Private Insurance Reform in the 1990s: Can it Solve the Health Care Crisis?

1992 ◽  
Vol 22 (2) ◽  
pp. 197-215 ◽  
Author(s):  
Thomas Bodenheimer
Keyword(s):  
Health Insurance ◽  
Social Insurance ◽  
Insurance Industry ◽  
Private Insurance ◽  
Health Sector ◽  
The United States ◽  
Healthy Population ◽  
Health Coverage ◽  
Insurance Reform ◽  
Health Insurance Reform

A number of health insurance reform proposals have surfaced at the state governmental level in the United States. These include Medicaid expansion for the below-poverty or near-poverty uninsured, state subsidy to individuals and/or businesses for the purchase of health insurance, risk pools for the medically uninsurable, insurance industry–initiated reforms within the small group market, the promotion of “stripped down” insurance plans that reduce premium cost, and state mandating of employer-sponsored health insurance for the employed uninsured. All of these insurance reform proposals have serious limitations: (1) they fail to address the inequities of the underwriting principle by which older and sicker people pay more for health insurance than the young and healthy population; (2) they extend the illogical linkage of employment and health insurance; and (3) they do not slow the rate of health cost inflation nor do they contain a mechanism to finance broader health coverage through savings within the health sector. An alternative to insurance reform is the establishment of a social insurance program that brings the entire population into a single risk pool.

scholarly journals Gender-Affirming Health Insurance Reform in the United States

2020 ◽  
Vol 8 (9S) ◽  
pp. 45-45
Author(s):  
Ledibabari M. Ngaage ◽  
Shan Xue ◽  
Mimi R. Borrelli ◽  
Bauback Safa ◽  
Jens U. Berli ◽  
...  
Keyword(s):  
United States ◽  
Health Insurance ◽  
The United States ◽  
Insurance Reform ◽  
Health Insurance Reform

Universal Health Insurance Reform in China

2018 ◽  
Vol 2 (2) ◽  
pp. 1-24
Author(s):  
Sabrina Ching Yuen Luk
Keyword(s):  
Health Insurance ◽  
Medical Insurance ◽  
The Elderly ◽  
Health Coverage ◽  
Term Care ◽  
Insurance Reform ◽  
Care For The Elderly ◽  
Health Insurance Reform ◽  
The Government ◽  
Universal Health

This article uses a refined version of historical institutionalism to critically examine the complex interplay of forces that shape the health insurance reform trajectory in China since the mid-1980s, problems that plague the current multi-layered social medical insurance system and solutions to these problems. It shows that achieving universal health coverage (UHC) requires the government to ensure financing equity between urban and rural insured participants, access to affordable health care and the financial sustainability of medical insurance funds. Facing the challenges of rapidly aging population, the government implements a pilot scheme that integrates medical and nursing care for the elderly and a pilot long-term care insurance scheme for disabled elderly. It is expected that these two pilot schemes can provide better financial protection and quality of medical services for the elderly.

Gender-Affirming Health Insurance Reform in the United States

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ledibabari Mildred Ngaage ◽  
Shan Xue ◽  
Mimi R. Borrelli ◽  
Bauback Safa ◽  
Jens U. Berli ◽  
...  
Keyword(s):  
United States ◽  
Health Insurance ◽  
The United States ◽  
Insurance Reform ◽  
Health Insurance Reform

Labor Market Consequences of State Health Insurance Regulation

ILR Review ◽  
2002 ◽  
Vol 56 (1) ◽  
pp. 136-159 ◽  
Author(s):  
Robert Kaestner ◽  
Kosali Ilayperuma Simon
Keyword(s):  
Labor Market ◽  
Health Insurance ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Labor Market Outcomes ◽  
Market Outcomes ◽  
Insurance Benefits ◽  
Insurance Reform ◽  
Health Insurance Reform ◽  
Group Health Insurance

This study, based mainly on the 1989–98 March Current Population surveys, finds that state-mandated health insurance benefits and small-group health insurance reform had no statistically significant effects on labor market outcomes such as the quantity of work, wages, and whether an employee worked for a small or large firm. The number and type of state-mandated health insurance benefits were unrelated to weeks of work, wages, and the prevalence of private insurance coverage, but positively associated with weekly work hours. Extensive small-group health insurance reform was associated with a slight decline in the prevalence of private insurance coverage in small firms, and this reform affected both full- and part-time employees. Less extensive reforms were not generally related to the prevalence of private insurance coverage. Overall, the authors do not find strong evidence that insurance regulations affected labor market outcomes, although they appear to cause a small decrease in private coverage.

Protect the Sick: Health Insurance Reform in One Easy Lesson

2008 ◽  
Vol 36 (4) ◽  
pp. 652-659 ◽  
Author(s):  
Deborah Stone
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Low Income ◽  
The Elderly ◽  
The United States ◽  
Government Programs ◽  
Insurance Reform ◽  
Sick People ◽  
Health Insurance Reform ◽  
Inducing Factors

In most other nations, insurance for medical care is called sickness insurance, and it covers sick people. In the United States, we have “health insurance,” and its major carriers — commercial insurers, large employers, and increasingly government programs — strive to avoid sick people and cover only the healthy. This perverse logic at the heart of the American health insurance system is the key to reform debates.Focusing on sick people versus healthy people might seem a strange way to view the coverage issue. Most discussions of insurance categorize people into other groupings: the insured versus the uninsured; Caucasian whites versus other racial and ethnic groups; men versus women; poor and low-income people versus everybody else; children, adults, and the elderly; or citizens versus immigrants and undocumented aliens. More recently, health researchers have begun talking about “vulnerable populations,” using most of the same demographic groupings and adding other illness-inducing factors such as social isolation, stress, and impoverished neighborhoods. But as I will show, insurance plans now use premiums, cost-sharing, and other design features in ways that indirectly divide each of these groups into the sick and the healthy, to the detriment of the sick. By shifting the costs of illness onto people who use medical care — that is, sick people — market-oriented reforms of the last few decades have eroded insurance in the name of strengthening it.

scholarly journals Health Reform: What's Insurance Got to Do with It? Recognizing Health Insurance as a Separate Species of Insurance

2010 ◽  
Vol 36 (2-3) ◽  
pp. 436-451 ◽  
Author(s):  
Wendy K. Mariner
Keyword(s):  
Health Insurance ◽  
Health Reform ◽  
Access To Health Care ◽  
The United States ◽  
Separate Species ◽  
Insurance Law ◽  
Insurance Reform ◽  
Patient Protection ◽  
Health Insurance Reform ◽  
Actuarial Fairness

Health reform debates in the United States are typically conducted using the language of insurance. President Barack Obama described his hopes for expanding access to care as “health insurance reform.” Both proponents and opponents of reform debated the merits of reform proposals leading to the Patient Protection and Affordable Care Act of 2010 in insurance terms. Yet, disagreements over the structure of reform reveal deep differences in what proponents and opponents of reform mean by insurance and the role it should play in mediating access to health care. Scholars of insurance law are likely to describe insurance somewhat narrowly as a risk spreading device. Industry representatives, among others, often view conventional indemnity insurance as the norm. From this perspective, reforms that move too far beyond underwriting risks can be seen as undermining actuarial fairness, threatening the very idea of insurance and possibly the industry itself.

scholarly journals What Counselors Need to Know About Health Care Reform

2010 ◽  
Vol 43 (1) ◽  
Author(s):  
Scott Barstow
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Sector ◽  
The United States ◽  
Care Services ◽  
The Law

More than 60 years after President Truman wrote those words and nearly 100 years since health insurance was proposed by Teddy Roosevelt, the United States has joined the rest of the developed nations in initiating a health care system aimed at establishing universal insurance coverage. President Barack Obama and his colleagues in the House and Senate succeeded where many, many others failed, but just barely. The legislation, described as "similar in scope to Great Society and New Deal programs," was enacted "without the benefit of the congressional majorities of those eras" (Oberlander, 2010). For some health care advocates, the law was a disappointment, as it missed opportunity to establish a "public option" for health insurance, a publicly financed and operated program similar to Medicare to provide broad coverage. For others, the legislation constituted the transformation of the United States into a socialist state, somehow endangering America's "freedoms." The reality is that the new law keeps the predominant role of private insurance coverage and welds it to a new framework of rules, investments in improving the effectiveness and efficiency of care, and a strengthened public health sector to establish a more rational system. The law will have a significant impact oi:i counselors as both consumers and providers of health care services, and its enactment has implications for counselor advocacy.

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