scholarly journals Impact of Type of Insurance Plan on Access and Utilization of Health Care Services for Adults Aged 18-64 Years With Private Health Insurance: United States, 2007-2008

Author(s):  
Robin A. Cohen
Risks ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 41
Author(s):  
Veronika Kalouguina ◽  
Joël Wagner

In compulsory health insurance in Switzerland, policyholders can choose two main features, the level of deductible and the type of plan. Deductibles can be chosen among six levels, which range from CHF 300 to 2500. While the coverage and benefits are identical, insurers offer several plans where policyholders must first call a medical hotline, consult their family doctor, or visit a doctor from a defined network. The main benefit of higher deductibles and insurance plans with limitations is lower premiums. The insureds’ decisions to opt for a specific cover depend on observed and unobserved characteristics. The aim of this research is to understand the correlation between insurance plan choices and lifestyle through the state of health and medical care consumption in the setting of Swiss mandatory health insurance. To do so, we account for individual health and medical health care consumption as unobserved variables employing structural equation modeling. Our empirical analysis is based on data from the Swiss Health Survey wherein lifestyle factors like the body mass index, diet, physical activity, and commuting mode are available. From the 9301 recorded observations, we find a positive relationship between having a “healthy” lifestyle, a low consumption of doctors’ services, and choosing a high deductible, as well as an insurance plan with restrictions. Conversely, higher health care services’ usage triggers the choice of lower deductibles and standard insurance plans.


2010 ◽  
Vol 43 (1) ◽  
Author(s):  
Scott Barstow

More than 60 years after President Truman wrote those words and nearly 100 years since health insurance was proposed by Teddy Roosevelt, the United States has joined the rest of the developed nations in initiating a health care system aimed at establishing universal insurance coverage. President Barack Obama and his colleagues in the House and Senate succeeded where many, many others failed, but just barely. The legislation, described as "similar in scope to Great Society and New Deal programs," was enacted "without the benefit of the congressional majorities of those eras" (Oberlander, 2010). For some health care advocates, the law was a disappointment, as it missed opportunity to establish a "public option" for health insurance, a publicly financed and operated program similar to Medicare to provide broad coverage. For others, the legislation constituted the transformation of the United States into a socialist state, somehow endangering America's "freedoms." The reality is that the new law keeps the predominant role of private insurance coverage and welds it to a new framework of rules, investments in improving the effectiveness and efficiency of care, and a strengthened public health sector to establish a more rational system. The law will have a significant impact oi:i counselors as both consumers and providers of health care services, and its enactment has implications for counselor advocacy.


2019 ◽  
Vol 49 (2) ◽  
pp. 343-359
Author(s):  
Milton Santos ◽  
Jonathan Filippon ◽  
Áquilas Mendes ◽  
Elias Kondilis

The General Agreement on Trade in Services (GATS), established in 1994, has been a key element of market liberalization of health care services. Brazil had the provision of health care services partially protected from international competition until 2015, when a constitutional change opened the national health care market to international provision. We performed a retrospective and prospective policy analysis based on a systematic policy document review, general literature review, and secondary data analysis mapping, describing and analyzing the international trade agreements signed by Brazil with the World Trade Organization (WTO) and the available legislation relevant to health care services. The provision of health care services was not included in the WTO commitments signed by Brazil during the analyzed period (1994–2018). Financing of private health insurance was part of the agreement since 1994. There was a mild liberalization of the private health insurance sector, while provision of health care services was forbidden to foreign investors until 2015. The mode 3 of GATS presents the greatest potential impact as it exposes health care provision to international competition. The international liberalization of the provision of health care services in Brazil is now legal and an observable consequence of the pressure to gradually lift trade barriers in the health and health care sector.


2010 ◽  
Vol 43 (1) ◽  
Author(s):  
Scott Barstow

More than 60 years after President Truman wrote those words and nearly 100 years since health insurance was proposed by Teddy Roosevelt, the United States has joined the rest of the developed nations in initiating a health care system aimed at establishing universal insurance coverage. President Barack Obama and his colleagues in the House and Senate succeeded where many, many others failed, but just barely. The legislation, described as "similar in scope to Great Society and New Deal programs," was enacted "without the benefit of the congressional majorities of those eras" (Oberlander, 2010). For some health care advocates, the law was a disappointment, as it missed opportunity to establish a "public option" for health insurance, a publicly financed and operated program similar to Medicare to provide broad coverage. For others, the legislation constituted the transformation of the United States into a socialist state, somehow endangering America's "freedoms." The reality is that the new law keeps the predominant role of private insurance coverage and welds it to a new framework of rules, investments in improving the effectiveness and efficiency of care, and a strengthened public health sector to establish a more rational system. The law will have a significant impact oi:i counselors as both consumers and providers of health care services, and its enactment has implications for counselor advocacy.


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