scholarly journals The Impacts Of A Free Health Insurance Policy In Vietnam

2021 ◽  
Author(s):  
◽  
Khoa Nguyen
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Outcomes ◽  
Social Health Insurance ◽  
Health Care Use ◽  
Social Health ◽  
Insurance Policy ◽  
Education Outcomes ◽  
Positive Effects ◽  
The Impact

<p>Social Health Insurance (SHI) is promoted as a policy that tackles the impoverishing effects of catastrophic spending that results from unexpected health shocks. This thesis contributes to the literature on the impact of social health insurance by examining the impact of a policy introduced in Vietnam in 2005. The new policy provided free health insurance for all children under six years. Using a difference-in-difference estimation strategy and eight national household surveys conducted between 2002 and 2016, I examine a variety of direct, indirect, and spill over effects of the policy. The direct effects of the policy are on insurance coverage, health care use, health care expenses, and self-reported morbidity of targeted children. The indirect effects are the persistent effects of the policy on the same set of health outcomes (and education outcomes) beyond the period of exposure to the policy. A third set of impacts cover spill over effects of the policy - on the health and education outcomes of older children living with targeted children, and a variety of household-level outcomes that reflect various dimensions of the wellbeing of household members. The results show that a free health insurance policy for young children has significant impacts on the health outcomes of children while they are covered by the policy and these persist, and also extend to educational outcomes beyond the age of eligibility. The policy also has positive spill over effects on older (untargeted) children living in targeted households, and positive effects on household wage income, and income per capita. On the other hand, the policy has no effects on the standard of living, household health expenditure, caloric consumption, and the likelihood of household spending on catastrophic healthcare.</p>

scholarly journals The Impacts Of A Free Health Insurance Policy In Vietnam

2021 ◽  
Author(s):  
◽  
Khoa Nguyen
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Outcomes ◽  
Social Health Insurance ◽  
Health Care Use ◽  
Social Health ◽  
Insurance Policy ◽  
Education Outcomes ◽  
Positive Effects ◽  
The Impact

<p>Social Health Insurance (SHI) is promoted as a policy that tackles the impoverishing effects of catastrophic spending that results from unexpected health shocks. This thesis contributes to the literature on the impact of social health insurance by examining the impact of a policy introduced in Vietnam in 2005. The new policy provided free health insurance for all children under six years. Using a difference-in-difference estimation strategy and eight national household surveys conducted between 2002 and 2016, I examine a variety of direct, indirect, and spill over effects of the policy. The direct effects of the policy are on insurance coverage, health care use, health care expenses, and self-reported morbidity of targeted children. The indirect effects are the persistent effects of the policy on the same set of health outcomes (and education outcomes) beyond the period of exposure to the policy. A third set of impacts cover spill over effects of the policy - on the health and education outcomes of older children living with targeted children, and a variety of household-level outcomes that reflect various dimensions of the wellbeing of household members. The results show that a free health insurance policy for young children has significant impacts on the health outcomes of children while they are covered by the policy and these persist, and also extend to educational outcomes beyond the age of eligibility. The policy also has positive spill over effects on older (untargeted) children living in targeted households, and positive effects on household wage income, and income per capita. On the other hand, the policy has no effects on the standard of living, household health expenditure, caloric consumption, and the likelihood of household spending on catastrophic healthcare.</p>

scholarly journals Impacts of the type of social health insurance on health service utilisation and expenditures: implications for a unified system in China

2018 ◽  
Vol 14 (4) ◽  
pp. 468-486 ◽  
Author(s):  
Si Ying Tan ◽  
Xun Wu ◽  
Wei Yang
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Rapid Expansion ◽  
Social Health ◽  
Service Utilisation ◽  
Provider Payment ◽  
Out Of Pocket Payments ◽  
The Impact

AbstractWhile moving towards unified social health insurance (SHI) is often a politically popular policy reform in countries where rapid expansion in health insurance coverage has given rise to the segmentation of SHI systems as different SHI schemes were rolled out to serve different populations, the potential impacts of reform on service utilisation and health costs have not been systematically studied. Using data from the Chinese Health and Retirement Longitudinal Study (CHARLS), we compared the mean costs incurred for both inpatient and outpatient care under different health insurance schemes, and the impact of different SHI schemes on treatment utilisation and health care costs using a two-part model. Our results show that Urban Employee Medical Insurance, which offers the most generous benefits, incurs the highest total costs prior to reimbursement when compared to other SHI schemes. Our analysis also shows that utilisation of SHI did not show significant reduction in out-of-pocket payments for outpatients. We argue that, unless effective measures are introduced to deal with perverse provider payment incentives, the move towards a unified system with more generous benefits may usher in a new wave of cost escalation for health care systems in China.

scholarly journals The impact of social health insurance on rural populations

2021 ◽  
Author(s):  
Colin Green ◽  
Bruce Hollingsworth ◽  
Miaoqing Yang
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Social Health Insurance ◽  
Social Health ◽  
Rural Populations ◽  
Access To Health Services ◽  
Access To Health ◽  
The Impact

AbstractImproving health outcomes of rural populations in low- and middle-income countries represents a significant challenge. A key part of this is ensuring access to health services and protecting households from financial risk caused by unaffordable medical care. In 2003, China introduced a heavily subsidised voluntary social health insurance programme that aimed to provide 800 million rural residents with access to health services and curb medical impoverishment. This paper provides new evidence on the impact of the scheme on health care utilisation and medical expenditure. Given the voluntary nature of the insurance enrolment, we exploit the uneven roll-out of the programme across rural counties as a natural experiment to explore causal inference. We find little effect of the insurance on the use of formal medical care and out-of-pocket health payments. However, there is evidence that it directed people away from informal health care towards village clinics, especially among patients with lower income. The insurance has also led to a reduction in the use of city hospitals among the rich. The shift to village clinics from informal care and higher-level hospitals suggests that the NRCMS has the potential to improve efficiency within the health care system and help patients to obtain less costly primary care. However, the poor quality of primary care and insufficient insurance coverage for outpatient services remains a concern.

The Impact of Social Health Insurance on Household Fertility Decisions

2016 ◽  
Vol 25 (5) ◽  
pp. 699-717 ◽  
Author(s):  
Stephen O. Abrokwah ◽  
Christine M. Moser ◽  
Edward Norton
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health ◽  
Fertility Decisions ◽  
The Impact

scholarly journals Factors Affecting Enrollment in Government Health Insurance Program in Kailali District

2019 ◽  
Vol 17 (3) ◽  
pp. 388-393
Author(s):  
Deepak Raj Paudel
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Illness ◽  
Social Health Insurance ◽  
Social Health ◽  
Factors Affecting ◽  
Government Health ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Insurance Enrollment

Background: Health care financial burden on households is high in Nepal. High health care expenditure is a major obstacle in achieving universal health coverage. The health insurance is expected to reduce healthcare expenditure. However, only small segments of the population are covered by health insurance in Nepal.This study assessed the factors affecting enrollment in government health insurance program in the first piloted district, Kailali, Nepal.Methods: A cross-sectional survey was conducted among 1048 households located in 26 wards of Kailali district after 21 months of the implementation of social health insurance program, Nepal. The sample was selected in two stages, first stage being the selection of wards and second, being the households.Results: The higher level of household economic status was associated with increased odds of enrollment in health insurance program (ORs=4.99, 5.04, 5.13, 8.05, for second, third, fourth, and the highest quintile of households, respectively). A higher level of head’s education was associated with increased odds of health insurance enrollment (ORs = 1.58, 1.78, 2.36, for primary, secondary, tertiary education, respectively). Presence of chronic illness in the household was positively associated with increased odds of health insurance enrollment (OR= 1.29). Conclusions: The poor and low educated groups were less benefited by social health insurance program in Kailali district, Nepal. Hence, policymakers should focus to implement income-based premium scheme for ensuring equal access to healthcare.Since household with chronic illness leads to high odds of being enrolled, a compulsory health insurance scheme can make the program financially sustainable.Keywords: Enrollment; health expenditure; health insurance; inequality; Nepal.

scholarly journals Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Abel Mekonne ◽  
Benyam Seifu ◽  
Chernet Hailu ◽  
Alemayehu Atomsa
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Health Professionals ◽  
Addis Ababa ◽  
Social Health Insurance ◽  
Social Health ◽  
Care Providers ◽  
The Government

Background. Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. Methods. A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. Result. A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR=2.9, 95% CI (1.2-7.3)], higher monthly income [AOR=2.2, 95% CI (1.2-4.3)], recent family illness [AOR=2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR=4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. Conclusion and Recommendation. The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.

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