
Janani Thapa ◽  
Ewan Cobran ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Insurance ◽  
Latent Class Analysis ◽  
Cancer Registry ◽  
High Probability ◽  
Private Health Insurance ◽  
Latent Class ◽  
Class Analysis ◽  
Risk Profiles ◽  
Surgical Delay

Surgical prostate cancer (PCa) treatment delay (TD) may increase the likelihood of recurrence of disease, and influence quality of life as well as survival disparities between Black and White men. We used latent class analysis (LCA) to identify risk profiles in localized, malignant PCa surgical treatment delays while assessing co-occurring social determinants of health. Profiles were identified by age, marital status, race, county of residence (non-Appalachian or Appalachian), and health insurance type (none/self-pay, public, or private) reported in the Tennessee Department of Health cancer registry from 2005 to 2015 for adults ≥18 years ( N = 18,088). We identified three risk profiles. The highest surgical delay profile (11% of the sample) with a 30% likelihood of delaying surgery >90 days were young Black men, <55 years old, living in a non-Appalachian county, and single/never married, with a high probability of having private health insurance. The medium surgical delay profile (46% of the sample) with a 21% likelihood of delay were 55–69 years old, White, married, and having private health insurance. The lowest surgical delay profile (42% of the sample) with a 14% likelihood of delay were ≥70 years with public health insurance as well as had a high probability of being White and married. We identified that even with health insurance coverage, Blacks living in non-Appalachian counties had the highest surgical delay, which was almost double that of Whites in the lowest delay profile. These disparities in PCa surgical delay may explain differences in health outcomes in Blacks who are most at-risk.

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