Universal Coverage: Will All Americans Finally Get Health Insurance?

2014 ◽  
pp. 275-298
Author(s):  
Marcia Clemmitt
Keyword(s):  
Health Insurance ◽  
Universal Coverage

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.

Pengaruh Pendapatan, Pengetahuan Dan Kerentanan Penyakit Terhadap Willingness To Pay (WTP) Premi Jaminan Kesehatan Pada Pekerja Sektor Informal

2021 ◽  
Vol 7 (1) ◽  
pp. 48-59
Author(s):  
Anom Dwi Prakoso
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Informal Sector ◽  
Low Income ◽  
Disease Susceptibility ◽  
Universal Coverage ◽  
Health Coverage ◽  
Cross Sectional ◽  
Susceptibility Data ◽  
Central Java

  Background: The Indonesian Government's target of Universal Coverage or 100% Health Insurance participation by 2019 failed to be achieved, even until the end of October 2020. The failure of universal coverage resulted in BPJS Health's finances getting worse after experiencing a deficit. Informal sector workers are the most dominant sector that has not participated in the Health Insurance scheme, totaling 30,487,891 workers. Low income, uncertainty each month, and the increase in contributions resulted in a decrease in Willingness to pay Health Insurance contributions. Research purposes: The purpose of this study is to analyze the effect of income, knowledge, and disease susceptibility to the willingness to pay (WTP) of health insurance contributions to informal sector workers. Method: This cross-sectional research was conducted in Kudus Regency, Central Java in January-February 2020. Sampling used purposive sampling with a total of 200 informal sector workers who had not yet participated in BPJS Kesehatan. The dependent variable is a willingness to pay. The independent variables are income, knowledge, and disease susceptibility. Data collection using a questionnaire and data analysis with logistic regression. Result: Willingness To Pay health insurance contributions for informal sector workers increased in income ≥Rp 2,218,451 (b = 2.02; 95% CI = 1.01-3.55; p = 0.044), high knowledge (b = 4.64; 95% CI = 2.36-8.31; p <0.001), high disease susceptibility (b = 3.01; 95% CI = 0.26-5.75; p = 0.031). Conclusion: Income, knowledge, and disease vulnerability have a significant effect on the willingness to pay for health insurance contributions for informal sector workers.   Keywords: Universal Health Coverage; Willingness To Pay; Health Insurance; informal sector workers.

Switzerland

2021 ◽  
pp. 652-676
Author(s):  
Christian Rüefli
Keyword(s):  
Health Insurance ◽  
Direct Democracy ◽  
Private Insurance ◽  
Universal Coverage ◽  
Individual Responsibility ◽  
Managed Competition ◽  
State Control ◽  
Market Mechanisms ◽  
Healthcare Politics ◽  
Mandatory Health Insurance

This chapter offers an in-depth look at health politics and the mandatory health insurance system in Switzerland. It traces the development of the Swiss healthcare system, characterized by the strong role of the cantons and private stakeholder organizations in managing the system as well as the reliance on voluntary private insurance for most of the twentieth century. Since 1994, when a law on mandatory health insurance was adopted, the main issues in Swiss healthcare politics have been increasing costs, managed competition, the introduction of case-based payment, and healthcare governance. Switzerland’s consociational political system, with its instruments of direct democracy, federalism, and corporatist interest representation, impedes the development of consensus across the left–right divide about whether the health system should rely more on market mechanisms and individual responsibility or on state control and universal coverage.

How Single-payer Stacks Up: Evaluating Different Models of Universal Health Coverage on Cost, Access, and Quality

2018 ◽  
Vol 48 (3) ◽  
pp. 568-585 ◽  
Author(s):  
Ashley Fox ◽  
Roland Poirier
Keyword(s):  
United States ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Universal Coverage ◽  
The United States ◽  
Health Coverage ◽  
Single Payer ◽  
Access And Quality ◽  
Universal Health

Described as “universal prepayment,” the national health insurance (or single-payer) model of universal health coverage is increasingly promoted by international actors as a means of raising revenue for health care and improving social risk protection in low- and middle-income countries. Likewise, in the United States, the recent failed efforts to repeal and replace the Affordable Care Act have renewed debate about where to go next with health reform and arguably opened the door for a single-payer, Medicare-for-All plan, an alternative once considered politically infeasible. Policy debates about single-payer or national health insurance in the United States and abroad have relied heavily on Canada’s system as an ideal-typical single-payer system but have not systematically examined health system performance indicators across different universal coverage models. Using available cross-national data, we categorize countries with universal coverage into those best exemplifying national health insurance (single-payer), national health service, and social health insurance models and compare them to the United States in terms of cost, access, and quality. Through this comparison, we find that many critiques of single-payer are based on misconceptions or are factually incorrect, but also that single-payer is not the only option for achieving universal coverage in the United States and internationally.

Changing Politics of Federal Health Insurance Programs

1987 ◽  
Vol 20 (02) ◽  
pp. 202-211
Author(s):  
M. Kenneth Bowler
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Low Income ◽  
Social Insurance ◽  
Universal Coverage ◽  
The Elderly ◽  
Health Providers ◽  
Financial Barriers ◽  
Payroll Tax ◽  
Insurance System

In 1965, when Medicare and Medicaid were enacted, concern about access to the health care system for the elderly and poor overrode concerns about cost. The legislation focused on removing financial barriers to health care for these groups, and implementation of the legislation was a matter of reaching agreements with hospitals and physicians over reimbursement and administrative procedures with the objective of insuring that health care resources would be available to the beneficiaries of these new federal health insurance programs (Wolkstein, 1984).Ideological conflict and the alignment of interest groups are central to understanding the politics of Medicare. The intense disagreement over public versus private financing of medical care, and of universal coverage versus covering only the needy (i.e., social insurance versus charity), were key points of contention that established the context within which Medicare and Medicaid were developed, debated and enacted. Labor unions led the liberal organizations and those representing the elderly in advocating a universal, non-income tested federal health insurance system. The American Medical Association (AMA) led the health industry, business and conservative groups in opposing federal financing of personal health care. The intense opposition of the health providers and political conservatives to a universal federal insurance system led the national health insurance advocates to shift to an incremental strategy, the objective of which was to achieve a universal federal health insurance program in stages, beginning with a payroll-tax-financed Medicare program covering all (not just low income) elderly who were eligible for social security pension benefits.

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