Participation, Pricing, and Enrollment in a Health Insurance “Public Option”: Evidence From Washington State's Cascade Care Program

2021 ◽  
Author(s):  
ADITI P. SEN ◽  
YASHASWINI SINGH ◽  
MARK K. MEISELBACH ◽  
MATTHEW D. EISENBERG ◽  
GERARD F. ANDERSON
Keyword(s):  
Health Insurance ◽  
Care Program

THE PEDIATRICIAN AND THE PUBLIC

PEDIATRICS ◽  
1951 ◽  
Vol 8 (3) ◽  
pp. 435-445
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Adult Life ◽  
Care Program ◽  
Dental Service ◽  
School Age ◽  
Present Communication ◽  
Dental Services ◽  
The Public ◽  
Comprehensive Programs

THE first communication is on "Health Insurance in Canada from the Paediatric View" by Dr. John Keith with an introductory letter from Dr. Alan Brown. In 1943, the Canadian Medical Association approved the principle of health insurance and set forth the opinion that health insurance programs should be developed by the various provinces in accordance with their local needs (J. Pediat. 31:228, Aug., 1947). In the intervening years some provinces have developed quite comprehensive programs of medical care (Pediatrics 7:430, 1951) whereas other provinces have taken very little action. The present communication describes these endeavors from the viewpoint of the pediatrician. The second communication from Dr. John T. Fulton, Dental Services Adviser of the U. S. Children's Bureau, describes his observations of New Zealand's National Dental Service. The medical care program in New Zealand has received wide publicity; the National Dental Service, which was inaugurated much earlier, has received relatively little comment until recently. The dental care problem everywhere is enormous. Children of school age average to develop one new caries lesion per year. The dental manpower currently available in this country does not begin to be adequate to deal with the problem; the result is that the majority of children enter adult life with a large accumulation of dental defects.

Liberal Default, Labor Support, and Conservative Neutrality: The Kaiser Permanente Medical Care Program After World War II

1989 ◽  
Vol 1 (2) ◽  
pp. 156-180 ◽  
Author(s):  
Rickey L. Hendricks
Keyword(s):  
World War Ii ◽  
Health Insurance ◽  
Private Sector ◽  
Medical Care ◽  
National Health Insurance ◽  
National Health ◽  
Care Program ◽  
The Political ◽  
World War ◽  
Kaiser Permanente

In the politically turbulent post–World War II period, proposed federal legislation to expand the welfare state pitted conservative Republicans against liberal Democrats in Congress. The conflict over national health insurance introduced between 1943 and 1947 in the Wagner-Murray- Dingell bill ended in a conservative victory with the bill stalled in committee. The primary constituents of the two sides were American Medical Association (AMA) spokesmen and corporate interests on the political right and labor leaders and public health advocates on the left. By 1946 the conservatives controlled Congress; thereafter liberal congressional reformers defaulted on the national health issue, as they had throughout the twentieth century, to corporate progressives and the tenets of “welfare capitalism.” Government continued as a regulator of “minimum standards” for business and industry. Provision of voluntary health insurance and direct medical services was left to the private sector. The Kaiser Permanente Medical Care Program emerged out of the political stalemate over health care in the middle 1940s as a highly efficient and popular prepaid group health plan, innovative in its large scale and total integration of service and facilities. Its survival and growth was due to its acceptability to both liberals and conservatives as a model private-sector alternative to national health insurance or any other form of state medicine.

scholarly journals The Role of Wealth and Health in Insurance Choice: Bivariate Probit Analysis in China

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Yiding Yue ◽  
Jinyou Zou
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Status ◽  
Care Program ◽  
Pension Plans ◽  
Bivariate Probit ◽  
Commercial Insurance ◽  
Health Care Program ◽  
Pension Program ◽  
Insurance Choice

This paper captures the correlation between the choices of health insurance and pension insurance using the bivariate probit model and then studies the effect of wealth and health on insurance choice. Our empirical evidence shows that people who participate in a health care program are more likely to participate in a pension plan at the same time, while wealth and health have different effects on the choices of the health care program and the pension program. Generally, the higher an individual’s wealth level is, the more likelihood he will participate in a health care program; but wealth has no effect on the participation of pension. Health status has opposite effects on choices of health care programs and pension plans; the poorer an individual’s health is, the more likely he is to participate in health care programs, while the better health he enjoys, the more likely he is to participate in pension plans. When the investigation scope narrows down to commercial insurance, there is only a significant effect of health status on commercial health insurance. The commercial insurance choice and the insurance choice of the agricultural population are more complicated.

scholarly journals Mengapa masyarakat sektor informal belum memiliki asuransi BPJS kesehatan: persepsi dari pengusaha online?

2017 ◽  
Vol 33 (12) ◽  
pp. 623
Author(s):  
Firman Firman ◽  
Helfi Agustin
Keyword(s):  
Health Insurance ◽  
Sampling Technique ◽  
Care Program ◽  
Health Providers ◽  
Personal Factors ◽  
Snowball Sampling ◽  
Health Insurance Literacy ◽  
Online Entrepreneurs ◽  
The Government ◽  
The City

Why don't online shop workers enroll in BPJS health insurance? a case study from the City of YogyakartaPurposeThis study aimed to explore why an informal sector group has not decided to become a part of BPJS health by identifying knowledge or health insurance literacy.MethodThis research was a qualitative study with a phenomenology approach. Determination of informants was used by snowball sampling technique. Data collection was conducted with in-depth interviews with 15 people from an online entrepreneurs group who live around the city of Yogyakarta. Data were identified with inductive thematic analysis related to health insurance literacy to determine any relationship pattern of re­search variables.ResultsThe majority of informants have knowledge health insurance as a health care program used to seek treatment when sick. Specifically, informants have difficulties in understanding and explaining the basic terms about BPJS health insurance such as membership type, premium, benefits package, services procedure, the way of registration. The main determinant is caused by personal factors of informants themselves who are not seeking information about BPJS health because busy with works, still young, unmarried, and get ill rarely. Another factor is informants more often rely on getting insurance information from friends or family, while information from the Government and BPJS organization itself is very rare.ConclusionLow health insurance literacy is the main cause why informants decide not to be participants in BPJS health insurance. So it’s necessary to educate people about the BPJS health insurance both from the government, BPJS organization, and especially health providers in health facilities.

Program design, implementation and performance: the case of social health insurance in India

2018 ◽  
Vol 14 (4) ◽  
pp. 487-508 ◽  
Author(s):  
Dayashankar Maurya ◽  
M. Ramesh
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Program Design ◽  
Implementation Process ◽  
Social Health Insurance ◽  
Care Program ◽  
Comparative Case Study ◽  
Opportunistic Behavior ◽  
Governance Mechanism

AbstractPublished works on health insurance tend to focus on program design and its impact, neglecting the implementation process that links the two and affects outcomes. This paper examines the National Health Insurance [Rashtriya Swasthya Bima Yojana (RSBY)] in India with the objective of assessing the role of implementation structures and processes in shaping performance. The central question that the paper addresses is: why does the performance of RSBY vary across states despite similar program design? Using a comparative case study approach analyzing the program’s functioning in three states, it finds the answer in the differences in governance of implementation. The unavoidable gaps in design of health care program allow abundant scope for opportunistic behavior on the part of different stakeholders. The study finds that the performance of the program, as a result, depends on the extent to which the governance mechanism is able to contain and channel opportunistic behavior during implementation. By opening up the black box of implementation, the paper contributes to improving the performance of national health insurance in India and elsewhere.

scholarly journals Mathematical Techniques of Modelling Salary-Based Health Care Contribution

2021 ◽  
Vol 2 (2) ◽  
pp. 97-112
Author(s):  
Ogungbenle Gbenga Michael
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Current Model ◽  
Insurance Coverage ◽  
Care Program ◽  
Good Health ◽  
Health Insurance Coverage ◽  
Quality Health Care ◽  
Quality Health ◽  
Mathematical Techniques

This paper is intended to support reforms counteracting the adverse health insurance contribution trends through constructing an actuarially equitable salary-based health care system for experienced health insurance underwriters. The focus is on contribution technique employed by experts who consult for health insurance funds especially when performing official duties as health insurance actuary. The objective is to construct actuarial models of computing employee’s, employer’s and government’s contribution for health insurance care program in a way that permits generally equitable cost-efficient health insurance coverage within the framework of obtainable health benefits policy. Nigeria’s low economic growth rate and primitive technology resulted in an increasing rate of health care costs and consequently, quality health care at affordable prices is far from the reach of enrollees because of inequitable distribution of costs. In order to solve this problem, we constructed a health care model with a deterministic salary function structure to compute contribution on behalf of enrollees as a paradigm shift to an actuarial system of modelling contribution with a goal to building a sustainable health insurance delivery that encourages good health outcomes. From our results, the rate derived from our current model is far below the official rating of  on employee’s salary which is not footed on actuarial basis and hence cheaper and more equitable to adopt.

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