scholarly journals Biased selection within the social health insurance market in Colombia

Health Policy ◽  
2006 ◽  
Vol 79 (2-3) ◽  
pp. 313-324 ◽  
Author(s):  
Ramon Castano ◽  
Andres Zambrano
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Insurance Market ◽  
Social Health ◽  
The Social ◽  
Health Insurance Market

scholarly journals Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

2021 ◽  
Vol 6 (2) ◽  
pp. e004117
Author(s):  
Aniqa Islam Marshall ◽  
Kanang Kantamaturapoj ◽  
Kamonwan Kiewnin ◽  
Somtanuek Chotchoungchatchai ◽  
Walaiporn Patcharanarumol ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Civil Servant ◽  
Social Health ◽  
Health Coverage ◽  
Medical Benefit ◽  
The Social ◽  
Universal Health ◽  
Universal Coverage Scheme

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

Consolidating the social health insurance schemes in China: towards an equitable and efficient health system

The Lancet ◽  
2015 ◽  
Vol 386 (10002) ◽  
pp. 1484-1492 ◽  
Author(s):  
Qingyue Meng ◽  
Hai Fang ◽  
Xiaoyun Liu ◽  
Beibei Yuan ◽  
Jin Xu
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Social Health Insurance ◽  
Social Health ◽  
The Social

scholarly journals Can universal access be achieved in a voluntary private health insurance market? Dutch private insurers caught between competing logics

2018 ◽  
Vol 14 (03) ◽  
pp. 315-336 ◽  
Author(s):  
Robert A. A. Vonk ◽  
Frederik T. Schut
Keyword(s):  
Health Insurance ◽  
Welfare State ◽  
Consumer Choice ◽  
Private Health Insurance ◽  
Universal Access ◽  
Social Health Insurance ◽  
Insurance Market ◽  
Primary Sources ◽  
Health Insurance Market ◽  
Health Insurers

AbstractFor almost a century, the Netherlands was marked by a large market for voluntary private health insurance alongside state-regulated social health insurance. Throughout this period, private health insurers tried to safeguard their position within an expanding welfare state. From an institutional logics perspective, we analyze how private health insurers tried to reconcile the tension between a competitive insurance market pressuring for selective underwriting and actuarially fair premiums (the insurance logic), and an upcoming welfare state pressuring for universal access and socially fair premiums (the welfare state logic). Based on primary sources and the extant historiography, we distinguish six periods in which the balance between both logics changed significantly. We identify various strategies employed by private insurers to reconcile the competing logics. Some of these were temporarily successful, but required measures that were incompatible with the idea of free entrepreneurship and consumer choice. We conclude that universal access can only be achieved in a competitive individual private health insurance market if this market is effectively regulated and mandatory cross-subsidies are effectively enforced. The Dutch case demonstrates that achieving universal access in a competitive private health insurance market is institutionally complex and requires broad political and societal support.

scholarly journals Governance and Purchasing Function under Social Health Insurance in Nepal: Looking Back and Moving Forward

2017 ◽  
Vol 15 (1) ◽  
pp. 85-87
Author(s):  
Vishnu Prasad Sapkota ◽  
Umesh Prasad Bhusal
Keyword(s):  
Health Insurance ◽  
Social Protection ◽  
Service Providers ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Coverage ◽  
Health Security ◽  
The Social ◽  
Development Committee ◽  
Health Services Needs

Nepal is pursuing Social Health Insurance as a way of mobilizing revenues to achieve Universal Health Coverage. The Social Health Insurance governance encourages service providers to maintain quality and efficiency in services provision by practicing strategic purchasing. Social Health Security Programme is a social protection program which aspires to achieve the goals of Social Health Insurance. Social Health Security Development Committee needs to consider following experiences to function as a strategic purchaser. The Social Health Security Development Committee need to be an independent body instead of falling under Ministry of Health. Similarly, purchasing of health services needs to be made strategic, i.e., Social Health Security Development Committee should use its financial power to guide the provider behavior that will eventually contribute to achieving the goals of quality and efficiency in service provision. The other social health security funds should be merged with Social Health Security Development Committee and develop a single national fund. Finally, the state has to regulate and monitor the performance of the SHI agency.

scholarly journals Current status of clinical orthodontics in European and American countries

2020 ◽  
Vol 10 ◽  
pp. 204-223
Author(s):  
Kazuo Tanne
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Developed Countries ◽  
Social Health ◽  
Current Status ◽  
Frequent Use ◽  
The Social ◽  
Lingual Appliance ◽  
Jaw Deformity ◽  
Extraction Treatment

Current status of clinical orthodontics in European and American countries was examined by means of a questionnaire survey through internet. In the European and American countries, most popular technique in daily orthodontic practice is preadjusted straight wire edgewise technique. In major developed countries in Europe and America, the treatment fee is considerably high, whereas the fee is relatively low in the countries under development and/or after economic crisis. Rate of non-extraction treatment among all the cases treated with multi-bracket appliances is significantly higher in Europe and America than in Asia except in a few countries. In the European and American countries, treatment system for jaw deformity patients is well developed with higher availability of the social health insurance than in Asia. The maximum CLP prevalence of 0.200 is found in Germany and Austria and the mean is around 0.140 or one to 700 births. In general, CLP treatment is covered by social health insurance in European and American countries. In Europe and America, lingual orthodontic technique has not become popular because patients never want to hide orthodontic appliance. Higher cost of lingual appliance and lack in information and technical skills may be the reasons of less frequent use of lingual appliance. Many interviewees replied that usage of TADs has not become so popular in USA and Canada as compared to that in Asia. In another word, the initial fascination with TADs wore off and are now used in selected patients as needed. This may be due to more harmonious maxillofacial structure with longer and wider dentitions in Caucasians which also results in higher rate of non-extraction treatment with multibracket appliances in European and American countries.

Sign in / Sign up

Export Citation Format

Share Document