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.

Health Insurance Eroding for Working Families: Employer-Provided Coverage Declines for Fifth Consecutive Year

2007 ◽  
Vol 37 (3) ◽  
pp. 441-467 ◽  
Author(s):  
Elise Gould
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Critical Time ◽  
Health Coverage ◽  
Insurance Reform ◽  
Health Insurance Reform ◽  
Working Families ◽  
Public Sector Health ◽  
The Government ◽  
Uninsured Children

In 2005, the percentage of Americans with employer-provided health insurance fell for the fifth year in a row. Workers and their families have been falling into the ranks of the uninsured at alarming rates. The downward trend in employer-provided coverage for children also continued into 2005. In the previous four years, children were less likely to become uninsured as public sector health coverage expanded, but in 2005 the rate of uninsured children increased. While Medicaid and SCHIP still work for many, the government has not picked up coverage for everybody who lost insurance. The weakening of this system—notably for children—is particularly difficult for workers and their families in a time of stagnating incomes. Furthermore, these programs are not designed to prevent low-income adults or middle- or high-income families from becoming uninsured. Government at the federal and state levels has responded to medical inflation with policy changes that reduce public insurance eligibility or with proposals to reduce government costs. Federal policy proposals to lessen the tax advantage of workplace insurance or to encourage a private purchase system could further destabilize the employer-provided system. Now is a critical time to consider health insurance reform. Several promising solutions could increase access to affordable health care. The key is to create large, varied, and stable risk pools.

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

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.

scholarly journals Gambaran Out of Pocket pada Awal Era JKN di Indonesia

2018 ◽  
pp. 141-146
Author(s):  
Ingan Tarigan ◽  
Taty Suryati
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Financial Protection ◽  
Health Coverage ◽  
Medical Expenses ◽  
The Poor ◽  
The Government ◽  
Universal Health

Abstrak Pogram Jaminan Kesehatan Nasional (JKN) salah satunya bertujuan memberikan perlindungan finansial khususnya biaya katastropik terhadap semua peserta. Penerima manfaat JKN berhak mendapatkan berbagai layanan sebagai bagian dari paket manfaat dasar tanpa mengeluarkan biaya pelayanan, dan diharapkan Out of Pocket (OOP) akan lebih rendah dibandingkan dengan mereka yang tidak memiliki asuransi kesehatan. Tujuan penulisan akan membandingkan total pengeluaran untuk kesehatan dari peserta jaminan kesehatan dengan yang tidak memiliki jaminan kesehatan pada awal era JKN. Dalam analisis ini, pengukuran pengeluaran perawatan kesehatan hanya mencakup biaya pengobatan langsung, seperti biaya konsultasi, pemakaian kamar di rumah sakit dan obat-obatan. Analisis dengan menggunakan data Susenas 2014 terdiri dari 274.673 individu dan 71.051 rumah tangga di 33 provinsi di Indonesia. Hasil penelitian menunjukkan bahwa pada awal era JKN ada sedikit perbedaan OOP pada penduduk miskin dibandingkan dengan penduduk dimana proteksi finansial terhadap penduduk miskin untuk pengeluaran kesehatan masih rendah.Kepemilikan jaminan kesehatan memberikan proteksi finansial akibat pengeluaran biaya kesehatan, khususnya pengeluaran biaya katastropik dibandingkan dengan yang tidak memiliki jaminan kesehatan. Kepesertaan penduduk miskin ditargetkan tahun 2019 sudah terpenuhi sehingga target pemerintah tentang Universal Health Coverage (UHC) perlindungan finansial pada penduduk miskin dan hampir miskin semakin tinggi atau OOP semakin mendekati nol. Kata kunci: OOP, Pembiayaan, Asuransi Kesehatan Abstract One of the main objectives of the JKN program is to provide financial protection, especially catastrophic costs to all members. JKN beneficiaries are entitled to various services as part of the basic benefit package without incurring service costs, and it is expected that Out of Pocket (OOP) will be lower than those who do not have health insurance. The purpose of writing will be to compare the total health expenditures of health insurance participants or beneficiaries and those without health insurance. In this analysis, the measurement of health care expenditures only includes direct medical expenses, such as consultation fees, hospital room usage and medication. Using Susenas data 2014 consists of 274,673 individuals and 71,051 households in 33 provinces in Indonesia. At the beginning of the JKN implementation, there was little difference of out of pocket in the poorest population compared to the richest population. This shows that financial protection to the poor for health expenditures are still low. The ownership of health insurance tends to provide financial protection due to health expenditures, especially catastrophic expenses compared to those without health insurance. In the Year of 2019 where the government targeted to Universal Health Coverage (UHC) expected protection financial on the poor and near poor is getting higher or out of pocket or getting closer up to zero. Keywords: OOP, Financial Protection, Health Insurance

scholarly journals Health insurance reform in China after the 16th National Congress of the Communist Party of China

2020 ◽  
pp. 1-10
Author(s):  
Khentsze Lyu
Keyword(s):  
Health Insurance ◽  
Communist Party ◽  
Healthcare Sector ◽  
Communist Party Of China ◽  
Insurance System ◽  
Insurance Reform ◽  
Stage Of Development ◽  
Health Insurance Reform ◽  
National Congress ◽  
The Government

This article reviews the health insurance reforms in China for the period from 2002 to the present. It stated that 16th National Congress of the Communist Party of China introduced significant amendments to health insurance system, balancing the negative impact of capitalist mechanisms, on the one hand, and justice and equality – on the other. This stage of development in China’s healthcare insurance system is described as the “second generation” in healthcare system, characterized with the change of government’s role in allocation of resources in healthcare sector: proliferation of “wild capitalism” in medicine is replaced with the concept of granting freedom to the market mechanisms under the government supervision. The reforms of PRC government in the area of health have a clear social focus. The state takes over responsibility for health of the citizens, which was released to a free market in the “new course” of the 1980s – 1990s. At the same time, the former paternalistic scheme is replaced by the equal system of interaction between society and the government. In all cases, the insurance funds are formed out of personal deposits of the citizens and deposits of local and central authorities. Municipalities are responsible for majority of decisions in the area of development of insurance schemes. The government’s role consists in establishment of minimum deposits and maximum coverage. This is how the central authorities, local administration and citizens are involved in insurance schemes on equal terms.

scholarly journals In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study

2020 ◽  
Author(s):  
Eric Abodey ◽  
Irene Vanderpuye ◽  
Isaac Mensah ◽  
Eric Badu
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Students With Disabilities ◽  
Universal Health Coverage ◽  
Access To Health Care ◽  
Health Workers ◽  
Policy Formulation ◽  
Health Coverage ◽  
The Government ◽  
Universal Health

Abstract Background: Accessibility of health care to students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health care to students with disabilities. This study, therefore, aims to explore the accessibility of health care to students with disabilities, in the quest of achieving universal health coverage in Ghana. Methods: Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data. Results : The study identified three themes – accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health care. The barriers faced by students with disabilities were unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health care. Conclusion : The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the National Health Insurance Scheme should be revised to adequately address the needs of people with disabilities.

Aged Care Services in India

2021 ◽  
pp. 114-143
Author(s):  
Wadad Kathy Tannous ◽  
Divya Ramachandran
Keyword(s):  
Filial Piety ◽  
Elderly Care ◽  
The Elderly ◽  
Aged Care ◽  
Geriatric Care ◽  
Term Care ◽  
Public And Private ◽  
Care Services ◽  
Care For The Elderly ◽  
The Government

India is the world's largest democracy and second most populous country with nearly 1.4 billion people. With reduced birth rates and increasing lifespans, it had nearly 104 million ‘senior citizens' in 2011, expected to grow to 300 million by 2050. Providing care for the elderly in India is a growing public and private concern. Filial piety is embedded in culture and long-term care for parents and the elderly is expected from children. However, over the last five decades there have been rapid changes in socioeconomic patterns with increasing mobility for work and rise of nuclear households. Despite this, elder care is still largely underdeveloped, with lack of formal training in geriatric care and geriatric care curriculum in medical education. Australia has a highly evolved elderly care system with care services that includes retirement villages, home care, residential care, and flexible care. These are provided by subsidization from the government and private user pay system. Australia is well poised to provide aged care expertise and services and shape elderly care in India.

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.

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