Features of health insurance: an analysis of the German experience

The article examines the models of health insurance in Western countries. A comparative analysis of forms of social insurance and sources of financing payments for four models of medical insurance is carried out. The practical aspects of the functioning of compulsory health insurance in Germany are investigated, its positive features are revealed. Attention is paid to medical insurance, which provides insurance in case of loss of health for any reason. It provides greater accessibility, quality and completeness to meet the diverse needs of the population in the provision of medical services, and is more effective than government funding of the health care system. In addition, the social and economic efficiency of health insurance related to reimbursement of citizens' expenses related to receiving medical care, as well as other expenses aimed at maintaining health, depends on how comprehensively the concept of developing insurance medicine in the country has been worked out. The positive and negative aspects of health insurance are analyzed. The forms of health insurance are considered: compulsory health insurance and voluntary health insurance. It was found that one of the first countries where health insurance was introduced was Germany. There are two types of health insurance in Germany: public and private. Germany's state health insurance is compulsory. That is, every employee, as well as persons trained in production (Auszubildende), are subject to compulsory state health insurance and must be members of one of their freely chosen state health insurance funds. At the same time, if a person wishes to receive medical services that are not included in the list of compulsory health insurance, he can conclude a supplementary health insurance contract with the insurance company. Voluntary health insurance allows you to choose an inpatient medical institution and the conditions of stay in it, special services of a personal physician.

SDG 3 and financing instruments in Austria and Ukraine: Challenges and perspectives

This study aims to conduct a comparative analysis of the SDG in healthcare achievement in Austria and Ukraine and to determine possible lessons for Ukraine based on best EU and world experiences. To identify existing challenges and perspectives a comparative analysis of key indicators of healthcare expenditures and health financing systems in Austria and Ukraine was carried out. Results indicate that in Ukraine there is a substantial lack of public funding for healthcare (only 682 US dollars per capita in 2018), a poor share of voluntary health insurance (less than 1%), significant amounts (on average 50%) of expenditures of the population in general spending on health. On the contrary, in Austria, there is sufficient public funding for healthcare (5,879 US dollars per capita in 2018), more than 5% share of voluntary health insurance, moderate amounts (on average 25%) of expenditures of the population in general spending on health. Austria’s experience as an EU-member country with a successful example of a financing strategy for the healthcare system is a sound example for Ukraine. The alternative financing tools (e.g. result-based financing, impact investment, public-private partnership) can be used as an additional financing mechanism of healthcare funding in Ukraine. The use of these instruments along with the improvement of the fiscal policy, social security, and governance based on Austrian experience can cut the existing financing gap to achieve SDG targets in healthcare in Ukraine. AcknowledgmentThis study is financed equally by the Austrian Federal Ministry of Education and Science and the Ministry of Education and Science of Ukraine.

Caesarean sections and health financing: a global analysis

ObjectivesThe objective of this study is to explore the association of health financing indicators with the proportion of births by caesarean section (CS) across countries.DesignEcological cross-country study.SettingThis study examines CS proportions across 172 countries.Main outcome measuresThe primary outcome was the percentage excess of CS proportion, defined as CS proportions above the global target of 19%. We also analysed continuous CS proportions, as well as excess proportion with a more restrictive 9% global target. Multivariable linear regressions were performed to test the association of health financing factors with the percentage excess proportions of CS. The health financing factors considered were total available health system resources (as percentage of gross domestic product), total contributions from private households (out-of-pocket, compulsory and voluntary health insurance contributions) and total national income.ResultsWe estimate that in 2018 there were a total of 8.8 million unnecessary CS globally, roughly two-thirds of which occurred in upper middle-income countries. Private health financing was positively associated with percentage excess CS proportion. In models adjusted for income and total health resources as well as human resources, each 10 per cent increase in out-of-pocket expenditure was associated with a 0.7 per cent increase in excess CS proportions. A 10 per cent increase in voluntary health insurance was associated with a 4 per cent increase in excess CS proportions.ConclusionsWe have found that health system finance features are associated with CS use across countries. Further monitoring of these indicators, within countries and between countries will be needed to understand the effect of financial arrangements in the provision of CS.

Does voluntary health insurance reduce the use of and the willingness to finance public health care in Sweden?

Voluntary private health insurance (VHI) has generally been of limited importance in national health service-type health care systems, especially in the Nordic countries. During the last decades however, an increase in VHI uptake has taken place in the region. Critics of this development argue that voluntary health insurance can undermine support for public health care, while proponents contend that increased private funding for health services could relieve strained public health care systems. Using data from Sweden, this study investigates empirically how voluntary health insurance affects the public health care system. The results of the study indicate that the public Swedish health care system is fairly resilient to the impact of voluntary health insurance with regards to support for the tax-based funding. No difference between insurance holders and non-holders was found in willingness to finance public health care through taxes. A slight unburdening effect on public health care use was observed as VHI holders appeared to use public health care to a lesser extent than those without an insurance. However, a majority of the insurance holders continued to use the public health care system, indicating only a modest substitution effect.

LEGAL CONSEQUENCES OF VIOLATION OF THE VOLUNTARY HEALTH INSURANCE CONTRACT UNDER UKRAINIAN LAW

The article is devoted to the study of the peculiarities of the legal consequences of violation of the contract of voluntary medical insurance under the legislation of Ukraine. Special attention is paid to the legal consequences of violation of the contract of voluntary medical insurance, such as: unilateral refusal of the contract, modification of the contract, payment of a penalty. The legal positions of the jurisprudence on the issues under consideration are given. The study of the legal consequences of breaching the health insurance contract is important in connection with the following. Such an appropriate form of mutual expression of the will of two or more persons is of scientific interest in view, firstly, of the increase in the share of the said contract in the structure of insurance and, secondly, of the direction of development of state policy in modern conditions in the field of health care. In the article there are specified the features of the medical insurance contract. There are also specified its peculiarities. Examining the legal consequence of a violation of a voluntary health insurance contract, such as a unilateral refusal, it was established that the Civil Code of Ukraine grants certain freedom to the parties in the event of termination of the contract. However, the legislation establishes certain restrictions in case of unilateral refusal of the insurer from the personal insurance contract. Cases of the insured's refusal to make insurance compensation are summarized in the category: those caused by the intentional behavior of the insured person (submission of false information about the fact of the occurrence of the insured event, as well as intentional actions of the insured person (insured person) aimed at the occurrence of an insured event, noncompliance with the prescriptions of the attending physician, which led to a complication of the disease)as well as those whose reasons do not depend on the insured's will (insured person) (receiving services that exceed the insured amount, suffering injuries or illnesses due to force majeure or receiving medical services that are not included in the insurance program). Having considered the judicial practice in cases of unilateral refusal of the contract, it was established that in case of violation of the contract of voluntary medical insurance, it is common for the insured to inattentive study the circumstances in which the insurer is obliged to make certain payments, as well as a false belief that they are not covered by the insurance case.

ržište privatnog zdravstvenog osiguranja u debatama o reformi zdravstvenog sistema u postsocijalističkim zemljama

Debates on the reform of health care fi nancing in the former socialist countries during the period of social transformation were conducted as part of a wider debate regarding changes in the overall social system. Existing financing models and innovative measures were reviewed. As part of such discussions, the voluntary health insurance market also received a lot of the attention. Diff erent views were expressed in the debates that were conducted during the 1990s, from seeing a suitable supplementary source of health care funding to those who highlighted the constraints in its implementation and modest results that can be expected. As one of the criteria for assessing the suitability of this mechanism, we could review what has been achieved so far in its application. Th e paper looks at the ground covered and the situation in the former socialist countries at the end of the second decade of this century, with particular reference to Serbia and countries in its surroundings. When it comes to Serbia it can be expected that the limiting factors from the last ten years will be still manifested in the future. It is estimated that there are weak prospects of activating voluntary health insurance as a way to alleviate the problems of insuffi cient fi nancing of the health care system.

ON THE ISSUE OF INCREASING THE FINANCIAL POTENTIAL OF HOUSEHOLDS

Households are full participants in economic relations. Their role is determined primarily by the financial potential, using which, households are able to provide consumption and capital accumulation. There are various approaches to the issue of the content of the concept of "financial potential". The issue of increasing the financial potential of households is no less urgent. The foregoing determines the relevance of the stated research. Its results are presented to the readers in this work. The article is devoted to the substantiation of increasing the financial potential of the household through the use of corporate insurance in practice, primarily in terms of voluntary health insurance. The materials of the article can be useful to companies for the development of social policy. Interest should be sparked by the value of corporate insurance, not only for the company and its employees, but for the economy as a whole.

CLUSTER REGRESSION ANALYSIS TO DETERMINE THE IMPACT OF GDP ON VOLUNTARY HEALTH INSURRANCE PREMIUS

Increasingly, the policy of the Russian Federation is aimed at the development of healthcare, and spending on the healthcare industry is becoming a serious problem for the financial stability of national health systems, even in highincome countries. Voluntary medical insurance, as one of the forms of medical insurance, contributes to the formation of all insurance premiums, thereby this form can be one of the indirect factors of socioeconomic development of Russia. The paper hypothesizes the existence of a relationship between the level of development of the welfare of the country and the volume of the premium fund of voluntary health insurance. A study was conducted on the relationship between voluntary health insurance and GDP, as one of the key indicators of the country's development, through correlation and regression analysis.