scholarly journals Kajian Literatur Sistematis: Skema Pengendalian Biaya dalam Asuransi Kesehatan Nasional di Beberapa Negara

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Eka Pujiyanti ◽  
Ery Setiawan ◽  
Euis Ratnasari Jasmin ◽  
Indah Pratiwi Suwandi
Keyword(s):  
Cost Containment ◽  
Cost Sharing ◽  
Social Insurance ◽  
Drug Market ◽  
Healthcare Services ◽  
Cochrane Library ◽  
Payment Systems ◽  
Waiting Period ◽  
The Government ◽  
The Cost

AbstrakPengendalian biaya merupakan salah satu dari beberapa strategi untuk memastikan keseimbangan finansial dari skema asu­ransi kesehatan nasional. Beberapa model pengendalian biaya yang umum digunakan secara global yaitu seperti cost-shar­ing, capping, dan sebagainya. Review ini dilakukan dengan tujuan untuk menentukan biaya dan dampak dari implementasi skema kebijakan sebagai instrumen pengendalian biaya di berbagai negara. Review sistematis dilakukan dengan mengambil data dari beberapa database yaitu Proquest, Pubmed, dan Cochrane Library dengan intervensi utamanya yaitu menggu­nakan metode cost-sharing. Hasil dari review difokuskan pada skema pengendalian biaya dari perspektif pemerintah, yaitu lingkup asuransi sosial yang dapat berupa modifikasi sistem pembayaran, cost-sharing, capping/quota, dan waiting period. Berdasarkan salah satu studi di Kanada, dapat dilihat bahwa dihasilkan dampak yang signifikan pada sistem kesehatan, mengurangi pengeluaran dan penggunaan obat yang tidak esensial, serta secara tidak langsung meningkatkan efisiensi pasar obat melalui kepedulian peserta dalam penggunan obat. Dalam penelitian ini dapat disimpulkan bahwa implementasi dari skema pengendalian biaya dapat mengurangi risiko bahaya dari perspektif peserta dengan kontribusi tambahan pada penggunaan pelayanan kesehatan. AbstractCost-containment is one of several strategies to ensure the financial sustainability of the National Health Insurance scheme. Sev­eral cost-containment models were commonly globally, such as cost-sharing, capping, and others. This review aims to determine the costs and impacts of implemented policy schemes as cost-containment instruments in various countries. We performed a systematic review from several primary databases (Proquest, Pubmed, and Cochrane Library) with the primary intervention are the cost-sharing methods. The results of our review focused on the cost containment scheme from the government perspective, in which the context of social insurance can be a modification of payment systems, cost-sharing, capping/quota, and waiting period. From one of the studies in Canada, we can see that the result has a significant impact on the health system, reducing the expendi­ture and the use of drugs that are not essential, and also indirectly improve the technical efficiency of the drug market through the care of participants in drug utilisation. In this research, it can be concluded that the implementation of cost containment schemes can reduce the moral hazard risk from the perspective of participants with additional contributions to the utilisation of healthcare services

Impact of carbon permit allocation rules on incentive contracts for carbon emission reduction

Kybernetes ◽  
2018 ◽  
Vol 49 (4) ◽  
pp. 1143-1167 ◽  
Author(s):  
Qinqin Li ◽  
Yujie Xiao ◽  
Yuzhuo Qiu ◽  
Xiaoling Xu ◽  
Caichun Chai
Keyword(s):  
Carbon Emissions ◽  
Cost Sharing ◽  
Emission Reduction ◽  
Revenue Sharing ◽  
Content Type ◽  
Allocation Rules ◽  
Permit Allocation ◽  
Revenue Sharing Contract ◽  
The Government ◽  
The Cost

Purpose The purpose of this paper is to examine the impact of carbon permit allocation rules (grandfathering mechanism and benchmarking mechanism) on incentive contracts provided by the retailer to encourage the manufacturer to invest more in reducing carbon emissions. Design/methodology/approach The authors consider a two-echelon supply chain in which the retailer offers three contracts (wholesale price contract, cost-sharing contract and revenue-sharing contract) to the manufacturer. Based on the two carbon permit allocation rules, i.e. grandfathering mechanism and benchmarking mechanism, six scenarios are examined. The optimal price and carbon emission reduction decisions and members’ equilibrium profits under six scenarios are analyzed and compared. Findings The results suggest that the revenue-sharing contract can more effectively stimulate the manufacturer to reduce carbon emissions compared to the cost-sharing contract. The cost-sharing contract can help to achieve the highest environmental performance, whereas the implementation of revenue-sharing contract can attain the highest social welfare. The benchmarking mechanism is more effective for the government to prompt the manufacturer to produce low-carbon products than the grandfathering mechanism. Although a loose carbon policy can expand the total emissions, it can improve the social welfare. Practical implications These results can provide operational insights for the retailer in how to use incentive contract to encourage the manufacturer to curb carbon emissions and offer managerial insights for the government to make policy decisions on carbon permit allocation rules. Originality/value This paper contributes to the literature regarding to firm’s carbon emissions reduction decisions under cap-and-trade policy and highlights the importance of carbon permit allocation methods in curbing carbon emissions.

scholarly journals Private Provision of Social Insurance: Drug-Specific Price Elasticities and Cost Sharing in Medicare Part D

2018 ◽  
Vol 10 (3) ◽  
pp. 122-153 ◽  
Author(s):  
Liran Einav ◽  
Amy Finkelstein ◽  
Maria Polyakova
Keyword(s):  
Cost Sharing ◽  
Social Insurance ◽  
Medicare Part D ◽  
Medicare Part ◽  
Elastic Demand ◽  
Part D ◽  
Price Elasticities ◽  
The Cost ◽  
Substantial Heterogeneity ◽  
Do So

We explore how private drug plans set cost sharing in the context of Medicare Part D. While publicly provided drug coverage typically involves uniform cost sharing across drugs, we document substantial heterogeneity in the cost sharing for different drugs within privately provided plans. We also document that private plans systematically set higher consumer cost sharing for drugs or classes associated with more elastic demand; to do so, we estimate price elasticities of demand across more than 150 drugs and across more than 100 therapeutic classes. We conclude by discussing the various channels that likely affect private plans’ cost-sharing decisions. (JEL G22, H51, I13, I18, L11, L65)

scholarly journals A Unified Welfare Analysis of Government Policies*

2020 ◽  
Vol 135 (3) ◽  
pp. 1209-1318 ◽  
Author(s):  
Nathaniel Hendren ◽  
Ben Sprung-Keyser
Keyword(s):  
Willingness To Pay ◽  
Low Income ◽  
Social Insurance ◽  
Welfare Analysis ◽  
The United States ◽  
Future Research ◽  
Long Term Effects ◽  
Marginal Value ◽  
The Government ◽  
The Cost

Abstract We conduct a comparative welfare analysis of 133 historical policy changes over the past half-century in the United States, focusing on policies in social insurance, education and job training, taxes and cash transfers, and in-kind transfers. For each policy, we use existing causal estimates to calculate the benefit that each policy provides its recipients (measured as their willingness to pay) and the policy’s net cost, inclusive of long-term effects on the government’s budget. We divide the willingness to pay by the net cost to the government to form each policy’s Marginal Value of Public Funds, or its ``MVPF''. Comparing MVPFs across policies provides a unified method of assessing their effect on social welfare. Our results suggest that direct investments in low-income children’s health and education have historically had the highest MVPFs, on average exceeding 5. Many such policies have paid for themselves as the government recouped the cost of their initial expenditures through additional taxes collected and reduced transfers. We find large MVPFs for education and health policies among children of all ages, rather than observing diminishing marginal returns throughout childhood. We find smaller MVPFs for policies targeting adults, generally between 0.5 and 2. Expenditures on adults have exceeded this MVPF range in particular if they induced large spillovers on children. We relate our estimates to existing theories of optimal government policy, and we discuss how the MVPF provides lessons for the design of future research.

Private Agencies for Public Purposes: Some New Perspectives on Policy Making in Health Insurance Between the Wars

1983 ◽  
Vol 12 (2) ◽  
pp. 165-193 ◽  
Author(s):  
Noelle Whiteside
Keyword(s):  
Health Insurance ◽  
Interwar Period ◽  
Social Insurance ◽  
Central Regulation ◽  
Insurance Policy ◽  
Public Subsidies ◽  
The Government ◽  
The Cost ◽  
The Unemployed

ABSTRACTThe approved societies, who were charged with the administration of health insurance in Britain, have long been blamed for the failure of the scheme to expand its coverage or scope in the interwar period. This paper takes a closer look at the administrative process and argues that societies were more vulnerable to central regulation than is commonly thought and were unable to resist cuts in public subsidies and extensions in liability introduced at their expense. They provided a convenient scapegoat for policies emanating primarily from the economic orthodoxy subscribed to by both government and the Treasury, modified to protect the unemployed during the slump. Health insurance policy was dominated to a large extent by the Government Actuary, who aimed to guarantee the cost effectiveness of the scheme. This paper also shows how administrative definitions and practices affected the classification of claimants to state social insurance at this time. It re-establishes the major weaknesses of the system, arguing that – in the light of recent discussions about reviving a system of national health insurance – we have much to learn from looking again at the experience of the interwar period.

scholarly journals Protocol for a systematic review of barriers, facilitators and outcomes in primary healthcare services for women in Pakistan

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043715
Author(s):  
Sara Rizvi Jafree ◽  
Qaisar Khalid Mahmood ◽  
Ain ul Momina ◽  
Florian Fischer ◽  
Jane Barlow
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Primary Healthcare ◽  
Healthcare Delivery ◽  
Synthesis Method ◽  
Healthcare Services ◽  
Barriers And Facilitators ◽  
Cochrane Library ◽  
Health Coverage ◽  
The Government

IntroductionThe lack of universal health coverage and high poverty rates among the majority of women in Pakistan makes it essential to understand the quality and effectiveness of primary healthcare services. The aim of this project is to systematically review the available literature for interventions for primary healthcare services for women in order to provide the basis for future healthcare policy. The primary objective is to identify the effectiveness of the intervention in terms of how successful it was in improving health of women; whereas the secondary aim is to identify barriers and facilitators for delivery of primary healthcare services.Methods and analysisA systematic review using a narrative synthesis will be undertaken, including qualitative, quantitative and mixed methods studies from January to June 2021. Electronic databases will be used including PubMed, BMC, Medline, CINAHL and Cochrane Library. The search will be conducted in English and no date restrictions will be applied. A thematic synthesis method will be used for data synthesis involving three steps: (1) the identification, coding and initial theme generation for effectiveness of primary healthcare interventions in Pakistan for women, (2) identification and grouping of overarching themes, and related subthemes, to develop descriptive themes for barriers and facilitators for primary healthcare delivery, and (3) generation of general analytical themes in order to present recommendations in terms of improved health outcomes for women.Ethics and disseminationEthics approval for this study was obtained from the Institutional Review Board, Forman Christian College University. Results will be disseminated via publications in international peer-reviewed journals. In addition, conference proceedings will be used to inform the government, researchers, donors, non-governmental organisations and other stakeholders. This study will result in a systematic identification and synthesis of barriers and facilitators for women’s health outcomes that will help inform future primary health policies.PROSPERO registration numberCRD42020203472.

Economic modelling of telehealth substitution of face-to-face specialist outpatient consultations for Queensland correctional facilities

2018 ◽  
Vol 42 (5) ◽  
pp. 522 ◽  
Author(s):  
Monica Taylor ◽  
Liam J. Caffery ◽  
Paul A. Scuffham ◽  
Anthony C. Smith
Keyword(s):  
Correctional Facility ◽  
Cost Savings ◽  
Healthcare Services ◽  
Correctional Facilities ◽  
Economic Modelling ◽  
Correctional Staff ◽  
Potential Cost ◽  
Face To Face ◽  
The Government ◽  
The Cost

Objective The provision of healthcare services to inmates in correctional facilities is costly and resource-intensive. This study aimed to estimate the costs of transporting prisoners from 11 Queensland correctional facilities to the Princess Alexandra Hospital Secure Unit (PAHSU) in Brisbane for non-urgent specialist outpatient consultations and identify the cost consequences that would result from the substitution of face-to-face visits with telehealth consultations. Methods A 12-month retrospective review of patient activity at the PAHSU was conducted to obtain the number of transfers per correctional facility. The total cost of transfers was calculated with estimates for transport vehicle costs and correctional staff escort wages, per diem and accommodation costs. A cost model was developed to estimate the potential cost savings from substituting face-to-face consultations with telehealth consultations. A sensitivity analysis on the cost variables was conducted. Costs are reported from a government funding perspective and presented in 2016 Australian dollars (A$). Results There were 3539 inmate appointments from July 2015 to June 2016 at the PAHSU, primarily for imaging, general practice, and orthopaedics. Telehealth may result in cost savings from negligible to A$969 731, depending on the proportion, and travel distance, of face-to-face consultations substituted by telehealth. Wages of correctional staff were found to be the most sensitive variable. Conclusions Under the modelled conditions, telehealth may reduce the cost of providing specialist outpatient consultations to prisoners in Queensland correctional facilities. Telehealth may improve the timeliness of services to a traditionally underserved population. What is known about the topic? Specialist medical services are located in only a few metropolitan centres across Australia, which requires some populations to travel long distances to attend appointments. Some face-to-face specialist outpatient consultations can be substituted by telehealth. What does this paper add? Prisoners from correctional facilities represent one specific population that requires complex travel arrangements for specialist medical appointments. Transportation of prisoners for specialist health appointments represents a substantial cost to the government. This paper quantifies the annual cost in Queensland for transporting prisoners, taking into account fuel and vehicle costs, staff wages, per diem rates, and accommodation. In addition, it quantifies the costs of substituting face-to-face consultations with telehealth consultations. What are the implications for practitioners? This research encourages practitioners to consider using telehealth services for prisoners, as well providing an argument for tertiary centres to include telehealth as a model of care for this population. Telehealth can result in major cost savings and state and federal governments should consider implementation especially in Australia where correctional facilities and specialist services are separated by great geographic distances.

scholarly journals Effect of government subsidies on supply chain decision-making and coordination in the context of COVID-19

2021 ◽  
Author(s):  
Wuyong Qian ◽  
Sen Yang
Keyword(s):  
Supply Chain ◽  
Social Welfare ◽  
Cost Sharing ◽  
Stackelberg Game ◽  
Government Subsidy ◽  
Effort Level ◽  
Welfare Level ◽  
Coordination Strategies ◽  
The Government ◽  
The Cost

Considering the two-stage supply chain composed of a leading retailer and a manufacturer under the background of the COVID-19 epidemic, the retailer determines the anti-epidemic effort level and bears the corresponding costs, and the manufacturer determines the cost-sharing rate under the coordination strategy. This paper analyses the pricing decision, anti-epidemic effort level and cost-sharing rate of supply chain under different government subsidy measures and coordination strategies. Finally, a numerical example is given to verify the applicability of the conclusion and the model. From the perspective of Stackelberg game, we find that under the background of the epidemic, government subsidy measures, coordination strategies and increasing marginal income of anti-epidemic efforts are conducive to higher anti-epidemic efforts and social welfare level. And the government can obtain the maximum anti-epidemic efforts and social welfare level by subsidising manufacturers with cost sharing.

scholarly journals What Drives Green Innovation? A Game Theoretic Analysis of Government Subsidy and Cooperation Contract

2019 ◽  
Vol 11 (20) ◽  
pp. 5584 ◽  
Author(s):  
Weimin Ma ◽  
Ranran Zhang ◽  
Shiwei Chai
Keyword(s):  
Cost Sharing ◽  
Revenue Sharing ◽  
Optimal Level ◽  
Production Costs ◽  
Green Innovation ◽  
Government Subsidies ◽  
Innovation Activities ◽  
Game Theoretic ◽  
The Government ◽  
The Cost

Green innovation, implemented by enterprises, contributes to sustainable development and environmental protection. However, because of the high cost and high risk of green innovation, enterprises are reluctant to step into green innovation activities in practice. Government subsidies are conducive to promoting green innovation in enterprises. To investigate firms’ preferences for green innovation, we consider a three-player game in a supply chain where a government offers subsidies (price, innovation, or both subsidies) to a manufacturer and a retailer, while the latter two players cooperate with each other through contracts (revenue-sharing and cost-sharing contracts). By exploring the impacts of government subsidies and cooperative contracts on the optimal level of green innovation efforts and profits of participants, we find that: (1) for green innovation that leads to increased production costs, the government should subsidize both the retailer and the manufacturer to improve the level of green innovation; (2) the revenue-sharing contract is more effective than the cost-sharing contract under the premise of government subsidies; and (3) the revenue-sharing ratio decreases in production and innovation costs, while the cost-sharing ratio increases in these two costs.

Renovating the View of Cost Sharing for the Underground Low Voltage Cable Projects in Hanoi

2019 ◽  
Vol 35 (5E) ◽  
Author(s):  
Pham Thi Thu Ha ◽  
Phan Dieu Huong
Keyword(s):  
Willingness To Pay ◽  
Cost Sharing ◽  
Low Voltage ◽  
Power Grid ◽  
Field Studies ◽  
Power Industry ◽  
Well Field ◽  
The Subject ◽  
Sharing Responsibility ◽  
The Cost

Underground power grid projects in Hanoi is so urgent that it requires immediate implementation. To synchronously and quickly implement the underground power grid projects, people in charge should not follow the outdated perspectives of just including the power industry, but also need to call for the support and cost sharing responsibility from consumers. This paper aims at approaching the subject both from the producers and consumers’ perspectives to together sharing the cost of putting the power grid underground not only in Hanoi but other metropolitans in Vietnam as well. Field studies (including 104 families) at Hoan Kiem District, Hanoi and CBA method were applied to investigate the willingness to pay (WTP) level of consumers to share the cost with the power industry for the underground power grid projects in Hanoi. The overview of the results shows that cost for the underground power grid in Hoan Kiem District ranging from 30,000 VND/household/month to 46,000VND/household/month. On the other hand, the willingness to pay of a typical household of four people within Hoan Kiem District ranges from 17,000VND/month to 24,000VND/month, with the most favorable method of annual payment within a detailed timeline.

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