scholarly journals Die Zukunft der Gesetzlichen Krankenversicherung zwischen Markt und Strukturkonservatismus

1997 ◽  
Vol 27 (106) ◽  
pp. 29-53
Author(s):  
Tomas Steffens
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Health Insurance ◽  
Free Market ◽  
Social Health Insurance ◽  
Public Health Insurance ◽  
Social Health ◽  
Structural Problems

While public health insurance (PHI) fees keep increasing, it is not the material structural problems of the PHI system but strategies towards the privatization of sickness risks which deterrnine the discussion in health policy. This article analyzes the effects of an introduction of free-market steering mechanisms on the planning principles of a social health insurance.

scholarly journals Digital health in a social health insurance system: new emergent market powers in Germany

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Posselt ◽  
E Kuhlmann
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Social Inequalities ◽  
Driving Forces ◽  
Digital Health ◽  
Social Health Insurance ◽  
Global Strategy ◽  
Social Health ◽  
Health Insurance System ◽  
Private Actors

Abstract Background This presentation analyses the dynamics of digital health from a governance perspective. It aims to explore the driving forces for the implementation of digital health in Germany. Germany is chosen as a case study of a social health insurance system, which is based on joint self-governance of sickness funds and providers, and strong corporatist power of the medical profession. Methods A qualitative explorative approach is applied, drawing on document analysis and other secondary sources. The research is based on a governance approach adapted from Glassman and Buse's model of public health policy reform. Results The WHO Global Strategy for Digital Health 2020-2024 serves as a key international policy framework. However, the analysis reveals firstly that implementation is shaped by national healthcare systems and may create different results; secondly, the global strategy provides only a weak guidance on the national level. In Germany, strong corporatism and weak state intervention is supporting market forces and private actors. Poorly developed digital health governance has opened a window of opportunity for market powers as driving forces for digital health, thus creating new risks of social inequalities. There is an urgent need for public health to step up advocacy for health literacy to improve the accessibility to digital health for all citizens. Conclusions National healthcare systems strongly shape the implementation of international digital health frameworks, which makes digital health an issue of governance. Stronger public health orientation and a people-centred approach are needed to counteract new emergent social inequalities created by market power. Key messages Market power and private actors are important drivers of digital health in the German healthcare system. Social health insurance systems may be vulnerable to market powers and new digital health inequalities.

Bulgaria

2021 ◽  
pp. 816-856
Author(s):  
Guergana Stolarov-Demuth
Keyword(s):  
Health Insurance ◽  
Healthcare System ◽  
Free Market ◽  
Social Health Insurance ◽  
Social Health ◽  
Reform Process ◽  
Control Mechanisms ◽  
Public And Private ◽  
Health Politics ◽  
Insurance System

This chapter provides an extended look at health politics and the compulsory health insurance system in Bulgaria. It traces the historical development of the Bulgarian healthcare system characterized by the introduction of social health insurance, which after the establishment of communist rule in Bulgaria after World War II was replaced with a state-run healthcare system. Starting in 1989, Bulgaria underwent a transition to democracy and free market economy. This triggered structural healthcare reforms, including the re-introduction of social health insurance with both public and private provision. However, as privatization was permitted without effective price control mechanisms and conditions for entry into the public insurance system, out-of-pocket payments became extensive, especially for pharmaceuticals. The main reform challenges have been to close the coverage gaps and secure sufficient financing by stipulating selective contracting with hospitals, strengthening the control on pharmaceuticals, and tightening the collection of insurance contributions. While political debates were initially structured along traditional left–right political party lines, since 2001 new center-right parties have shaped Bulgarian health politics. Nevertheless, the reform process still suffered from lack of continuity, and private interest groups have successfully blocked cost-containment policies.

scholarly journals PECULIARITIES OF GRANTING EMPLOYMENT LEAVE IN CASE OF SARS-COV-2 INFECTION UNDER ROMANIAN REGULATION. LESSONS FOR THE FUTURE

2021 ◽  
Vol 52 (3) ◽  
pp. 50-507
Author(s):  
Sorin-Alexandru VERNEA ◽  
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Social Health Insurance ◽  
Regulatory Framework ◽  
Social Health ◽  
Insurance Benefits ◽  
Biological Risk ◽  
Medical Leave ◽  
The Future

Through this paper, the author analyzes the nature of medical leave granted under the conditions of Emergency Ordinance no. 158/2005 on leave and social health insurance benefits and under Law no. 136/2020 on the establishment of measures in the field of public health at epidemiological and biological risk. The paper is divided into two sections, the first aimed at identifying the nature of medical leave as regulated in Romanian legislation, and the second following the particularities of medical leave granted in case of infection with Sars-CoV-2. Finally, brief conclusions were drawn regarding the reliability of the regulatory framework regarding medical leave for quarantine or isolation.

Health Policy and Politics

2020 ◽  
pp. 504-520
Author(s):  
Maria Petmesidou
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Insurance ◽  
National Health System ◽  
Social Health Insurance ◽  
Policy Formation ◽  
Fiscal Sustainability ◽  
Social Health ◽  
Systematic Research ◽  
Public Provision

This chapter critically examines the health policy trajectory and reform dynamics since the restoration of democracy in Greece in 1974. After a brief Introduction, the second section highlights the distinctive features of the Greek health-care system that make it a ‘sui generis’ case in comparative studies. It uses analytical tools from the available literature on policy formation (such as, the concepts of ‘institutional layering’ and ‘windows of opportunity’ for policy breakthroughs), and sets out an explanatory framework for understanding the prolonged ‘halfway transformation’ from a deeply fragmented social health insurance system to universal health care. The third section provides a short historical account of the origins and development of social health insurance up to the late-1970s. Section 4 scrutinizes the (incomplete) establishment of a National Health System (ESY, Εθνικό Σύστημα Υγείας), in 1983, the policy stalemate during the 1990s, and the failed attempt to tackle persistent fragmentation and inequalities in coverage and funding, in the early 2000s. Section 5 unravels the confluence of factors during the crisis years, and under the three bailout programmes, which catalysed significant changes in light of the 1983 ‘path shift’, though in a way that greatly weakened the scope and quality of public provision. The concluding section stresses the need for systematic research on the complex issue of equity, comprehensiveness, and fiscal sustainability under conditions of strained public resources.

Which Therapeutic Progress Shall be Paid by Social Health Insurance?

2007 ◽  
Author(s):  
Jürgen Wasem ◽  
Hans-Dieter Nolting ◽  
Yvonne Grabbe ◽  
Stefan Loos
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health

scholarly journals Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

2021 ◽  
Vol 6 (2) ◽  
pp. e004117
Author(s):  
Aniqa Islam Marshall ◽  
Kanang Kantamaturapoj ◽  
Kamonwan Kiewnin ◽  
Somtanuek Chotchoungchatchai ◽  
Walaiporn Patcharanarumol ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Civil Servant ◽  
Social Health ◽  
Health Coverage ◽  
Medical Benefit ◽  
The Social ◽  
Universal Health ◽  
Universal Coverage Scheme

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

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