The Case for Universal Health Insurance

2019 ◽  
pp. 233-247
Author(s):  
Alex Rajczi
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Universal Health Insurance ◽  
Complete Case ◽  
Personal Cost ◽  
Single Payer ◽  
Fiscal Risk ◽  
The Face ◽  
Universal Health

The previous chapters have examined three significant objections to universal health insurance—objections focused on fiscal risk, efficacy, and personal cost. This chapter synthesizes the responses to those concerns, revealing that they fit together into a single, coherent outlook on the ethics of health care. It is argued that in light of the considerations offered in previous chapters, the Affordable Care Act is problematic—deserving of support only in the face of inferior alternatives. In contrast, there are no similar problems with well-designed single-payer or regulated-market systems. The chapter concludes with some reflections on the next steps in a complete case for universal health insurance.

The Ethical Issues Raised in Health Care Debates

2019 ◽  
pp. 54-80
Author(s):  
Alex Rajczi
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Ethical Issues ◽  
Universal Health Insurance ◽  
Substantial Evidence ◽  
Personal Cost ◽  
Fiscal Risk ◽  
Alternative Hypotheses ◽  
Personal Costs ◽  
Universal Health

This book will ask whether universal health insurance systems are objectionable on the ground that they are inefficacious, fiscally risky, or require that individuals bear excessive personal costs. These issues are of serious philosophical interest, but there is also substantial evidence that opinions about fiscal risk, efficacy, and personal cost drive many Americans’ actual views on health care. This chapter surveys the polling data about these issues. The end of the chapter discusses the limitations of this evidence as well as alternative hypotheses about the drivers of the health care debate.

Introduction

2019 ◽  
pp. 1-5
Author(s):  
Alex Rajczi
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Insurance ◽  
National Health ◽  
National Health Policy ◽  
Universal Health Insurance ◽  
Insurance System ◽  
Access To Health ◽  
Fiscal Risk ◽  
Universal Health

Most Americans see the need for a national health policy that guarantees reasonable access to health insurance for all citizens, but some worry that a universal health insurance system would be inefficient, create excessive fiscal risk, or demand too much of them, either by increasing their taxes or by rendering their own health insurance unaffordable. After describing these three objections and the role they play in health care debates, the introduction outlines the contents of each chapter. It concludes with some remarks about how data will be handled in the book’s later chapters.

Personal Cost

2019 ◽  
pp. 81-165
Author(s):  
Alex Rajczi
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Universal Health Insurance ◽  
Health Insurance System ◽  
Insurance System ◽  
Personal Cost ◽  
The Social ◽  
Theories Of Justice ◽  
Personal Costs ◽  
Universal Health

Some people object to social minimum programs, including certain health care programs, because they believe the programs impose excessive taxes and other personal costs on those who fund them. This chapter argues that the most plausible philosophical reconstruction of this objection would rely on a personal cost principle which says that, in general, the proper level of the social minimum is at least partly a function of whether the benefits provided by the social minimum programs outweigh the costs, when judged on a scale that assigns disproportionate weight to those who bear the costs. It is argued that the personal cost principle can find a place within several plausible theories of justice, and that, in addition, the benefits of a well-designed universal health insurance system outweigh its costs.

scholarly journals Low acuity paediatric emergency visits under single-payer universal health insurance in Taiwan, 2000–2015: a population-based repeated cross-sectional design

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042084
Author(s):  
I-Anne Huang ◽  
Yiing-Jenq Chou ◽  
I-Jun Chou ◽  
Yu-Tung Huang ◽  
Jhen-Ling Huang ◽  
...  
Keyword(s):  
Health Insurance ◽  
Paediatric Population ◽  
Population Based ◽  
Universal Health Insurance ◽  
Cross Sectional ◽  
Single Payer ◽  
Insurance Programme ◽  
Ed Visits ◽  
Cross Sectional Design ◽  
Universal Health

ObjectivesEmergency services utilisation is a critical policy concern. The paediatric population is the main user of emergency department (ED) services, and the main contributor to low acuity (LA) ED visits. We aimed to describe the trends of ED and LA ED visits under a comprehensive, universal health insurance programme in Taiwan, and to explore factors associating with potentially unnecessary ED utilisation.Design and settingWe used a population-based, repeated cross-sectional design to analyse the full year of 2000, 2005, 2010 and 2015 National Health Insurance claims data individually for individuals aged 18 years and under.ParticipantsWe identified 5 538 197, 4 818 213, 4 401 677 and 3 841 174 children in 2000, 2005, 2010 and 2015, respectively.Primary and secondary outcome measuresWe adopted a diagnosis grouping system and severity classification system to define LA paediatric ED (PED) visits. Generalised estimating equation was applied to identify factors associated with LA PED visits.ResultsThe annual LA PED visits per 100 paediatric population decreased from 10.32 in 2000 to 9.04 in 2015 (12.40%). Infectious ears, nose and throat, dental and mouth diseases persistently ranked as the top reasons for LA visits (55.31% in 2000 vs 33.94% in 2015). Physical trauma-related LA PED visits increased most rapidly between 2000 and 2015 (0.91–2.56 visits per 100 population). The dose–response patterns were observed between the likelihood of incurring LA PED visit and either child’s age (OR 1.06–1.35 as age groups increase, p<0.0001) or family socioeconomic status (OR 1.02–1.21 as family income levels decrease, p<0.05).ConclusionDespite a comprehensive coverage of emergency care and low cost-sharing obligations under a single-payer universal health insurance programme in Taiwan, no significant increase in PED utilisation for LA conditions was observed between 2000 and 2015. Taiwan’s experience may serve as an important reference for countries considering healthcare system reforms.

BPJS Kesehatan Memberikan Jaminan Kesehatan Terhadap Pasien Atau Masyarakat

2021 ◽  
Vol 7 (2) ◽  
pp. 146-154
Author(s):  
Aidha Puteri Mustikasari
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
The State ◽  
Universal Health Care ◽  
Universal Health Insurance ◽  
Universal Health ◽  
Provide Health Insurance

Abstrak. Kepesertaan BPJS Kesehatan pada tahun 2020 tidak akan mencakup 90% penduduk Indonesia, namun rencana Universal Health Care Implementation (UHC) telah direncanakan sejak tahun sebelumnya. Di masa pandemi Covid, sejumlah besar status kepesertaan BPJS Kesehatan  dicabut karena terlambat, padahal masyarakat membutuhkan layanan kesehatan dan asuransi dengan kondisi yang ada. Kajian ini bersifat norma deskriptif , dibahas dalam konteks kepesertaan BPJS kesehatan, dan cukup  menggunakan prinsip asuransi dengan hanya memberikan jaminan kepada peserta, tetapi negara mengikuti kewajiban UUD 1945 yaitu memberikan jaminan kesehatan dan pelayanan kepada warga negara. Untuk mendukung keberadaan jaminan kesehatan universal, Indonesia perlu menerapkan formulir kepesertaan dan  sanksi untuk ketentuan wajib  peserta jaminan sosial yang efektif dan efisien. Abstract. BPJS Health membership in 2020 will not cover 90% of Indonesia's population, but the Universal Health Care Implementation (UHC) plan has been planned since the previous year. During the Covid pandemic, a large number of BPJS Health membership statuses were revoked because they were late, even though people needed health services and insurance with the existing conditions. This study is descriptive in nature, discussed in the context of BPJS health participation, and it is sufficient to use the insurance principle by only providing guarantees to participants, but the state follows the obligations of the 1945 Constitution, namely to provide health insurance and services to citizens. To support the existence of universal health insurance, Indonesia needs to implement an effective and efficient membership form and sanctions for mandatory provisions for social security participants.

Back to the future: Polish health care reform

2003 ◽  
Vol 36 (4) ◽  
pp. 385-403 ◽  
Author(s):  
Rachel Filinson ◽  
Piotr Chmielewski ◽  
Darek Niklas
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Workers ◽  
Universal Health Insurance ◽  
Care Workers ◽  
Insurance Funds ◽  
Physician Resistance ◽  
Polish Government ◽  
Health Insurance Funds ◽  
Universal Health

In January 1999, the Polish government implemented a new law reorganizing the health care in the country. This paper includes an outline of the changes, the main impact of which consisted of introduction of universal health insurance administered by Health Insurance Funds (‘‘Kasy Chorych’’). In June 2001 and 2002, a survey of insurance administrators and health care workers provided data concerning the reception of the new system, the perceived inadequacies, and the postulated changes. The intended objective of privatization of health provisions appears as remote as it was before the changes. The major obstacles are identified as political hurdles, physician resistance, and continued dependence on state allocations.

The effect of universal health insurance for children in Vietnam

2017 ◽  
Vol 14 (3) ◽  
pp. 299-314 ◽  
Author(s):  
Binh T. Nguyen ◽  
Anthony T. Lo Sasso
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Outcomes ◽  
Hospital Admissions ◽  
Living Standard ◽  
Universal Health Insurance ◽  
Public And Private ◽  
Outpatient Visits ◽  
Reported Health ◽  
Universal Health

AbstractOur research investigates the effects of the 2005 universal health insurance program for children under age 6 in Vietnam on health care utilization, household out-of-pocket (OOP) spending and self-reported health outcomes using data from the Vietnam Household Living Standard Survey in 2002–2004–2006–2008. We use difference-in-differences to compare children eligible for the program to older children who are ineligible for the program. Results indicate that the program increased insurance coverage by 250% for children age 0–5 relative to the pre-policy period. We found large increases in both outpatient visits and hospital admissions. Health insurance availability also increased outpatient visits at both public and private facilities, suggesting that public and private health care services are complements. Although health insurance was associated with a decrease in inpatient OOP spending for children aged 3–5, it did not reduce outpatient OOP spending for children in general. Health insurance was associated with modest improvements in self-reported health outcomes. Our research suggests that expanded access to insurance among Vietnamese children improved access to care and health outcomes, though it did not necessarily reduce OOP spending.

Universal Health Insurance

2017 ◽  
Author(s):  
George Klosko
Keyword(s):  
Health Insurance ◽  
Middle Class ◽  
National Health Insurance ◽  
National Health ◽  
Affordable Care Act ◽  
Major Theme ◽  
Universal Health Insurance ◽  
Health Insurance System ◽  
The Poor ◽  
Universal Health

Continuation of the struggle for national health insurance. Bill Clinton’s attempt to reform national health insurance, a cause taken up by Barack Obama, who in large part succeeded with his Affordable Care Act, passed in 2010. A major theme of the chapter is how the aim of universal health insurance, and so serving the poor, came to be overshadowed by the need to address abuses in the health insurance system and the concerns of the middle class.

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