Switzerland

2021 ◽  
pp. 652-676
Author(s):  
Christian Rüefli
Keyword(s):  
Health Insurance ◽  
Direct Democracy ◽  
Private Insurance ◽  
Universal Coverage ◽  
Individual Responsibility ◽  
Managed Competition ◽  
State Control ◽  
Market Mechanisms ◽  
Healthcare Politics ◽  
Mandatory Health Insurance

This chapter offers an in-depth look at health politics and the mandatory health insurance system in Switzerland. It traces the development of the Swiss healthcare system, characterized by the strong role of the cantons and private stakeholder organizations in managing the system as well as the reliance on voluntary private insurance for most of the twentieth century. Since 1994, when a law on mandatory health insurance was adopted, the main issues in Swiss healthcare politics have been increasing costs, managed competition, the introduction of case-based payment, and healthcare governance. Switzerland’s consociational political system, with its instruments of direct democracy, federalism, and corporatist interest representation, impedes the development of consensus across the left–right divide about whether the health system should rely more on market mechanisms and individual responsibility or on state control and universal coverage.

Supplementary Health Insurance and Regulation of Healthcare Systems

2019 ◽  
Author(s):  
Brigitte Dormont
Keyword(s):  
Health Insurance ◽  
Cost Sharing ◽  
Social Insurance ◽  
Private Insurance ◽  
Social Health Insurance ◽  
Social Health ◽  
Managed Competition ◽  
Benefit Package ◽  
Care Services ◽  
Supplementary Health Insurance

Most developed nations provide generous coverage of care services, using either a tax financed healthcare system or social health insurance. Such systems pursue efficiency and equity in care provision. Efficiency means that expenditures are minimized for a given level of care services. Equity means that individuals with equal needs have equal access to the benefit package. In order to limit expenditures, social health insurance systems explicitly limit their benefit package. Moreover, most such systems have introduced cost sharing so that beneficiaries bear some cost when using care services. These limits on coverage create room for private insurance that complements or supplements social health insurance. Everywhere, social health insurance coexists along with voluntarily purchased supplementary private insurance. While the latter generally covers a small portion of health expenditures, it can interfere with the functioning of social health insurance. Supplementary health insurance can be detrimental to efficiency through several mechanisms. It limits competition in managed competition settings. It favors excessive care consumption through coverage of cost sharing and of services that are complementary to those included in social insurance benefits. It can also hinder achievement of the equity goals inherent to social insurance. Supplementary insurance creates inequality in access to services included in the social benefits package. Individuals with high incomes are more likely to buy supplementary insurance, and the additional care consumption resulting from better coverage creates additional costs that are borne by social health insurance. In addition, there are other anti-redistributive mechanisms from high to low risks. Social health insurance should be designed, not as an isolated institution, but with an awareness of the existence—and the possible expansion—of supplementary health insurance.

The Netherlands

2021 ◽  
pp. 520-557
Author(s):  
Karen M. Anderson ◽  
Ruud J. Van Druenen
Keyword(s):  
Health Insurance ◽  
The Netherlands ◽  
Party System ◽  
Large Scale ◽  
Private Insurance ◽  
Social Health Insurance ◽  
State Regulation ◽  
Managed Competition ◽  
Health Politics ◽  
Private Actors

This chapter provides an extended look at health politics and the mandated health insurance system in the Netherlands. It traces the historical development of the Dutch healthcare system, analyzing the emergence of a bifurcated public–private system and its replacement with mandated private insurance in 2006. The Dutch case is thus notable for large-scale privatization accompanied by expanding state regulation of private actors. Dramatic shifts in the party system since the 1980s shaped reform processes as the center-left consensus in favor of social health insurance and redistributive financing was replaced by center-right consensus supporting managed competition among private insurers. Reforms adopted since 2005 have aimed to control costs without sacrificing quality, largely by strengthening managed competition and the regulation underpinning it.

Slovenia

2021 ◽  
pp. 788-808
Author(s):  
Tamara Popic
Keyword(s):  
Health Insurance ◽  
Primary Care Physicians ◽  
Private Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Party Competition ◽  
Social Health ◽  
Large Hospital ◽  
Health Politics ◽  
Universal Health

This chapter offers an in-depth look at health politics and the universal health system in Slovenia based on compulsory social health insurance. It traces the development of the Slovenian healthcare system from the first health insurance schemes to the more established insurance system with universal coverage and focus on social medicine under communism. Since its independence in 1992, Slovenian politics has been marked by a pragmatic model of party competition with an important role in healthcare policymaking played by neo-corporatist structures. The major post-communist reform was the introduction of complementary private health insurance in 1993, which covers the majority of the population. Several unsuccessful reform proposals sought the abolition of complementary private insurance, the fairness of which remains the most controversial question regarding the system. Other healthcare issues outlined in the chapter include large hospital debt and uneven distribution of primary care physicians.

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.

Health Insurance Differentials Among Minority Children With Chronic Conditions and the Role of Federal Agencies and Private Foundations in Improving Financial Access

PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. 1040-1047
Author(s):  
Margaret A. McManus ◽  
Paul Newacheck
Keyword(s):  
Health Insurance ◽  
Race And Ethnicity ◽  
Health Care Policy ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Minority Population ◽  
Hispanic Children ◽  
Health Services Use ◽  
Financial Barriers ◽  
White Children

Minorities experience a disproportionate share of the financial barriers resulting from higher rates of uninsuredness and a greater reliance on Medicaid vs private insurance. As a result, health services use and patterns of expenditures vary markedly by race and ethnicity.1,2 National survey data reveal a rapid increase in the number of uninsured black and Hispanic persons between 1977 and 1987.3 The major factors contributing to this increase are (1) overall growth in the size of the minority population, especially Hispanics; (2) reductions in private insurance coverage; and (3) the lack of significant expansions in public programs, largely Medicaid (note: several Medicaid eligibility expansions affecting poor children occurred during and after 1987). In 1987, 14% of white children younger than age 18 were uninsured compared to 22% of black children and 33% of Hispanic children (Cornelius LJ. Unpublished data). Black and Hispanic persons were more likely to rely on Medicaid as their primary financing source than were white persons.3 In 1987, 8% of white children were covered by Medicaid vs 38% of black and 28% of Hispanic children (Cornelius LJ. Unpublished data from the Agency for Health Care Policy and Research, 1992.). Despite Medicaid's importance as a financing source, low reimbursement rates have resulted in inadequate provider participation and corresponding access barriers.4,5 In comparison with white persons, minorities have less access to employer-based insurance benefits. Part of the reason lies in the types of jobs that are disproportionately held by minorities. Personal service and agricultural employers typically do not offer health insurance to their employees.

Healthcare of the Netherlands

2022 ◽  
pp. 67-69
Author(s):  
Elena Vladimirovna Frolova ◽  
Keyword(s):  
Health Insurance ◽  
The Netherlands ◽  
Western Europe ◽  
Private Insurance ◽  
The State ◽  
Insurance Companies ◽  
Malignant Neoplasms ◽  
Average Life Expectancy ◽  
Medical Reform ◽  
Cause Of Deaths

The Netherlands is a state located in Western Europe bordering Germany and Belgium. The population of the country is just over 17million people. In terms of GDP, theNetherlands is among the twenty richest countries in the world, and in terms of exports, it is in the top ten. The average life expectancy in theNetherlands is 81.4 years; in the structure ofmortality, malignant neoplasms come out on top, which distinguishes the state from other European countries, where the main cause of deaths is cardiovascular diseases. The compulsory health insurance system was introduced in the country in 2006 after the medical reform. A distinctive feature of the Dutch healthcare system is its relative autonomy from the state, which performs only the function of an external controller, and all other powers belong to the municipal authorities. As a result, several private insurance companies have been admitted to health insurance in the Netherlands, which create healthy competition among themselves, thereby contributing to better quality and more affordable healthcare.

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