DRGs and the Professional Independence of Physicians

2011 ◽  
pp. 173-191 ◽  
Author(s):  
Lorraine Frisina ◽  
Mirella Cacace
Keyword(s):  
Social Insurance ◽  
Diagnosis Related Groups ◽  
Private Insurance ◽  
Present Contribution ◽  
Social Insurance System ◽  
Hospital System ◽  
The Public ◽  
Insurance System ◽  
Medicare Program ◽  
Professional Independence

This chapter examines the effects of diagnosis related groups (DRGs) on the professional independence of physicians in three distinct types of healthcare systems: the U.S. private insurance system, where DRGs were first developed and subsequently implemented in the public Medicare program in 1983; the British National Health Service (NHS), which adopted an analogous version of DRGs referred to as Health Resource Groups (HRGs) in 1992; and the German social insurance system, which adopted its own DRG version (G-DRGs) based on a refined version of the Australian model that is to be fully phased into the hospital system by 2009. By examining these three cases, the present contribution asks (a) whether it is possible to identify any effects of DRGs on the professional independence of physicians; and (b) whether these effects are specific to the respective healthcare system and/or DRG version at hand.

scholarly journals Finansowe aspekty rozwoju zintegrowanego publicznego systemu ubezpieczeń społecznych w Polsce

2020 ◽  
Vol 64 (4) ◽  
pp. 33-51
Author(s):  
Roman Garbiec ◽  
Keyword(s):  
Social Insurance ◽  
Integrated System ◽  
Research Tool ◽  
Insurance Fund ◽  
Financial Efficiency ◽  
Social Insurance System ◽  
The Public ◽  
Insurance System ◽  
Social Insurance Fund ◽  
The Social

The paper presents an initial concept of an integrated public social insurance system in Poland. The first part presents a diagnosis of the financial basis for the functioning of this system in the years 1991–2018. In the second part of the paper the diagnosis gives an indication of the directions for further development of this system, allowing it to become an integrated system, the financing of which does not negatively impact the functioning of the Polish economy and prevents the collapse of the public finances of the state. The aim of the paper is to define the financial foundations of an integrated social insurance system in Poland. The basic assumption of the study was the need to improve the financial efficiency of the public social security system through systemic and parametric reconstruction. The research tool used for the diagnosis was the analysis of documents (legal acts in the field of social insurance and financial statements of the Social Insurance Fund (FUS)). The research tool used for the diagnosis was the financial efficiency indicators relevant to the purposes of the analysis. The main conclusion of the study is that a parametric and systemic reconstruction of the Polish social insurance system is possible, which should lead to a balance of revenues and expenses in the Social Insurance Fund.

scholarly journals Wykonawcy wspólnie realizujący zamówienie publiczne a art. 8 ust. 2a ustawy z dnia 13 października 1998 r. o systemie ubezpieczeń społecznych

2018 ◽  
Vol 113 ◽  
pp. 105-120
Author(s):  
Ariel Przybyłowicz
Keyword(s):  
Social Security ◽  
Social Insurance ◽  
Public Procurement ◽  
Civil Law ◽  
Social Insurance System ◽  
Employment Contract ◽  
The Public ◽  
Insurance System ◽  
The Social ◽  
Public Contract

CONTRACTORS JOINTLY IMPLEMENTING A PUBLIC CONTRACT AND ARTICLE 8 SEC. 2A OF THE ACT OF 13TH OF OCTOBER 1998 ON THE SOCIAL INSURANCE SYSTEMArticle 8 para. 2a of the Act on the social insurance system includes the so-called extended employee defi nition. For social security purposes, it is also a person who has entered into a civil law contract with his own employer or with another entity, but performs this contract for his own employer. This provision creates signifi cant practical problems, including the problems on the basis of public procurements. One of the problematic questions is employing of the same people by several contractors, who perform the public procurement together as a consortium. The question then arises whether the work performed on the basis of a civil law contract concluded with one of such contractors, next to the employment contract concluded with another contractor, constitutes the title of social insurance according to the mentioned provision. In the article the Author presents potential confi gurations of such employment and tries to answer the question, in which of those confi gurations is the Article 8 para. 2a of the Act on the social insurance system applicable. According to Author, its automatic application in all of those situations is unacceptable.

Social versus Private Insurance

2018 ◽  
Author(s):  
Pierre Pestieau ◽  
Mathieu Lefebvre
Keyword(s):  
Social Insurance ◽  
Private Insurance ◽  
Population Ageing ◽  
Fiscal Competition ◽  
Public Insurance ◽  
The Public ◽  
Social Risks ◽  
The Family ◽  
Private And Public

This chapter looks at the role of the public versus the private sector in the provision of insurance against social risks. After having discussed the evolution of the role of the family as support in the first place, the specificity of social insurance is emphasized in opposition to private insurance. Figures show the extent of spending on both private and public insurance and the chapter presents economic reasons to why the latter is more developed than the former. Issues related to moral hazard and adverse selection are addressed. The chapter also discusses somewhat more general arguments supporting social insurance such as population ageing, unemployment, fiscal competition and social dumping.

scholarly journals How Well Does the U.S. Social Insurance System Provide Social Insurance?

2010 ◽  
Vol 118 (1) ◽  
pp. 76-112 ◽  
Author(s):  
Mark Huggett ◽  
Juan Carlos Parra
Keyword(s):  
Social Insurance ◽  
Social Insurance System ◽  
Insurance System ◽  
The U.S

scholarly journals Institutional Design and Incentives for Migrant Workers to Participate in Social Insurance in China: Evidence from a Policy Experiment in Chengdu City

2021 ◽  
Author(s):  
Yihao Tian ◽  
Yuxiao Chen ◽  
Mei Zhou ◽  
Shaoyang Zhao
Keyword(s):  
Social Security ◽  
Migrant Workers ◽  
Security Policy ◽  
Social Insurance ◽  
Participation Rate ◽  
National Bureau ◽  
Social Insurance System ◽  
Insurance System ◽  
The Social ◽  
Social Security Policy

Abstract Background: Rural-to-urban migration has increased rapidly in China since the early 1980s, with the number of migrants reaching 376 million in 2020 (National Bureau of Statistics [NBS], 2020). Despite this sharp trend and the significant contributions that the migrants have made to urban development, migrant workers have had very limited access to the social insurance that the majority of urban workers have enjoyed. Methods: Based on the background of the social insurance system adjustment in Chengdu in 2011, we establish a difference-in-differences (DID) model to empirically test the impacts of change in social insurance policy contribution rates on migrant workers' social insurance participation rates, using the China Migrants Dynamic Survey (CMDS) data from 2009-2016.Results: The social insurance participation rate of migrant workers was significantly reduced after they are incorporated into the urban worker insurance system. Meanwhile, there is no significant change in the wages of migrant workers, but the working hours became longer and the consumption level turned lower. That is to say, simply changing the social insurance model of migrant workers from "comprehensive social insurance" to "urban employee insurance" reduces the incentives for migrant workers to participate in the insurance and harm the overall welfares of migrant workers.Conclusion: The design of the social security policy is an important reason for lower participation rate of migrants. Therefore, it is necessary to solve the problem of insufficient incentives through targeted social security policies. Specifically, the first is to formulate a social security policy contribution rate suitable for the migrants. The second is to establish a comprehensive social security policy and gradually integrate the social security system.

scholarly journals Institutional Design and Incentives for Migrant Workers to Participate in Social Insurance in China: Evidence From a Policy Experiment in Chengdu City

2021 ◽  
Vol 9 ◽  
Author(s):  
Yihao Tian ◽  
Yuxiao Chen ◽  
Mei Zhou ◽  
Shaoyang Zhao
Keyword(s):  
Social Security ◽  
Migrant Workers ◽  
Security Policy ◽  
Social Insurance ◽  
Institutional Design ◽  
Participation Rate ◽  
Social Insurance System ◽  
Insurance System ◽  
The Social ◽  
Social Security Policy

Rural-to-urban migration has increased rapidly in China since the early 1980s, with the number of migrants has reached 376 million by 2020. Despite this sharp trend and the significant contributions that migrants have made to urban development, the migrant workers have had very limited access to the social insurance that the majority of urban workers enjoy. Against the background of the social insurance system adjustment in Chengdu in 2011, this study uses a difference-in-differences (DID) model to empirically test the impacts of changes in the social insurance policy contribution rates on the social insurance participation rates of migrant workers, using the China Migrants Dynamic Survey (CMDS) data for 2009–2016. We find that the social insurance participation rate of migrant workers was significantly reduced after they were incorporated into the urban worker insurance system. There was no significant change in the wages of migrant workers, but the working hours were increased and their consumption level decreased. In other words, simply changing the social insurance model of migrant workers from “comprehensive social insurance” to “urban employee insurance” reduces the incentives for migrant workers to participate in insurance and harms the overall welfare of migrant workers. Our study indicates that the design of the social security policy is an important reason for the lower participation rate of migrants. It is necessary to solve the problem of insufficient incentives through the targeted social security policies; primarily, the formulation of a social security policy contribution rate suitable for the migrants, and the establishment of a comprehensive social security policy and the gradual integration of the social security system.

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