Ensuring America's Health: Publicly Constructing the Private Health Insurance Industry

2011 ◽  
Author(s):  
Christy Ford Chapin
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Health Insurance Industry

scholarly journals Policy change and private health insurance: did the cheapest policy do the trick?

2002 ◽  
Vol 25 (6) ◽  
pp. 33 ◽  
Author(s):  
James R G Butler
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Policy Change ◽  
Financial Incentives ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Government Expenditure ◽  
Policy Changes ◽  
Community Rating ◽  
Health Insurance Industry

From the introduction of Australia's national health insurance scheme (Medicare) in 1984 until recently, the proportion of the population covered by private health insurance declined steadily. Following an Industry Commission inquiry into the private health insurance industry in 1997,a number of policy changes were effected in an attempt to reverse this trend. The main policy changes were of two types: "carrots and sticks" financial incentives that provided subsidies for purchasing, or tax penalties for not purchasing, private health insurance; and lifetime community rating, which aimed to revise the community rating regulations governing private health insurance in Australia. This paper argues that the membership uptake that has occurred recently is largely attributable to the introduction of lifetime community rating which goes some way towards addressing the adverse selection associated with the previous community rating regulations. This policy change had virtually no cost to government. However, it was introduced after subsidies for private health insurance were already in place. The chronological sequencing of these policies has resulted in substantial increases in government expenditure on private health insurance subsidies, with such increases not being a cause but rather an effect of increased demand for private health insurance.The paper also considers whether the decline in membership that has occurred since the implementation of lifetime community rating presages the re-emergence of an adverse selection problem in private health insurance. Much of the decline to date may be attributable to failure on the part of some members to honour premium payments when they first fell due. However, the changing age composition of the insured pool since September 2000,resulting in an increasing average age of those insured, suggests the possible reappearance of an adverse selection dynamic. Thus the 'trick' delivered by lifetime community rating may not be maintained in the longer term.

scholarly journals Australia's private health insurance industry: structure, competition, regulation and role in a less than 'ideal world'

2011 ◽  
Vol 35 (1) ◽  
pp. 23 ◽  
Author(s):  
Ardel Shamsullah
Keyword(s):  
Health Insurance ◽  
Social Insurance ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Public Awareness ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Industry Structure ◽  
Funding Policy ◽  
Health Insurance Industry

Australia’s private health insurance funds have been prominent participants in the nation’s health system for 60 years. Yet there is relatively little public awareness of the distinctive origins of the health funds, the uncharacteristic organisational nature of these commercial enterprises and the peculiarly regulated nature of their industry. The conventional corporate responsibility to shareholders was, until recently, completely irrelevant, and remains marginal to the sector. However, their purported answerability to contributors, styled as ‘members’, was always doubtful for most health funds. After a long period of remarkable stability in the sector, despite significant shifts in health funding policy, recent years have brought notable changes, with mergers, acquisitions and exits from the industry. The research is based on the detailed study of the private health funds, covering their history, organisational character and industry structure. It argues that the funds have always been divorced from the disciplines of the competitive market and generally have operated complacently within a system of comprehensive regulation and generous subsidy. The prospect of the private health funds enjoying an expanded role under a form of ‘social insurance’, as suggested by the National Health and Hospitals Reform Commission, is not supported. What is known about the topic? Government policies promoting private health insurance have long been the subject of public debate and have received considerable academic analysis. The health funds have a high profile in the media and with the public, reflecting the extent of private health insurance coverage. What does this paper add? There is relatively little awareness of the unique nature of the private health insurance industry. This paper highlights the distinctive organisational origins of the health funds, the recent changes to the structure of the sector which have complicated their corporate identities and the complex role they play in an extraordinarily regulated private health insurance industry. What are the implications for practitioners? Awareness of the nature of the sector should take us beyond perennial concerns about premium rises and the level of private health insurance coverage to better appreciate the diverse nature of the industry, the constraints under which the funds operate and the potential they may have to deliver ‘social insurance’.

The Private Health Insurance Industry: The Real Barrier to Healthcare Access?

1994 ◽  
Vol 3 (1) ◽  
pp. 99-107
Author(s):  
Mark Yarborough
Keyword(s):  
Health Insurance ◽  
Healthcare System ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Healthcare Access ◽  
Access To Healthcare ◽  
The Real ◽  
Barriers To Access ◽  
Health Insurance Industry

Any humane society needs a just and compassionate way to care for those who are sick, and should be vigilant in identifying and eliminating barriers that frustrate efforts to adequately care for the sick. Some current insurance underwriting practices constitute effective barriers to access to healthcare and serve to diminish the place of freedom and justice in our healthcare system.

scholarly journals The Private Insurance Market: Not Very Big and Not Insuring Much, Either

2018 ◽  
Vol 46 (4) ◽  
pp. 877-882 ◽  
Author(s):  
Jacqueline Fox
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Private Health Insurance ◽  
Insurance Industry ◽  
Private Insurance ◽  
Insurance Market ◽  
Insurance Companies ◽  
Medicare Program ◽  
Health Insurance Industry

Creating a single national health insurance pool is not likely to destabilize the economy by supplanting the private health insurance industry. This industry insures a relatively small percentage of the population and holds very little of the risk such insurance implies. In effect, insurance companies function as middlemen, bundling risk packages to distribute to other, larger companies and so serve a limited purpose. Were insurers to handle claims for a national pool as they do for the Medicare program, any destabilization to the economy more broadly would be further minimized.

scholarly journals Private hospital insurance status among a state-wide injured population

2006 ◽  
Vol 30 (2) ◽  
pp. 252 ◽  
Author(s):  
Fiona J Clay ◽  
Joan Ozanne-Smith
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Private Hospital ◽  
Insurance Industry ◽  
Risk Groups ◽  
Public Hospitals ◽  
Australian Government ◽  
Public And Private ◽  
Health Insurance Industry ◽  
Injured Patients

Injury is a leading cause of inpatient hospital episodes. Over a 4-year period (1997?2000) the Australian Government introduced measures to support the private health insurance industry by providing incentives for people to take up private health insurance (PHI) in order to take the pressure off public hospitals. This study examined the levels of PHI for moderately and severely injured people in Victoria as a way of determining the effectiveness of government incentives. The method involved an analysis of all Victorian public and private hospital injury admissions between July 2000 and June 2003. We found that people with injuries, either unintentional or intentional, had lower levels of PHI than state norms. While numbers of injured patients occupying private hospital beds initially increased, levels then dropped below the levels before the introduction of the incentives. The burden of injury is substantial and suggests that incentives need to be targeted towards at-risk groups.

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