scholarly journals The Value of Choice in Mandatory Health Insurance

2021 ◽  
Author(s):  
Christian Biener ◽  
Lan Zou
2021 ◽  
pp. 652-676
Author(s):  
Christian Rüefli

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.


Author(s):  
Alex Voorhoeve

This chapter critically examines a common liberal egalitarian view about the justification for, and proper content of, mandatory health insurance. This view holds that a mandate is justified as the best way to ensure that those in poor health gain health insurance on equitable terms. It also holds that a government should mandate what a representative prudent individual would purchase for themselves if they were placed in fair conditions of choice. The chapter argues that this common justification for a mandate is incomplete. A further reason for mandated insurance is that it helps secure social egalitarian public goods that would be underprovided if insurance were optional. It also argues that rather than mandating what a representative individual would choose for themselves, we should design the mandatory package by appealing to a pluralistic egalitarian view, which cares about improving people’s well-being, reducing unfair inequality, and maintaining egalitarian social relations.


This is the fourth volume of the continuing series, Oxford Studies in Political Philosophy. We collect here new and refereed work by leaders in the field. Authors in this volume are Zofia Stemplowska and Adam Swift, Thomas Sinclair, Allen Buchanan, Kasper Lippert-Rasmussen, Zoltan Miklosi, Ralf M. Bader, Alex Voorhoeve, and Alex Zakaras. The chapters are grouped into three categories: Legitimacy, Egalitarianism, and Liberty and Coercion. They address such various themes as the interaction of justice, equality, and political legitimacy; difficulties in the Kantian account of the state and proposals for removing them; institutional legitimacy reevaluated; luck egalitarianism; relational egalitarianism; the nature of liberty; mandatory health insurance and at what level it might best benefit a population; and the issue of citizens’ complicity in their government’s immoral actions with an analysis of various levels of such possible complicity.


2018 ◽  
pp. 125-132
Author(s):  
Dean Karlan ◽  
Jacob Appel

This chapter assesses a study conducted with SKS Microfinance and insurer ICICI-Lombard where the researchers added a mandatory health insurance policy to SKS microloans to test the theory that bundling policies with other products creates a viable pool of clients for insurers. SKS's bundling of insurance with microloans proved so problematic that, at the end of the day, there were not enough insured clients for researchers to study the impact of getting insurance on health experience or financial performance. The obvious failure here is low participation after randomization. The deeper question is why low participation became an issue. This points to two contributing failures. First, there was a partner organization burden around learning new skills. The second contributing failure can be traced all the way back to the project's inception. Before the study began, SKS had never bundled insurance with its loans. In terms of research setting, they were dealing with an immature product.


Author(s):  
G. Zeveleva

The article focuses on a healthcare reform, one of the pillars of Barack Obama’s presidency. The author argues that the reform was driven by social considerations, and the goal was to make the American healthcare system more just by implementing universal mandatory health insurance. The author analyses how implementation of Obama’s reform has turned into an arduous process, and why the enactment of some of its regulations were postponed. The article examines why some of the new regulations have already begun to function, while others are due to begin in 2018 and 2020. In 2014 the reform entered its critical phase, as its most controversial element on mandatory health insurance for all Americans came into effect. Failure to comply is met with the fine, while citizens with low incomes can rely on state support. Opponents of the reform are still undertaking efforts to eliminate the universal health insurance requirement. The author comes to the conclusion that despite the challenges Obama has already made the pages of history as the president who succeeded in implementing universal health insurance. One of his greatest achievements has been the triumph over many of the healthcare reform’s opponents as he wrote the reform into law in the spring of 2010. All previous attempts to reform the national system had been met with failure due to conservative resistance. The controversy around this topic stems from many Americans’ understanding of fundamental values. The central point of debate is not about the American healthcare system, but rather about what kind of country the United States of America will be in the 21st Century. Democrats believe that the reform will make the country more just, while their opponents fear that the USA will turn into a welfare state with less freedom and more control of federal authority.


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