The Political Dynamics of the Elderly Health Insurance Reform in Japan

Seongjo Kim

doi:10.35656/jkp.26.1.7

Dental Expenditure by Household Income in Korea over the Period 2008–2017: A Review of the National Dental Insurance Reform

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083859 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3859

Author(s):

Hosung Shin ◽

Han-A Cho ◽

Bo-Ra Kim

Keyword(s):

Health Insurance ◽

Concentration Index ◽

Dental Health ◽

Age Groups ◽

The Elderly ◽

Dental Service ◽

Delta Method ◽

Dental Services ◽

Insurance Reform ◽

Health Insurance Reform

Since 2009, the National Health Insurance in Korea (NHI) has been implementing a series of policies to expand the scope of dental benefits. This study reviewed the changes in co-payments and dental use patterns before (2008 to 2012) and after (2013 to 2017) the NHI’s dental health insurance reform. The study used Korea Health Panel data of 7681 households (16,493 household members) from a 10-year period (2008–2017). Dental expenditures and equivalent income using square root of household size were analyzed. Dental services were categorized into 13 types and a concentration index and 95% confidence interval using the delta method was calculated to identify income-related inequalities by a dental service. Dental expenditures and the number of dental services used increased significantly, while the proportion of out-of-pocket spending by the elderly decreased. The expenditure ratio for implant services to total dental expenditures increased substantially in all age groups, but the ratio of expenditures for dentures and fixed bridges decreased relatively. The concentration index of implant services was basically in favor of the rich, but there was no longer a significant bias favoring the better-off after the reforms. The dental health insurance reform in Korea appears to contribute not only to lowering the ratio of out-of-pocket to total dental expenses per episode in the elderly but also to improving the inequality of dental expenses.

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Universal Health Insurance Reform in China

International Journal of Public and Private Perspectives on Healthcare Culture and the Environment ◽

10.4018/ijppphce.2018070101 ◽

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.

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Protect the Sick: Health Insurance Reform in One Easy Lesson

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2008.00319.x ◽

2008 ◽

Vol 36 (4) ◽

pp. 652-659 ◽

Cited By ~ 5

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.

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