Active and retired public employees' health insurance: potential data sources.

Science.gov (United States)

Morrill, Melinda Sandler

2014-12-01

Employer-provided health insurance for public sector workers is a significant public policy issue. Underfunding and the growing costs of benefits may hinder the fiscal solvency of state and local governments. Findings from the private sector may not be applicable because many public sector workers are covered by union contracts or salary schedules and often benefit modifications require changes in legislation. Research has been limited by the difficulty in obtaining sufficiently large and representative data on public sector employees. This article highlights data sources researchers might utilize to investigate topics concerning health insurance for active and retired public sector employees. Copyright © 2014 Elsevier B.V. All rights reserved.

Cost-Utility Analysis of Extending Public Health Insurance Coverage to Include Diabetic Retinopathy Screening by Optometrists.

Science.gov (United States)

van Katwyk, Sasha; Jin, Ya-Ping; Trope, Graham E; Buys, Yvonne; Masucci, Lisa; Wedge, Richard; Flanagan, John; Brent, Michael H; El-Defrawy, Sherif; Tu, Hong Anh; Thavorn, Kednapa

2017-09-01

Diabetic retinopathy (DR) is one of the leading causes of vision loss and blindness in Canada. Eye examinations play an important role in early detection. However, DR screening by optometrists is not always universally covered by public or private health insurance plans. This study assessed whether expanding public health coverage to include diabetic eye examinations for retinopathy by optometrists is cost-effective from the perspective of the health care system. We conducted a cost-utility analysis of extended coverage for diabetic eye examinations in Prince Edward Island to include examinations by optometrists, not currently publicly covered. We used a Markov chain to simulate disease burden based on eye examination rates and DR progression over a 30-year time horizon. Results were presented as an incremental cost per quality-adjusted life year (QALY) gained. A series of one-way and probabilistic sensitivity analyses were performed. Extending public health coverage to eye examinations by optometrists was associated with higher costs ($9,908,543.32) and improved QALYs (156,862.44), over 30 years, resulting in an incremental cost-effectiveness ratio of $1668.43/QALY gained. Sensitivity analysis showed that the most influential determinants of the results were the cost of optometric screening and selected utility scores. At the commonly used threshold of $50,000/QALY, the probability that the new policy was cost-effective was 99.99%. Extending public health coverage to eye examinations by optometrists is cost-effective based on a commonly used threshold of $50,000/QALY. Findings from this study can inform the decision to expand public-insured optometric services for patients with diabetes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Evolution of global contribution in multi-level threshold public goods games with insurance compensation

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Du, Jinming; Tang, Lixin

2018-01-01

Understanding voluntary contribution in threshold public goods games has important practical implications. To improve contributions and provision frequency, free-rider problem and assurance problem should be solved. Insurance could play a significant, but largely unrecognized, role in facilitating a contribution to provision of public goods through providing insurance compensation against the losses. In this paper, we study how insurance compensation mechanism affects individuals’ decision-making under risk environments. We propose a multi-level threshold public goods game model where two kinds of public goods games (local and global) are considered. Particularly, the global public goods game involves a threshold, which is related to the safety of all the players. We theoretically probe the evolution of contributions of different levels and free-riders, and focus on the influence of the insurance on the global contribution. We explore, in both the cases, the scenarios that only global contributors could buy insurance and all the players could. It is found that with greater insurance compensation, especially under high collective risks, players are more likely to contribute globally when only global contributors are insured. On the other hand, global contribution could be promoted if a premium discount is given to global contributors when everyone buys insurance.

Rural-Urban Differences in Access to Preventive Health Care Among Publicly Insured Minnesotans.

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Loftus, John; Allen, Elizabeth M; Call, Kathleen Thiede; Everson-Rose, Susan A

2018-02-01

Reduced access to care and barriers have been shown in rural populations and in publicly insured populations. Barriers limiting health care access in publicly insured populations living in rural areas are not understood. This study investigates rural-urban differences in system-, provider-, and individual-level barriers and access to preventive care among adults and children enrolled in a public insurance program in Minnesota. This was a secondary analysis of a 2008 statewide, cross-sectional survey of publicly insured adults and children (n = 4,388) investigating barriers associated with low utilization of preventive care. Sampling was stratified with oversampling of racial/ethnic minorities. Rural enrollees were more likely to report no past year preventive care compared to urban enrollees. However, this difference was no longer statistically significant after controlling for demographic and socioeconomic factors (OR: 1.37, 95% CI: 1.00-1.88). Provider- and system-level barriers associated with low use of preventive care among rural enrollees included discrimination based on public insurance status (OR: 2.26, 95% CI: 1.34-2.38), cost of care concerns (OR: 1.72, 95% CI: 1.03-2.89) and uncertainty about care being covered by insurance (OR: 1.70, 95% CI: 1.01-2.85). These and additional provider-level barriers were also identified among urban enrollees. Discrimination, cost of care, and uncertainty about insurance coverage inhibit access in both the rural and urban samples. These barriers are worthy targets of interventions for publicly insured populations regardless of residence. Future studies should investigate additional factors associated with access disparities based on rural-urban residence. © 2017 National Rural Health Association.

SCHIP Directors' Perception of Schools Assisting Students in Obtaining Public Health Insurance

Science.gov (United States)

Price, James H.; Rickard, Megan

2009-01-01

Background: Health insurance coverage increases access to health care. There has been an erosion of employer-based health insurance and a concomitant rise in children covered by public health insurance programs, yet more than 8 million children are still without health insurance coverage. Methods: This study was a national survey to assess the…

Effectiveness of the toll-free line for public insurance programs.

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Saunders, Cynthia M

2005-03-01

Toll-free lines for public insurance programs are a major point of entry to inquire about information. More than 1 million Californians are eligible for public insurance programs based on income but not yet enrolled. In 2000 and 2002, a "mystery-shopper" survey was conducted to ascertain overall effectiveness and interlanguage variation for information provided in Armenian, Cantonese, English, Farsi, Hmong, Khmer, Korean, Russian, Spanish, and Vietnamese. Although the 2002 study showed statistically significant improvements from 2000, many constructs remained problematic. In 2002, for example, statistically significant interlanguage variation was identified in discussing and checking eligibility for the program. Specifically, Spanish and Armenian callers were less likely than other language callers to have eligibility checked or deemed eligible. Removing barriers to enrollment in public insurance programs often requires political solutions, but improving customer service for the toll-free line necessitates efficiency and a focus on continuous quality improvement.

Public-private partnership role in increasing the quality of the health insurance services

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Dan CONSTANTINESCU

2012-10-01

Full Text Available In a context in which the social politics tend to become an optimization instrument for adapting the social security system to the market’s forces, and the talk of some analysts about reinventing the European social model, the partnership between the public sector and the private one in the social domain presumes, besides a tight collaboration, a combination of advantages specific to the private sector, more competitive and efficient, with the ones from the public sector, more responsible toward the society regarding the public money spending. The existence of the private health insurances cannot be tied, causally, to a social politics failure, reason for which they don’t intend, usually, to replace the public insurances, but rather, to offer a complementary alternative for them. In such a context, the public-private partnership’s goal regards both increasing the insurant’s satisfaction and increasing his/her access degree to services, and increasing the investments profitability made by the insurant and insurer. We are facing thus a mixed competitive system that combines the peculiarities of the public and private sectors. Interesting is the fact that, although the different meanings for the quality term may generate some problems regarding implementing quality management in the two health insurance sectors, the experts in the area reckon that establishing a good relationship between public buyers and private providers of healthcare can reduce the costs of public health programs. An essential condition for operating efficiently the partnership model is defining correctly the basic medical services packet financed by the public budget. Which doesn’t exclude the possibility of administrating by the private insurers, the sums of money gathered from the employees and employers contributions to the health fund, as a recently initiated project of law intends to do in Romania.

Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.

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Wong, Charlene A; Kulhari, Sajal; McGeoch, Ellen J; Jones, Arthur T; Weiner, Janet; Polsky, Daniel; Baker, Tom

2018-05-29

The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices. To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison. In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information). Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges. Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the total cost estimates on public versus private exchanges for a standardized consumer. Nearly all studied consumer decision aids saw increased deployment in the public marketplaces in OEP4 compared to OEP3. Over half of the public exchanges (n = 7 of 13) had total cost estimators (versus 5 of 14 in OEP3) in window-shopping and integrated provider lookups (window-shopping: 7; real-shopping: 8). The most common default plan orders were by premium or total cost estimate. Notable features on private health insurance exchanges were unique data presentation (e.g., infographics) and further personalized shopping (e.g., recommended plan flags). Health plan total cost estimates varied substantially between the public and private exchanges (average difference $1526). The ACA's public health insurance exchanges offered more tools in OEP4 to help consumers select a plan. While private health insurance exchanges presented notable features, the total cost estimates for a standardized consumer varied widely on public

Connecting Capital and Catastrophe in a Modeled World - How re/insurance and public science interact to manage risk for societal benefit

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Douglas, R.

2010-12-01

Society, at local and global scales, seeks improved ways of managing the impact and sharing the costs of extreme natural events across populations via public and private mechanisms. Concerns over potential climate change and climate variability are amplifying the importance of these questions among public policy, business and regulatory communities. Through its financial obligations to exposed populations, the international insurance and reinsurance sector is directly affected by the frequency, severity and impact of extreme events. In many jurisdictions insurance contracts are regulated to tolerate the maximum probable loss events which are expected at 1 in 200 year return periods. This risk tolerance requirement renders re/insurers to undertake distinctive risk analysis among financial sector institutions. Natural catastrophe risk is a major component of re/insurer risk at the 1:200 year return period and a significant driver of the minimum capital requirements imposed on re/insurers. Historic claims records are insufficient on their own to evaluate potential losses at these return periods and over the last twenty years a significant sub-sector of the re/insurance industry has emerged known as catastrophe risk modelling. This has brought a progress and influential approach in applying science to gain a great handle of the expected losses to portfolios by developing increasingly robust analysis of hazards, exposures, vulnerabilities and impacts. As a result of these innovations the re/insurance sector has become more resilient to natural catastrophes. In recent years there has been an accelerated and deepening interaction between the re/insurance sector and public science across natural hazards risk research. The medium of modelling is providing a common vehicle for science and industry communities to collaborate and new supply chains are emerging from blue sky public science, through to applied research and operation modelling. Increasingly both sides are sharing

How does retiree health insurance influence public sector employee saving?

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Clark, Robert L; Mitchell, Olivia S

2014-12-01

Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers.Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. Copyright © 2014 Elsevier B.V. All rights reserved.

75 FR 5706 - Federal Housing Administration: Insurance for Manufactured Housing: Reopening of Public Comment...

Science.gov (United States)

2010-02-04

... 2502-AI45 Federal Housing Administration: Insurance for Manufactured Housing: Reopening of Public.... ACTION: Proposed rule; reopening of public comment period. SUMMARY: On September 15, 2008, HUD published a proposed rule entitled ``Federal Housing Administration: Insurance for Manufactured Housing.'' The...

Insurance premiums and insurance coverage of near-poor children.

Science.gov (United States)

Hadley, Jack; Reschovsky, James D; Cunningham, Peter; Kenney, Genevieve; Dubay, Lisa

States increasingly are using premiums for near-poor children in their public insurance programs (Medicaid/SCHIP) to limit private insurance crowd-out and constrain program costs. Using national data from four rounds of the Community Tracking Study Household Surveys spanning the seven years from 1996 to 2003, this study estimates a multinomial logistic regression model examining how public and private insurance premiums affect insurance coverage outcomes (Medicaid/SCHIP coverage, private coverage, and no coverage). Higher public premiums are significantly associated with a lower probability of public coverage and higher probabilities of private coverage and uninsurance; higher private premiums are significantly related to a lower probability of private coverage and higher probabilities of public coverage and uninsurance. The results imply that uninsurance rates will rise if both public and private premiums increase, and suggest that states that impose or increase public insurance premiums for near-poor children will succeed in discouraging crowd-out of private insurance, but at the expense of higher rates of uninsurance. Sustained increases in private insurance premiums will continue to create enrollment pressures on state insurance programs for children.

School superintendents' perceptions of schools assisting students in obtaining public health insurance.

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Rickard, Megan L; Price, James H; Telljohann, Susan K; Dake, Joseph A; Fink, Brian N

2011-12-01

Superintendents' perceptions regarding the effect of health insurance status on academics, the role schools should play in the process of obtaining health insurance, and the benefits/barriers to assisting students in enrolling in health insurance were surveyed. Superintendents' basic knowledge of health insurance, the link between health and learning, and specific school system practices for assisting students were also examined. A 4-page questionnaire was sent to a national random sample of public school superintendents using a 4-wave postal mailing. Only 19% of school districts assessed the health insurance status of students. School districts' assistance in helping enroll students in health insurance was assessed using Stages of Change theory; 36% of superintendents' school districts were in the action or maintenance stages. The schools most often made health insurance materials available to parents (53%). The perceived benefits identified by more than 80% of superintendents were to keep students healthier, reduce the number of students with untreated health problems, reduce school absenteeism, and improvement of students' attention/concentration during school. The 2 most common perceived barriers identified by at least 50% of superintendents were not having enough staff or financial resources. Most superintendents believed schools should play a role in helping students obtain health insurance, but the specific role was unclear. Three fourths of superintendents indicated overwhelmingly positive beliefs regarding the effects of health insurance status on students' health and academic outcomes. School personnel and public policy makers can use the results to support collaboration in getting students enrolled in health insurance. © 2011, American School Health Association.

Auditing Access to Outpatient Rehabilitation Services for Children With Traumatic Brain Injury and Public Insurance in Washington State.

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Fuentes, Molly M; Thompson, Leah; Quistberg, D Alex; Haaland, Wren L; Rhodes, Karin; Kartin, Deborah; Kerfeld, Cheryl; Apkon, Susan; Rowhani-Rahbar, Ali; Rivara, Frederick P

2017-09-01

To identify insurance-based disparities in access to outpatient pediatric neurorehabilitation services. Audit study with paired calls, where callers posed as a mother seeking services for a simulated child with history of severe traumatic brain injury and public or private insurance. Outpatient rehabilitation clinics. Sample of rehabilitation clinics (N=287): 195 physical therapy (PT) clinics, 109 occupational therapy (OT) clinics, 102 speech therapy (ST) clinics, and 11 rehabilitation medicine clinics. Not applicable. Acceptance of public insurance and the number of business days until the next available appointment. Therapy clinics were more likely to accept private insurance than public insurance (relative risk [RR] for PT clinics, 1.33; 95% confidence interval [CI], 1.22-1.44; RR for OT clinics, 1.40; 95% CI, 1.24-1.57; and RR for ST clinics, 1.42; 95% CI, 1.25-1.62), with no significant difference for rehabilitation medicine clinics (RR, 1.10; 95% CI, 0.90-1.34). The difference in median wait time between clinics that accepted public insurance and those accepting only private insurance was 4 business days for PT clinics and 15 days for ST clinics (P≤.001), but the median wait time was not significantly different for OT clinics or rehabilitation medicine clinics. When adjusting for urban and multidisciplinary clinic statuses, the wait time at clinics accepting public insurance was 59% longer for PT (95% CI, 39%-81%), 18% longer for OT (95% CI, 7%-30%), and 107% longer for ST (95% CI, 87%-130%) than that at clinics accepting only private insurance. Distance to clinics varied by discipline and area within the state. Therapy clinics were less likely to accept public insurance than private insurance. Therapy clinics accepting public insurance had longer wait times than did clinics that accepted only private insurance. Rehabilitation professionals should attempt to implement policy and practice changes to promote equitable access to care. Copyright © 2017

Competing health policies: insurance against universal public systems

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Asa Ebba Cristina Laurell

2016-01-01

Full Text Available Objectives: This article analyzes the content and outcome of ongoing health reforms in Latin America: Universal Health Coverage with Health Insurance, and the Universal and Public Health Systems. It aims to compare and contrast the conceptual framework and practice of each and verify their concrete results regarding the guarantee of the right to health and access to required services. It identifies a direct relationship between the development model and the type of reform. The neoclassical-neoliberal model has succeeded in converting health into a field of privatized profits, but has failed to guarantee the right to health and access to services, which has discredited the governments. The reform of the progressive governments has succeeded in expanding access to services and ensuring the right to health, but faces difficulties and tensions related to the permanence of a powerful, private, industrial-insurance medical complex and persistence of the ideologies about medicalized 'good medicine'. Based on these findings, some strategies to strengthen unique and supportive public health systems are proposed.

Enhancing employee capacity to prioritize health insurance benefits.

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Danis, Marion; Goold, Susan Dorr; Parise, Carol; Ginsburg, Marjorie

2007-09-01

To demonstrate that employees can gain understanding of the financial constraints involved in designing health insurance benefits. While employees who receive their health insurance through the workplace have much at stake as the cost of health insurance rises, they are not necessarily prepared to constructively participate in prioritizing their health insurance benefits in order to limit cost. Structured group exercises. Employees of 41 public and private organizations in Northern California. Administration of the CHAT (Choosing Healthplans All Together) exercise in which participants engage in deliberation to design health insurance benefits under financial constraints. Change in priorities and attitudes about the need to exercise insurance cost constraints. Participants (N = 744) became significantly more cognizant of the need to limit insurance benefits for the sake of affordability and capable of prioritizing benefit options. Those agreeing that it is reasonable to limit health insurance coverage given the cost increased from 47% to 72%. It is both possible and valuable to involve employees in priority setting regarding health insurance benefits through the use of structured decision tools.

How the Affordable Care Act Has Helped Women Gain Insurance and Improved Their Ability to Get Health Care: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016.

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Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beautel, Sophie

2017-08-01

ISSUE: Prior to the Affordable Care Act (ACA), one-third of women who tried to buy a health plan on their own were either turned down, charged a higher premium because of their health, or had specific health problems excluded from their plans. Beginning in 2010, ACA consumer protections, particularly coverage for preventive care screenings with no cost-sharing and a ban on plan benefit limits, improved the quality of health insurance for women. In 2014, the law’s major insurance reforms helped millions of women who did not have employer insurance to gain coverage through the ACA’s marketplaces or through Medicaid. GOALS: To examine the effects of ACA health reforms on women’s coverage and access to care. METHOD: Analysis of the Commonwealth Fund Biennial Health Insurance Surveys, 2001–2016. FINDINGS AND CONCLUSIONS: Women ages 19 to 64 who shopped for new coverage on their own found it significantly easier to find affordable plans in 2016 compared to 2010. The percentage of women who reported delaying or skipping needed care because of costs fell to an all-time low. Insured women were more likely than uninsured women to receive preventive screenings, including Pap tests and mammograms.

Partnerships for disaster risk insurance in the EU

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Mysiak, Jaroslav; Dionisio Pérez-Blanco, C.

2016-11-01

With increasing costs inflicted by natural hazard perils, and amidst state budget cuts, concerns are mounting about the capacity of governments to design sustainable, equitable and affordable risk management schemes. The participation of the private sector along with the public one through public-private partnerships (PPPs) has gained importance as a means of providing catastrophic natural hazard insurance to address these seemingly conflicting objectives. In 2013 the European Commission launched a wide-ranging consultation about what EU action could be appropriate to improve the performance of insurance markets. Simultaneously, the EU legislator instigated major reforms in the legislation and regulations that pertain to how PPPs are designed or operate. This paper has a dual objective: first, we review and summarize the manifold legal background that influences the provision of insurance against natural catastrophes. Second, we examine how PPPs designed for sharing and transferring risk operate within the European regulatory constraints, illustrated using the example of the UK Flood Reinsurance Scheme (Flood RE) between the state and the Association of British Insurers.

Compensating wage differentials and the impact of health insurance in the public sector on wages and hours.

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Qin, Paige; Chernew, Michael

2014-12-01

This paper examines the trade-off between wages and employer spending on health insurance for public sector workers, and the relationship between coverage and hours worked. Our primary approach compares trends in wages and hours for public employees with and without state/local government provided health insurance using individual-level micro-data from the 1992-2011 CPS. To adjust for differences between insured and uninsured public sector employees, we create a matched sample based on an employee's propensity to receive health insurance. We assess the relationship between state contribution to the health plan premium, state-level healthcare spending, and the wages and hours of state and local government employees. We find modest reductions in wages are associated with having employer-sponsored health insurance (ESHI), although this effect is not precisely measured. The reduction in wages associated with having ESHI is larger among non-unionized workers. Further, we find little evidence that provision of health insurance increases hours worked. Copyright © 2014 Elsevier B.V. All rights reserved.

CONSIDERATIONS REGARDING SOCIAL INSURANCE IN THE ROMANIAN PUBLIC HEALTH SYSTEM

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Aracsia-Magdalena Benţia

2017-12-01

Full Text Available Objectives of the study: the study aims to analyze the issue of social health insurance in Romania and to provide legislative solutions in combating them. The research methods used are the qualitative research method and the observation method. Results and implications of the study: 1 establish a 2020-2030 Strategy to prevent disease by launching national campaigns for healthy eating, reducing smoking and alcohol consumption, and introducing the color scheme for food; 2 decentralizing the system, establishing a public-private partnership, increasing the patient's freedom in choosing doctors and services; 3 limiting the cost of medical care by introducing caps, as well as co-payments; 4 institutional reform of the public sector in this area. In some opinions, "Experience in other countries consistently suggests that introducing a private funding system would create more problems than it would solve. That is why efforts should be focused rather on institutional reform of the public sector"; 5 developing legislation to make differentiated payments for medical services; 6 closure of non-accredited hospitals and their privatization; 7 establishment of private health insurance houses.

School Nurses' Perceptions and Practices of Assisting Students in Obtaining Public Health Insurance

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Rickard, Megan L.; Hendershot, Candace; Khubchandani, Jagdish; Price, James H.; Thompson, Amy

2010-01-01

Background: From January through June 2009, 6.1 million children were uninsured in the United States. On average, students with health insurance are healthier and as a result are more likely to be academically successful. Some schools help students obtain health insurance with the help of school nurses. Methods: This study assessed public school…

41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

THE BUSINESS OF WELLNESS: THE HEALTH INSURANCE INDUSTRY’S RESPONSE TO PUBLIC HEALTH CAMPAIGNS, 1960-1990

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Christiane Diehl-Taylor

1999-01-01

Full Text Available This paper examines the health insurance industry’s response to the welliness movement between 1960 and 1990. Based primarily on insurance and personnel management trade publications, it argues that the health insurance industry cautiously joined the weliness campaigns of the 70s and 80s despite its on-going reservations regarding the actuarial basis for rate differentials. The industry’s business-like conservatism was overcome by its recognition of wellness promotion as a cost-control measure, public relations tool, and means to stave off the threat of further governmental oversight and regulation.

How a new 'public plan' could affect hospitals' finances and private insurance premiums.

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Dobson, Allen; DaVanzo, Joan E; El-Gamil, Audrey M; Berger, Gregory

2009-01-01

Two key health reform bills in the House of Representatives and Senate include the option of a "public plan" as an additional source of health coverage. At least initially, the plan would primarily be structured to cover many of the uninsured and those who now have individual coverage. Because it is possible, and perhaps even likely, that this new public payer would pay less than private payers for the same services, such a plan could negatively affect hospital margins. Hospitals may attempt to recoup losses by shifting costs to private payers. We outline the financial pressures that hospitals and private payers could experience under various assumptions. High uninsured enrollment in a public plan would bolster hospital margins; however, this effect is reversed if the privately insured enter a public plan in large proportions, potentially stressing the hospital industry and increasing private insurance premiums.

Public Health Policy in Support of Insurance Coverage for Smoking Cessation Treatments.

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Schwartz, Robert; Haji, Farzana; Babayan, Alexey; Longo, Christopher; Ferrence, Roberta

2017-05-01

Insurance coverage for evidence-based smoking cessation treatments (SCTs) promotes uptake and reduces smoking rates. Published studies in this area are based in the US where employers are the primary source of health insurance. In Ontario, Canada, publicly funded healthcare does not cover SCTs, but it can be supplemented with employer-sponsored benefit plans. This study explores factors affecting the inclusion/exclusion of smoking cessation (SC) benefits. In total, 17 interviews were conducted with eight employers (auto, retail, banking, municipal and university industries), four health insurers, two government representatives and three advisors/consultants. Overall, SCT coverage varied among industries; it was inconsistently restrictive and SCT differed by coverage amount and length of use. Barriers impeding coverage included the lack of the following: Canadian-specific return on investment (ROI), SC cost information, employer demand, government regulations/incentives and employee awareness of and demand. A Canadian evidence-based calculation of ROI for SC coupled with government incentives and public education may be needed to promote uptake of SCT coverage by employers. Copyright © 2017 Longwoods Publishing.

The Match Quality Gains from Unemployment Insurance

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Centeno, Mario

2004-01-01

The benefits of unemployment insurance (UI) by measuring its effect in match quality are assessed. The relationship between post-unemployment job tenure and measures of the state level UI generosity and the unemployment rate at the time of the job is analyzed, using NLSY data.

The Impact of Including Immigrants without Permanent Residence Status in the Public Health Insurance System in the Czech Republic

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Tepperová Jana

2016-03-01

Full Text Available Whether an individual can or cannot participate in the Czech public health insurance system depends on several characteristics, one of which is whether he/she has permanent residence status in the Czech Republic, and a second whether he/she is employed. This means that those without permanent residence status, including self-employed migrants from third countries, their dependent relatives, and the dependent relatives of third country employees in the Czech Republic, cannot participate in the public health insurance system. Some argue that such migrants should be included in the system, since commercial health insurance is disadvantageous and the contributions they would pay into the public health insurance system would increase the public health insurance agencies’ income. We estimate the value of the contributions to public health insurance that would be paid by third country self-employed and non-working immigrants, if they were insured based on data from 2011 to 2013, and compare this to the assumed costs of their medical care. To calculate the contributions for self-employed migrants we use data on the distribution of the tax base for self-employed persons from personal income tax returns. Our estimation results in an overall negative balance of 22 million CZK on the data for 2012 and 2013. In the current system this deficit would be covered by the state, which would pay contributions to the system for certain (state insured persons amounting to 97 million CZK; overall therefore the inclusion of these immigrants would result in a positive balance of 75 million CZK.

The Roots of North America's First Comprehensive Public Health Insurance System

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Ostry, Aleck

2001-06-01

Full Text Available The Canadian province of Saskatchewan in 1944 it inherited a long tradition of "socialized" medicine in many rural regions. However, urban medicine was based on fee-for-service payment of physicians and no private health insurance. In crafting North America's first public health insurance system, the government built on the rural medical infrastructure already in place by expanding a rural salaried system of physician payment and successfully promoted a regional comprehensive insurance system piloted in a southern region of the province. However, major demographic shifts from countryside to city during the 1950s, burgeoning physician supply, increased immigration of physicians into the provinces' cities, and aggressive expansion of urban-based private insurance for physician services into rural regions, shifted the balance of medical power away from rural towards urban centers in the province. The increasing resistance, by the medical profession, to health-care reform in Saskatchewan in the 1950s must be considered within a geographic framework as rural regions of the province became the major battleground between government and insurance third party payers. While historical comparisons should not be overstated, re-visiting this struggle may be useful in the current era in which the pressure for privatization of the medical system in Canada appear to be growing.

The Role of Public and Private Insurance Expansions and Premiums for Low-income Parents: Lessons From State Experiences.

Science.gov (United States)

Guy, Gery P; M Johnston, Emily; Ketsche, Patricia; Joski, Peter; Adams, E Kathleen

2017-03-01

Numerous states have implemented policies expanding public insurance eligibility or subsidizing private insurance for parents. To assess the impact of parental health insurance expansions from 1999 to 2012 on the likelihood that parents are insured; their children are insured; both the parent and child within a family unit are insured; and the type of insurance. Cross-sectional analysis of the 2000-2013 March supplements to the Current Population Survey, with data from the Medical Expenditure Panel Survey-Insurance Component and the Area Resource File. Cross-state and within-state multivariable regression models estimated the effects of health insurance expansions targeting parents using 2-way fixed effect modeling and difference-in-difference modeling. All analyses controlled for household, parent, child, and local area characteristics that could affect insurance status. Expansions increased parental coverage by 2.5 percentage points, and increased the likelihood of both parent and child being insured by 2.1 percentage points. Substantial variation was observed by type of expansion. Public expansions without premiums and special subsidized plan expansions had the largest effects on parental coverage and increased the likelihood of jointly insuring both the parent and child. Higher premiums were a substantial deterrent to parents' insurance. Our findings suggest that premiums and the type of insurance expansion can have a substantial impact on the insurance status of the family. These findings can help inform states as they continue to make decisions about expanding Medicaid under the Affordable Care Act to cover all family members.

The effects of mandatory health insurance on equity in access to outpatient care in Indonesia.

Science.gov (United States)

Hidayat, Budi; Thabrany, Hasbullah; Dong, Hengjin; Sauerborn, Rainer

2004-09-01

This paper examines the effects of mandatory health insurance on access and equity in access to public and private outpatient care in Indonesia. Data from the second round of the 1997 Indonesian Family Life Survey were used. We adopted the concentration index as a measure of equity, and this was calculated from actual data and from predicted probability of outpatient-care use saved from a multinomial logit regression. The study found that a mandatory insurance scheme for civil servants (Askes) had a strongly positive impact on access to public outpatient care, while a mandatory insurance scheme for private employees (Jamsostek) had a positive impact on access to both public and private outpatient care. The greatest effects of Jamsostek were observed amongst poor beneficiaries. A substantial increase in access will be gained by expanding insurance to the whole population. However, neither Askes nor Jamsostek had a positive impact on equity. Policy implications are discussed.

Insuring against Health Shocks: Health Insurance and Household Choices

OpenAIRE

Liu, Kai

2015-01-01

This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investme...

HIAA's The Business of Insurance: An Introduction.

Science.gov (United States)

Rosen, Anita; Lynch, Margaret E.

This booklet is intended to help students gain a broad understanding of the meaning, characteristics, organization, products, and functions of the insurance industry. The following topics are discussed: the concept of and need for insurance; basic principles of insurance (risk assessment, insurability and insurable interest, determination of…

Crop insurance: Risks and models of insurance

Directory of Open Access Journals (Sweden)

Čolović Vladimir

2014-01-01

Full Text Available The issue of crop protection is very important because of a variety of risks that could cause difficult consequences. One type of risk protection is insurance. The author in the paper states various models of insurance in some EU countries and the systems of subsidizing of insurance premiums by state. The author also gives a picture of crop insurance in the U.S., noting that in this country pays great attention to this matter. As for crop insurance in Serbia, it is not at a high level. The main problem with crop insurance is not only the risks but also the way of protection through insurance. The basic question that arises not only in the EU is the question is who will insure and protect crops. There are three possibilities: insurance companies under state control, insurance companies that are public-private partnerships or private insurance companies on a purely commercial basis.

Gaining public acceptance for Temelin NPP

International Nuclear Information System (INIS)

Novak, Miroslav

1995-01-01

, this gave the CEZ utility the opportunity to communicate efficiently with the public about nuclear energy and Temelin in the way Western European and American utilities do. CEZ became a recognized partner and was in a position to begin gaining (or losing) credit. How to gain public credit ( experience of 1993-1994): by always telling the truth, of course. We resumed discussions with representatives of towns and villages around Temelin, who initially were against the completion of the plant. We began to meet regularly every two months. They asked questions and we answered them. Their attitude changed: they were no more resolutely against but demanded supervision of the construction and securing absolute safety. We have adopted rules that prevent appreciable financial help to be given to the communes before the power plant is put in operation. There was another aspect that had to be confirmed, namely, that the Czech Republic really needs electricity from Temelin and that Temelin is the cheapest option in the new political and economic environment. Public opinion as a whole continued to support nuclear power but the voices of opponents, among whom were important persons such as the prime minister in the first Czech post-revolution government, were gaining in strength. Communities in the surroundings of Temelin formed an association against completion of the plant and began to exert pressure on the government to put a stop to the construction. The public was kept informed about nuclear power, the Information center at the plant was active, but it was vital that the government should support the construction and say its clear and unambiguous 'yes'. The utility on its own could not affect the state of affairs. In March 1993, the Czech government discussed the completion of Temelin and gave its nearly unanimous consent. So, for the first time since 1989, the CEZ utility got into a position which the majority of utilities operating nuclear power plants worldwide enjoys. In

The Normative Foundations of (Social) Insurance

DEFF Research Database (Denmark)

Landes, Xavier

Insurance mechanisms are prevalent in industrialized societies, in both public and private sectors. Insurance is offered for various risks ranging from fire to accident. They also constitute the core of the modern welfare state (public health insurance, unemployment benefits and public pensions......). The analysis of (public) insurance has however remained marginal in political theory because insurance is often perceived as a simple tool for pursuing equality, i.e. a tool without any moral significance proper. This text proposes an alternative view by drawing a continuum between insurance as a technology......, which is the common interpretation in economics, and insurance as a social practice, which characterizes social theory. The goal is to underline how the technology of insurance alters social practices by, for instance, promoting equal standing or transforming the paradigm of individual responsibility...

Chondral Injuries and Irreparable Meniscal Tears Among Adolescents With Anterior Cruciate Ligament or Meniscal Tears Are More Common in Patients With Public Insurance.

Science.gov (United States)

Williams, Ariel A; Mancini, Nickolas S; Solomito, Matthew J; Nissen, Carl W; Milewski, Matthew D

2017-07-01

Access to health care services is a critical component of health care reform and may differ among patients with different types of insurance. Hypothesis/Purpose: The purpose was to compare adolescents with private and public insurance undergoing surgery for anterior cruciate ligament (ACL) and/or meniscal tears. We hypothesized that patients with public insurance would have a delayed presentation from the time of injury and therefore would have a higher incidence of chondral injuries and irreparable meniscal tears and lower preoperative International Knee Documentation Committee (IKDC) scores than patients with private insurance. Cross-sectional study; Level of evidence, 3. This was a retrospective study of patients under 21 years of age undergoing ACL reconstruction and/or meniscal repair or debridement from January 2013 to March 2016 at a single pediatric sports medicine center. Patients were identified by a search of Current Procedural Terminology (CPT) codes. A chart review was performed for insurance type; preoperative diagnosis; date of injury, initial office visit, and surgery; preoperative IKDC score; intraoperative findings; and procedures. The study group consisted of 119 patients (mean age, 15.0 ± 1.7 years). Forty-one percent of patients had private insurance, while 59% had public insurance. There were 27 patients with isolated meniscal tears, 59 with combined meniscal and ACL tears, and 33 with isolated ACL tears. The mean time from injury to presentation was 56 days (range, 0-457 days) in patients with private insurance and 136 days (range, 0-1120 days) in patients with public insurance ( P = .02). Surgery occurred, on average, 35 days after the initial office visit in both groups. The mean preoperative IKDC score was 53 in both groups. Patients with meniscal tears with public insurance were more likely to require meniscal debridement than patients with private insurance (risk ratio [RR], 2.3; 95% CI, 1.7-3.1; P = .02). Patients with public insurance

Patient perceptions of asthma-related financial burden: public vs. private health insurance in the United States.

Science.gov (United States)

Patel, Minal R; Caldwell, Cleopatra H; Song, Peter X K; Wheeler, John R C

2014-10-01

Given the complexity of the health insurance market in the United States and the confusion that often stems from these complexities, patient perception about the value of health insurance in managing chronic disease is important to understand. To examine differences between public and private health insurance in perceptions of financial burden with managing asthma, outcomes, and factors that explain these perceptions. Secondary analysis was performed using baseline data from a randomized clinical trial that were collected through telephone interviews with 219 African American women seeking services for asthma and reporting perceptions of financial burden with asthma management. Path analysis with multigroup models and multiple variable regression analyses were used to examine associations. For public (P financial burden through different explanatory pathways. When adjusted for multiple morbidities, asthma control, income, and out-of-pocket expenses, those with private insurance used fewer inpatient (P financial burden was associated with more urgent office visits (P financial burden regardless of health insurance report more urgent health care visits and lower quality of life. Burden may be present despite having and being able to generate economic resources and health insurance. Further policy efforts are indicated and special attention should focus on type of coverage. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Motor Third Party Liability Insurance in Russia: Gaining Competitive Advantage

OpenAIRE

Rogozin, Konstantin

2006-01-01

The report identifies which factors of service-based offerings are of utmost importance for customers, considers the areas of MTPL insurance that may contain a potential sources for differentiation, and stresses importance of knowing customer needs and requirements. This report should assist the insurance company to categorise and systematise relevant information so as to develop a product position, which may give a competitive advantage.

Multilevel predictors of colorectal cancer testing modality among publicly and privately insured people turning 50.

Science.gov (United States)

Wheeler, Stephanie B; Kuo, Tzy-Mey; Meyer, Anne Marie; Martens, Christa E; Hassmiller Lich, Kristen M; Tangka, Florence K L; Richardson, Lisa C; Hall, Ingrid J; Smith, Judith Lee; Mayorga, Maria E; Brown, Paul; Crutchfield, Trisha M; Pignone, Michael P

2017-06-01

Understanding multilevel predictors of colorectal cancer (CRC) screening test modality can help inform screening program design and implementation. We used North Carolina Medicare, Medicaid, and private, commercially available, health plan insurance claims data from 2003 to 2008 to ascertain CRC test modality among people who received CRC screening around their 50th birthday, when guidelines recommend that screening should commence for normal risk individuals. We ascertained receipt of colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) from billing codes. Person-level and county-level contextual variables were included in multilevel random intercepts models to understand predictors of CRC test modality, stratified by insurance type. Of 12,570 publicly-insured persons turning 50 during the study period who received CRC testing, 57% received colonoscopy, whereas 43% received FOBT/FIT, with significant regional variation. In multivariable models, females with public insurance had lower odds of colonoscopy than males (odds ratio [OR] = 0.68; p testing, 42% received colonoscopy, whereas 58% received FOBT/FIT, with significant regional variation. In multivariable models, females with private insurance had lower odds of colonoscopy than males (OR = 0.43; p < 0.05). People living 10-15 miles away from endoscopy facilities also had lower odds of colonoscopy than those living within 5 miles (OR = 0.91; p < 0.05). Both colonoscopy and FOBT/FIT are widely used in North Carolina among insured persons newly age-eligible for screening. The high level of FOBT/FIT use among privately insured persons and women suggests that renewed emphasis on FOBT/FIT as a viable screening alternative to colonoscopy may be important.

Insuring against health shocks: Health insurance and household choices.

Science.gov (United States)

Liu, Kai

2016-03-01

This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

Public views of health insurance in Japan during the era of attaining universal health coverage: a secondary analysis of an opinion poll on health insurance in 1967

Directory of Open Access Journals (Sweden)

Ikuma Nozaki

2017-07-01

Full Text Available While Japan’s success in achieving universal health insurance over a short period with controlled healthcare costs has been studied from various perspectives, that of beneficiaries have been overlooked. We conducted a secondary analysis of an opinion poll on health insurance in 1967, immediately after reaching universal coverage. We found that people continued to face a slight barrier to healthcare access (26.8% felt medical expenses were a heavy burden and had high expectations for health insurance (60.5% were satisfied with insured medical services and 82.4% were willing to pay a premium. In our study, younger age, having children before school age, lower living standards, and the health insurance scheme were factors that were associated with a willingness to pay premiums. Involving high-income groups in public insurance is considered to be the key to ensuring universal coverage of social insurance.

The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions. NBER Working Paper No. 20178

Science.gov (United States)

Cohodes, Sarah; Kleiner, Samuel; Lovenheim, Michael F.; Grossman, Daniel

2014-01-01

Public health insurance programs comprise a large share of federal and state government expenditure, and these programs are due to be expanded as part of the 2010 Affordable Care Act. Despite a large literature on the effects of these programs on health care utilization and health outcomes, little prior work has examined the long-term effects of…

SERVICE QUALITY MEASUREMENT AND DEMAND FOR INSURANCE: AN EMPIRICAL STUDY FROM NIGERIAN INSURANCE INDUSTRY

Directory of Open Access Journals (Sweden)

Abass, OlufemiAdebowale

2016-11-01

Full Text Available Insurance provides financial protection to the insured, though; its acceptance by Nigerian insuring public is still low. This can sharply be traced to low awareness of insurance service. More importantly, quality of service to the few who embraced it had been low. Therefore, insuring public perceives insurance service as defective because customers’ expectations are not met. The objective of this research is to find out whether application of service quality measurement will drive demand for insurance products. Hypothesis was tested to find out whether SERVQUAL measurement is not significantly related to demand for insurance products in Nigeria. The study adopts descriptive research design; hypothesis was tested using regression analysis. The study reveals that there is a significant relationship between application of SERVQUAL measurement and demand for insurance. It is recommended that insurance companies operating in Nigeria should adopt SERVQUAL measurement which will further increase customer retention and loyalty.

[Public health, prevention and federalism: insights from the implementation of the federal law on health insurance].

Science.gov (United States)

Rüefli, Christian; Sager, Fritz

2004-01-01

In 1996, the new Swiss law on health care insurance (KVG) introduced the coverage of certain preventive measures. This provided an opportunity to include research-based public health issues in federal health policy. The present article examines the problems with which the realization of those goals in a Federalist health care system with strong cantonal autonomy as it is found in Switzerland was confronted. Comparative qualitative case studies design (vaccination of school age children and screening-mammography). Switzerland's federalist health care system strongly hinders the realisation of the Confederation's public health goals. Prevention falls into the cantons' autonomy and the federal KVG (Krankenversicherungsgesetz; Health insurance law) only regulates the coverage of the services provided, but does not contain any instruments to assure implementation in consistency with the policy goals. Under those circumstances, conflicts of interest between the implementing actors, varying cantonal preferences, and scarce resources block the implementation of public health goals. The results imply stronger leadership of the Confederation in prevention policy and an improved consideration of implementation aspects in approving new measures to obligatory insurance coverage.

Insurance against climate change and flood risk: Insurability and decision processes of insurers

Science.gov (United States)

Hung, Hung-Chih; Hung, Jia-Yi

2016-04-01

1. Background Major portions of the Asia-Pacific region is facing escalating exposure and vulnerability to climate change and flood-related extremes. This highlights an arduous challenge for public agencies to improve existing risk management strategies. Conventionally, governmental funding was majorly responsible and accountable for disaster loss compensation in the developing countries in Asia, such as Taiwan. This is often criticized as an ineffective and inefficient measure of dealing with flood risk. Flood insurance is one option within the toolkit of risk-sharing arrangement and adaptation strategy to flood risk. However, there are numerous potential barriers for insurance companies to cover flood damage, which would cause the flood risk is regarded as uninsurable. This study thus aims to examine attitudes within the insurers about the viability of flood insurance, the decision-making processes of pricing flood insurance and their determinants, as well as to examine potential solutions to encourage flood insurance. 2. Methods and data Using expected-utility theory, an insurance agent-based decision-making model was developed to examine the insurers' attitudes towards the insurability of flood risk, and to scrutinize the factors that influence their decisions on flood insurance premium-setting. This model particularly focuses on how insurers price insurance when they face either uncertainty or ambiguity about the probability and loss of a particular flood event occurring. This study considers the factors that are expected to affect insures' decisions on underwriting and pricing insurance are their risk perception, attitudes towards flood insurance, governmental measures (e.g., land-use planning, building codes, risk communication), expected probabilities and losses of devastating flooding events, as well as insurance companies' attributes. To elicit insurers' utilities about premium-setting for insurance coverage, the 'certainty equivalent,' 'probability

Private health insurance: implications for developing countries.

Science.gov (United States)

Sekhri, Neelam; Savedoff, William

2005-02-01

Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage.

Partnerships for disaster risk insurance in the EU

Directory of Open Access Journals (Sweden)

J. Mysiak

2016-11-01

Full Text Available With increasing costs inflicted by natural hazard perils, and amidst state budget cuts, concerns are mounting about the capacity of governments to design sustainable, equitable and affordable risk management schemes. The participation of the private sector along with the public one through public–private partnerships (PPPs has gained importance as a means of providing catastrophic natural hazard insurance to address these seemingly conflicting objectives. In 2013 the European Commission launched a wide-ranging consultation about what EU action could be appropriate to improve the performance of insurance markets. Simultaneously, the EU legislator instigated major reforms in the legislation and regulations that pertain to how PPPs are designed or operate. This paper has a dual objective: first, we review and summarize the manifold legal background that influences the provision of insurance against natural catastrophes. Second, we examine how PPPs designed for sharing and transferring risk operate within the European regulatory constraints, illustrated using the example of the UK Flood Reinsurance Scheme (Flood RE between the state and the Association of British Insurers.

41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

Approaches to gaining public acceptance of repository siting

International Nuclear Information System (INIS)

Numark, N.J.; Wonder, E.F.

1989-01-01

An eight-country survey reveals a diversity of strategies that have been followed for siting radioactive waste repositories, as well as a range of levels of public acceptance of siting efforts. Although the strategies are not necessarily interchangeable from country to country, certain inferences may be drawn from worldwide siting experience regarding ways to maximize public acceptance. Furthermore, waste management organizations in these countries have placed varying amounts of stock in technical review by outside experts and in a range of communications strategies as means of improving public acceptance. Our survey of worldwide experience also allows some general observations to be made regarding the effectiveness of these efforts. Combining a strategy that elevates public acceptance to part of the overall mission of siting a waste management facility with strategies for appropriate communications and external technical review may be necessary and sufficient for gaining improvements in public acceptance of proposed repository sites

Do self-insurance and disability insurance prevent consumption loss on disability?

OpenAIRE

Steffan G. Ball; Hamish W. Low

2009-01-01

In this paper we show the extent to which public insurance and self-insurance mitigate the cost of health shocks that limit the ability to work. We use consumption data from the UK to estimate the insurance provided by the government disability programme and account for the effectiveness of alternative self-insurance mechanisms. Individuals with a work-limiting health condition, but in receipt of disability insurance, have 7 percent lower consumption than those without such a condition. Self-...

Does public insurance provide better financial protection against rising health care costs for families of children with special health care needs?

Science.gov (United States)

Yu, Hao; Dick, Andrew W; Szilagyi, Peter G

2008-10-01

Health care costs grew rapidly since 2001, generating substantial economic pressures on families, especially those with children with special health care needs (CSHCN). To examine how the growth of health care costs affected financial burden for families of CSHCN between 2001 and 2004 and to determine the extent to which health insurance coverage protected families of CSHCN against financial burden. In 2001-2004, 5196 families of CSHCN were surveyed by the national Medical Expenditure Panel Survey (MEPS). The main outcome was financial burden, defined as the proportion of family income spent on out-of-pocket (OOP) health care expenditures for all family members, including OOP costs and premiums. Family insurance coverage was classified as: (1) all members publicly insured, (2) all members privately insured, (3) all members uninsured, (4) partial coverage, and (5) a mix of public and private with no uninsured periods. An upward trend in financial burden for families of CSHCN occurred and was associated with growth of economy-wide health care costs. A multivariate analysis indicated that, given the economy-wide increase in medical costs between 2001 and 2004, a family with CSHCN was at increased risk in 2004 for having financial burden exceeding 10% of family income [odds ratio (OR) = 1.39; P financial burden exceeding 20% of family income. Over 15% of families with public insurance had financial burden exceeding 10% of family income compared with 20% of families with private insurance (P financial burden of >10% or 20% of family income than privately-insured families. Rising health care costs increased financial burden on families of CSHCN in 2001-2004. Public insurance coverage provided better financial protection than private insurance against the rapidly rising health care costs for families of CSHCN.

42 CFR 60.14 - The insurance premium.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false The insurance premium. 60.14 Section 60.14 Public... LOAN PROGRAM The Loan § 60.14 The insurance premium. (a) General. (1) The Secretary insures each lender... lender an insurance premium. The insurance premium is due to the Secretary on the date of disbursement of...

Still-Born Autonomy Insurance Plan in Quebec: An Example of a Public Long-Term Care Insurance System in Canada.

Science.gov (United States)

Hébert, Réjean

2016-01-01

Funding long-term care (LTC) is a challenge under the existing Beveridgean universal healthcare system. The Autonomy Insurance (AI) plan developed in Quebec was an attempt to introduce public LTC insurance into our healthcare system. The AI benefit was based on an assessment of the needs of older people and those with disabilities using a disability scale (SMAF) and case-mix classification system (Iso-SMAF Profiles). Under the plan, the benefit would be used to fund public institutions or purchase services from private organizations. Case managers were responsible for assessments and helping users and their families plan services and decide how to use the AI benefit. Funding AI was based on general tax revenues without capitalized funding, under a separate protected budget program. Projections were made for the additional budget needed to support AI, which would have mitigated the forecast increase in LTC spending due to population aging. All the legal, administrative, funding, training and contractual issues were dealt with, for implementation of the plan in April 2015. Unfortunately, the project was still-born for political reasons, but it demonstrates the feasibility of this essential innovation for Canada.

Improving Risk Management and Resiliency: A Plan for a Proactive National Policy on Insurance Practices in FEMA’s Public Assistance Program

Science.gov (United States)

2013-12-01

and reduce insurance costs. 178 Department of Finance and Deregulation , “Managing the Cost of Damage to Road Infrastructure Caused by Natural...MANAGEMENT AND RESILIENCY: A PLAN FOR A PROACTIVE NATIONAL POLICY ON INSURANCE PRACTICES IN FEMA’S PUBLIC ASSISTANCE PROGRAM by Gregory W. Eaton...AND RESILIENCY: A PLAN FOR A PROACTIVE NATIONAL POLICY ON INSURANCE PRACTICES IN FEMA’S PUBLIC ASSISTANCE PROGRAM 5. FUNDING NUMBERS 6. AUTHOR(S

Health insurance theory: the case of the missing welfare gain.

Science.gov (United States)

Nyman, John A

2008-11-01

An important source of value is missing from the conventional welfare analysis of moral hazard, namely, the effect of income transfers (from those who purchase insurance and remain healthy to those who become ill) on purchases of medical care. Income transfers are contained within the price reduction that is associated with standard health insurance. However, in contrast to the income effects contained within an exogenous price decrease, these income transfers act to shift out the demand for medical care. As a result, the consumer's willingness to pay for medical care increases and the resulting additional consumption is welfare increasing.

[Public and private: insurance companies and medical care in Mexico].

Science.gov (United States)

Tamez, S; Bodek, C; Eibenschutz, C

1995-01-01

During the late 70's and early 80's in Mexico, as in the rest of Latin-America, sanitary policies were directed to support the growth of the private sector of health care at the expense of the public sector. This work analyzes the evolution of the health insurance market as a part of the privatization process of health care. The analysis based on economic data, provides the political profile behind the privatization process as well as the changes in the relations between the State and the health sector. The central hypothesis is that the State promotes and supports the growth of the private market of medical care via a series of legal, fiscal and market procedures. It also discusses the State roll in the legal changes related to the national insurance activity. A comparative analysis is made about the evolution of the insurance industry in Argentina, Brazil, Chile and Mexico during the period 1986-1992, with a particular enfasis in the last country. One of the principal results is that the Premium/GNP and Premium/per capita, display a general growth in the 4 countries. This growth is faster for Mexico for each one) because the privatization process occurred only during the most recent years. For the 1984-1991 period in Mexico the direct premium as percentage of the GNP raised from 0.86% to 1.32%. If one focussed only in the insurance for health and accidents branches the rice goes form 8.84% in 1984 to 19.08% in 1991. This indicates that the insurance industry is one of the main targets of the privatization process of the health care system in Mexico. This is also shown by the State support to fast expansion of the big medical industrial complex of the country. Considering this situation in the continuity of the neoliberal model of Mexico, this will profound the inequity and inequality.

Risk allocation in a public-private catastrophe insurance system : an actuarial analysis of deductibles, stop-loss, and premiums

NARCIS (Netherlands)

Paudel, Y.; Botzen, W. J. W.; Aerts, J. C. J. H.; Dijkstra, T. K.

A public-private (PP) partnership could be a viable arrangement for providing insurance coverage for catastrophe events, such as floods and earthquakes. The objective of this paper is to obtain insights into efficient and practical allocations of risk in a PP insurance system. In particular, this

Risk allocation in a public-private catastrophe insurance system : An actuarial analysis of deductibles, stop-loss, and premiums

NARCIS (Netherlands)

Paudel, Y.; Botzen, W.J.W.; Dijkstra, Th.; Aerts, J.C.J.H.

2015-01-01

A public-private (PP) partnership could be a viable arrangement for providing insurance coverage for catastrophe events, such as floods and earthquakes. The objective of this paper is to obtain insights into efficient and practical allocations of risk in a PP insurance system. In particular, this

[Evidence-based medicine and public health law: statutory health insurance].

Science.gov (United States)

Dreher, Wolfgang

2004-09-01

Beyond all differences in terminology and legal principles between the laws governing private health insurance, the governmental financial support for civil, servants and statutory health insurance the fundamental issues to be solved by the courts in case of litigation are quite similar. But only a part of these refer to the quality of medical services, which is the main concern of Evidence-based Medicine (EbM); EbM, though, is not able to contribute towards answering the equally important question of how to distinguish between "treatment" and "(health-relevant) lifestyle". The respective definitions that have been developed in the particular fields of law are only seemingly divergent from each other and basically unsuitable to aid the physician in his clinical decision-making because the common blanket clauses of public health law are regularly interpreted as rules for the exclusion of certain claims and not as a confirmatory paraphrase of what is clinically necessary. If on the other hand medical quality is what lies at the core of litigation, reference to EbM may become necessary. In fact, it is already common practice in the statutory health insurance system that decision-making processes in the Federal Committee being responsible for quality assurance (Bundesausschuss) are based on EbM principles and that in exceptional cases only the courts have to medically review the Federal Committee's decisions.

Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

Science.gov (United States)

Nandi, Sulakshana; Schneider, Helen; Dixit, Priyanka

2017-01-01

Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private) and out of pocket (OOP) expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members) of the 2014 National Sample Survey (71st Round) on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP) expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP) expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure). The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests the need to

Effects of public premiums on children's health insurance coverage: evidence from 1999 to 2003.

Science.gov (United States)

Kenney, Genevieve; Hadley, Jack; Blavin, Fredric

This study uses 2000 to 2004 Current Population Survey data to examine the effects of public premiums on the insurance coverage of children whose family incomes are between 100% and 300% of the federal poverty level. The analysis employs multinomial logistic models that control for factors other than premium costs. While the magnitude of the estimated effects varies across models, the results consistently indicate that raising public premiums reduces enrollment in public programs, with some children who forgo public coverage having private coverage instead and others being uninsured. The results indicate that public premiums have larger effects when applied to lower-income families.

[Occupational health services as the insurance product and insurance economic instruments].

Science.gov (United States)

Rydlewska-Liszkowska, Izabela

2014-01-01

One of the most controversial issues in restructuring the Polish health insurance system is the implementation of private voluntary insurance and creation within it a new insurance product known as occupational health services (OHS). In this article some opportunities and dilemmas likely to be faced by providers and employers/employees, when contracting with insurance institutions, are considered as a contribution to the discussion on private insurance in Poland. The basic question is how private insurance institutions could influence the promotion of different preventive activities at the company level by motivating both OHS providers and employers. The descriptive qualitative method has been applied in the analysis of legal acts, scientific publications selected according to keywords (Pubmed), documents and expert evaluations and research project results. Taking into account the experiences of European countries, described in publications, international experts' opinions and results of research projects the solution proposed in Poland could be possible under the following several prerequisites: inclusion of a full scope of occupational health services into the insurance product, constant supervision of occupational medicine professionals, monitoring of the health care quality and the relations between private insurers and OHS provider and implementation of the economic incentives scheme to ensure an adequate position of OHS providers on the market. The proposed reconstruction of the health insurance system, comprising undoubtedly positive elements, may entail some threats in the area of health, organization and economy. Private voluntary health insurance implementation requires precisely defined solutions concerning the scope of insurance product, motivation scheme and information system.

The Great Recession of 2007-2009 and Public Insurance Coverage for Children in Alabama: Enrollment and Claims Data from 1999-2011.

Science.gov (United States)

Morrisey, Michael A; Blackburn, Justin; Becker, David J; Sen, Bisakha; Kilgore, Meredith L; Caldwell, Cathy; Menachemi, Nir

2016-01-01

This study examined the impact of the Great Recession of 2007-2009 on public health insurance enrollment and expenditures in Alabama. Our analysis was designed to provide a framework for other states to conduct similar analyses to better understand the relationship between macroeconomic conditions and public health insurance costs. We analyzed enrollment and claims data from Medicaid and the Children's Health Insurance Program (CHIP) in Alabama from 1999 through 2011. We examined the relationship between county-level unemployment rates and enrollment in Medicaid and CHIP, as well as total county-level expenditures in the two programs. We used linear regressions with county fixed effects to estimate the impact of unemployment changes on enrollment and expenditures after controlling for population and programmatic changes in eligibility and cost sharing. A one-percentage-point increase in a county's unemployment rate was associated with a 4.3% increase in Medicaid enrollment, a 0.9% increase in CHIP enrollment, and an overall increase in public health insurance enrollment of 3.7%. Each percentage-point increase in unemployment was associated with a 6.2% increase in total public health insurance expenditures on children, with Medicaid spending rising by 7.5% and CHIP spending rising by 1.8%. In response to the 6.4 percentage-point increase in the state's unemployment rate during the Great Recession, combined enrollment of children in Alabama's public health insurance programs increased by 24% and total expenditures rose by 40%. Recessions have a substantial impact on the number of children enrolled in CHIP and Medicaid, and a disproportionate impact on program spending. Programs should be aware of the likely magnitudes of the effects in their budget planning.

Community health events for enrolling uninsured into public health insurance programs: implications for health reform.

Science.gov (United States)

Cheng, Scott; Tsai, Kai-ya; Nascimento, Lori M; Cousineau, Michael R

2014-01-01

To determine whether enrollment events may serve as a venue to identify eligible individuals, enroll them into health insurance programs, and educate them about the changes the Patient Protection and Affordable Care Act will bring about. More than 2900 surveys were administered to attendees of 7 public health insurance enrollment events in California. Surveys were used to identify whether participants had any change in understanding of health reform after participating in the event. More than half of attendees at nearly all events had no knowledge about health reform before attending the event. On average, more than 80% of attendees knew more about health reform following the event and more than 80% believed that the law would benefit their families. Enrollment events can serve as an effective method to educate the public on health reform. Further research is recommended to explore in greater detail the impact community enrollment events can have on expanding public understanding of health reform.

A RANGELAND GRASSHOPPER INSURANCE PROGRAM

OpenAIRE

Skold, Melvin D.; Davis, Robert M.

1995-01-01

The incidence of benefits and costs from controlling rangeland grasshoppers on public grazing lands poses problems of economic efficiency and distributional equity. Public grasshopper control programs operate like public disaster assistance. However, grasshopper infestations are an insurable risk. This article proposes a rangeland grasshopper insurance program which reduces the economic inefficiencies and distributional inequities of the existing program.

75 FR 30106 - Terrorism Risk Insurance Program; Recordkeeping Requirements for Insurers Compensated Under the...

Science.gov (United States)

2010-05-28

... DEPARTMENT OF THE TREASURY Terrorism Risk Insurance Program; Recordkeeping Requirements for... Budget. The Terrorism Risk Insurance Program Office within the Department of the Treasury is soliciting... original and two copies) to: Terrorism Risk Insurance Program, Public Comment Record, Suite 2100...

Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

Directory of Open Access Journals (Sweden)

Sulakshana Nandi

Full Text Available Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private and out of pocket (OOP expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members of the 2014 National Sample Survey (71st Round on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure. The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests

Immigrants' access to health insurance: no equality without awareness.

Science.gov (United States)

Dzúrová, Dagmar; Winkler, Petr; Drbohlav, Dušan

2014-07-14

The Czech government has identified commercial health insurance as one of the major problems for migrants' access to health care. Non-EU immigrants are eligible for public health insurance only if they have employee status or permanent residency. The present study examined migrants' access to the public health insurance system in Czechia. A cross-sectional survey of 909 immigrants from Ukraine and Vietnam was conducted in March and May 2013, and binary logistic regression was applied in data analysis. Among immigrants entitled to Czech public health insurance due to permanent residency/asylum, 30% were out of the public health insurance system, and of those entitled by their employment status, 50% were out of the system. Migrants with a poor knowledge of the Czech language are more likely to remain excluded from the system of public health insurance. Instead, they either remain in the commercial health insurance system or they simultaneously pay for both commercial and public health insurance, which is highly disadvantageous. Since there are no reasonable grounds to stay outside the public health insurance, it is concluded that it is lack of awareness that keeps eligible immigrants from entering the system. It is suggested that no equal access to health care exists without sufficient awareness about health care system.

Immigrants’ Access to Health Insurance: No Equality without Awareness

Directory of Open Access Journals (Sweden)

Dagmar Dzúrová

2014-07-01

Full Text Available The Czech government has identified commercial health insurance as one of the major problems for migrants’ access to health care. Non-EU immigrants are eligible for public health insurance only if they have employee status or permanent residency. The present study examined migrants’ access to the public health insurance system in Czechia. A cross-sectional survey of 909 immigrants from Ukraine and Vietnam was conducted in March and May 2013, and binary logistic regression was applied in data analysis. Among immigrants entitled to Czech public health insurance due to permanent residency/asylum, 30% were out of the public health insurance system, and of those entitled by their employment status, 50% were out of the system. Migrants with a poor knowledge of the Czech language are more likely to remain excluded from the system of public health insurance. Instead, they either remain in the commercial health insurance system or they simultaneously pay for both commercial and public health insurance, which is highly disadvantageous. Since there are no reasonable grounds to stay outside the public health insurance, it is concluded that it is lack of awareness that keeps eligible immigrants from entering the system. It is suggested that no equal access to health care exists without sufficient awareness about health care system.

Public vs private administration of rural health insurance schemes: a comparative study in Zhejiang of China.

Science.gov (United States)

Zhou, Xiaoyuan; Mao, Zhengzhong; Rechel, Bernd; Liu, Chaojie; Jiang, Jialin; Zhang, Yinying

2013-07-01

Since 2003, China has experimented in some of the country's counties with the private administration of the New Cooperative Medical Scheme (NCMS), a publicly subsidized health insurance scheme for rural populations. Our study compared the effectiveness and efficiency of private vs public administration in four counties in one of China's most affluent provinces in the initial stage of the NCMS's implementation. The study was undertaken in Ningbo city of Zhejiang province. Out of 10 counties in Ningbo, two counties with private administration for the NCMS (Beilun and Ninghai) were compared with two others counties with public administration (Zhenhai and Fenghua), using the following indicators: (1) proportion of enrollees who were compensated for inpatient care; (2) average reimbursement-expense ratio per episode of inpatient care; (3) overall administration cost; (4) enrollee satisfaction. Data from 2004 to 2006 were collected from the local health authorities, hospitals and the contracted insurance companies, supplemented by a randomized household questionnaire survey covering 176 households and 479 household members. In our sample counties, private administration of the NCMS neither reduced transaction costs, nor improved the benefits of enrollees. Enrollees covered by the publicly administered NCMS were more likely to be satisfied with the insurance scheme than those covered by the privately administered NCMS. Experience in the selected counties suggests that private administration of the NCMS did not deliver the hoped-for results. We conclude that caution needs to be exercised in extending private administration of the NCMS.

Patterns and Correlates of Tic Disorder Diagnoses in Privately and Publicly Insured Youth

Science.gov (United States)

Olfson, Mark; Crystal, Stephen; Gerhard, Tobias; Huang, Cecilia; Walkup, James T.; Scahill, Lawrence; Walkup, John T.

2011-01-01

Objective: This study examined the prevalence and demographic and clinical correlates of children diagnosed with Tourette disorder, chronic motor or vocal tic disorder, and other tic disorders in public and private insurance plans over the course of a 1-year period. Method: Claims were reviewed of Medicaid (n = 10,247,827) and privately (n =…

Psychiatric inpatient expenditures and public health insurance programmes: analysis of a national database covering the entire South Korean population

Directory of Open Access Journals (Sweden)

Chung Woojin

2010-09-01

Full Text Available Abstract Background Medical spending on psychiatric hospitalization has been reported to impose a tremendous socio-economic burden on many developed countries with public health insurance programmes. However, there has been no in-depth study of the factors affecting psychiatric inpatient medical expenditures and differentiated these factors across different types of public health insurance programmes. In view of this, this study attempted to explore factors affecting medical expenditures for psychiatric inpatients between two public health insurance programmes covering the entire South Korean population: National Health Insurance (NHI and National Medical Care Aid (AID. Methods This retrospective, cross-sectional study used a nationwide, population-based reimbursement claims dataset consisting of 1,131,346 claims of all 160,465 citizens institutionalized due to psychiatric diagnosis between January 2005 and June 2006 in South Korea. To adjust for possible correlation of patients characteristics within the same medical institution and a non-linearity structure, a Box-Cox transformed, multilevel regression analysis was performed. Results Compared with inpatients 19 years old or younger, the medical expenditures of inpatients between 50 and 64 years old were 10% higher among NHI beneficiaries but 40% higher among AID beneficiaries. Males showed higher medical expenditures than did females. Expenditures on inpatients with schizophrenia as compared to expenditures on those with neurotic disorders were 120% higher among NHI beneficiaries but 83% higher among AID beneficiaries. Expenditures on inpatients of psychiatric hospitals were greater on average than expenditures on inpatients of general hospitals. Among AID beneficiaries, institutions owned by private groups treated inpatients with 32% higher costs than did government institutions. Among NHI beneficiaries, inpatients medical expenditures were positively associated with the proportion of

Genetic screening, health care and the insurance industry. Should genetic information be made available to insurers?

Science.gov (United States)

Ossa, Diego F; Towse, Adrian

2004-06-01

The potential use of genetic tests in insurance has raised concerns about discrimination and individuals losing access to health care either because of refusals to test for treatable diseases, or because test-positives cannot afford premiums. Governments have so far largely sought to restrict the use of genetic information by insurance companies. To date the number of tests available with significant actuarial value is limited. However, this is likely to change, raising more clearly the question as to whether the social costs of adverse selection outweigh the social costs of individuals not accessing health care for fear of the consequences of test information being used in insurance markets. In this contribution we set out the policy context and model the potential trade-offs between the losses faced by insurers from adverse selection by insurees (which will increase premiums reducing consumer welfare) and the detrimental health effects that may result from persons refusing to undergo tests that could identify treatable health conditions. It argues that the optimal public policy on genetic testing should reflect overall societal benefit, taking account of these trade-offs. Based on our model, the factors that influence the outcome include: the size of and value attached to the health gains from treatment; deterrent effects of a disclosure requirement on testing for health reasons; incidence of the disease; propensity of test-positives to adverse select; policy value adverse selectors buy in a non-disclosure environment; and price elasticity of demand for insurance. Our illustrative model can be used as a benchmark for developing other scenarios or incorporating real data in order to address the impact of different policies on disclosure and requirement to test.

Healthy and Ready to Learn: Effects of a School-Based Public Health Insurance Outreach Program for Kindergarten-Aged Children

Science.gov (United States)

Jenkins, Jade Marcus

2018-01-01

Background: Rates of child insurance coverage have increased due to expansions in public programs, but many eligible children remain uninsured. Uninsured children are less likely to receive preventative care, which leads to poorer health and achievement in the long term. This study is an evaluation of a school-based health insurance outreach…

Insurance, Public Assistance, and Household Flood Risk Reduction: A Comparative Study of Austria, England, and Romania.

Science.gov (United States)

Hanger, Susanne; Linnerooth-Bayer, Joanne; Surminski, Swenja; Nenciu-Posner, Cristina; Lorant, Anna; Ionescu, Radu; Patt, Anthony

2018-04-01

In light of increasing losses from floods, many researchers and policymakers are looking for ways to encourage flood risk reduction among communities, business, and households. In this study, we investigate risk-reduction behavior at the household level in three European Union Member States with fundamentally different insurance and compensation schemes. We try to understand if and how insurance and public assistance influence private risk-reduction behavior. Data were collected using a telephone survey (n = 1,849) of household decisionmakers in flood-prone areas. We show that insurance overall is positively associated with private risk-reduction behavior. Warranties, premium discounts, and information provision with respect to risk reduction may be an explanation for this positive relationship in the case of structural measures. Public incentives for risk-reduction measures by means of financial and in-kind support, and particularly through the provision of information, are also associated with enhancing risk reduction. In this study, public compensation is not negatively associated with private risk-reduction behavior. This does not disprove such a relationship, but the negative effect may be mitigated by factors related to respondents' capacity to implement measures or social norms that were not included in the analysis. The data suggest that large-scale flood protection infrastructure creates a sense of security that is associated with a lower level of preparedness. Across the board there is ample room to improve both public and private policies to provide effective incentives for household-level risk reduction. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

Association between supplementary private health insurance and visits to physician offices versus hospital outpatient departments among adults with diabetes in the universal public insurance system.

Science.gov (United States)

You, Chang Hoon; Choi, Ji Heon; Kang, Sungwook; Oh, Eun-Hwan; Kwon, Young Dae

2018-01-01

Diabetes mellitus is a chronic disease with a high prevalence across the world as well as in South Korea. Most cases of diabetes can be adequately managed at physician offices, but many diabetes patients receive outpatient care at hospitals. This study examines the relationship between supplementary private health insurance (SPHI) ownership and the use of hospitals among diabetes outpatients within the universal public health insurance scheme. Data from the 2011 Korea Health Panel, a nationally representative sample of Korean individuals, was used. For the study, 6,379 visits for diabetes care were selected while controlling for clustered errors. Multiple logistic regression models were used to examine determinants of hospital outpatient services. This study demonstrated that the variables of self-rated health status, comorbidity, unmet need, and alcohol consumption significantly correlated with the choice to use a hospital services. Patients with SPHI were more likely to use medical services at hospitals by 1.71 times (95% CI 1.068-2.740, P = 0.026) compared to patients without SPHI. It was confirmed that diabetic patients insured by SPHI had more use of hospital services than those who were not insured. People insured by SPHI seem to be more likely to use hospital services because SPHI lightens the economic burden of care.

Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review.

Science.gov (United States)

Prinja, Shankar; Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

2017-01-01

Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or

[Private health insurance in Brazil: approaches to public/private patterns in healthcare].

Science.gov (United States)

Sestelo, José Antonio de Freitas; Souza, Luis Eugenio Portela Fernandes de; Bahia, Lígia

2013-05-01

This article draws on a previous review of 270 articles on private health plans published from 2000 to 2010 and selects 17 that specifically address the issue of the relationship between the public and private healthcare sectors. Content analysis considered the studies' concepts and terms, related theoretical elements, and predominant lines of argument. A reading of the argumentative strategies detected the existence of a critical view of the modus operandi in the public/private relationship based on Social Medicine and the theoretical tenets of the Brazilian Health Reform Movement. The study also identified contributions based on neoliberal business approaches that focus strictly on economic issues to discuss private health insurance. Understanding the public/private link in healthcare obviously requires the development of a solid empirical base, analyzed with adequate theoretical assumptions due to the inherent degree of complexity in the public/private healthcare interface.

Comparing WTP values of different types of QALY gain elicited from the general public.

Science.gov (United States)

Pennington, Mark; Baker, Rachel; Brouwer, Werner; Mason, Helen; Hansen, Dorte Gyrd; Robinson, Angela; Donaldson, Cam

2015-03-01

The appropriate thresholds for decisions on the cost-effectiveness of medical interventions remain controversial, especially in 'end-of-life' situations. Evidence of the values placed on different types of health gain by the general public is limited. Across nine European countries, 17,657 people were presented with different hypothetical health scenarios each involving a gain of one quality adjusted life year (QALY) and asked about their willingness to pay (WTP) for that gain. The questions included quality of life (QoL) enhancing and life extending health gains, and a scenario where respondents faced imminent, premature death. The mean WTP values for a one-QALY gain composed of QoL improvements were modest (PPP$11,000). When comparing QALY gains obtained in the near future, the valuation of life extension exceeded the valuation of QoL enhancing gains (mean WTP PPP$19,000 for a scenario in which a coma is avoided). The mean WTP values were higher still when respondents faced imminent, premature death (PPP$29,000). Evidence from the largest survey on the value of health gains by the general public indicated a higher value for life extending gains compared with QoL enhancing gains. A further modest premium may be indicated for life extension when facing imminent, premature death. Copyright © 2013 John Wiley & Sons, Ltd.

Insured without moral hazard in the health care reform of China.

Science.gov (United States)

Wong, Chack-Kie; Cheung, Chau-Kiu; Tang, Kwong-Leung

2012-01-01

Public insurance possibly increases the use of health care because of the insured person's interest in maximizing benefits without incurring out-of-pocket costs. A newly reformed public insurance scheme in China that builds on personal responsibility is thus likely to provide insurance without causing moral hazard. This possibility is the focus of this study, which surveyed 303 employees in a large city in China. The results show that the coverage and use of the public insurance scheme did not show a significant positive effect on the average employee's frequency of physician consultation. In contrast, the employee who endorsed public responsibility for health care visited physicians more frequently in response to some insurance factors. On balance, public insurance did not tempt the average employee to consult physicians frequently, presumably due to personal responsibility requirements in the insurance scheme.

Predictors of Language Gains Among School-Age Children With Language Impairment in the Public Schools.

Science.gov (United States)

Justice, Laura M; Jiang, Hui; Logan, Jessica A; Schmitt, Mary Beth

2017-06-10

This study aimed to identify child-level characteristics that predict gains in language skills for children with language impairment who were receiving therapy within the public schools. The therapy provided represented business-as-usual speech/language treatment provided by speech-language pathologists in the public schools. The sample included 272 kindergartners and first-graders with language impairment who participated in a larger study titled "Speech-Therapy Experiences in the Public Schools." Multilevel regression analyses were applied to examine the extent to which select child-level characteristics, including age, nonverbal cognition, memory, phonological awareness, vocabulary, behavior problems, and self-regulation, predicted children's language gains over an academic year. Pratt indices were computed to establish the relative importance of the predictors of interest. Phonological awareness and vocabulary skill related to greater gains in language skills, and together they accounted for nearly 70% of the explained variance, or 10% of total variance at child level. Externalizing behavior, nonverbal cognition, and age were also potentially important predictors of language gains. This study significantly advances our understanding of the characteristics of children that may contribute to their language gains while receiving therapy in the public schools. Researchers can explore how these characteristics may serve to moderate treatment outcomes, whereas clinicians can assess how these characteristics may factor into understanding treatment responses.

Health insurance and health services utilization in Ireland.

Science.gov (United States)

Harmon, C; Nolan, B

2001-03-01

The numbers buying private health insurance in Ireland have continued to grow, despite a broadening in entitlement to public care. About 40% of the population now have insurance, although everyone has entitlement to public hospital care. In this paper, we examine in detail the growth in insurance coverage and the factors underlying the demand for insurance. Attitudinal responses reveal the importance of perceptions about waiting times for public care, as well as some concerns about the quality of that care. Individual characteristics, such as education, age, gender, marital status, family composition and income all influence the probability of purchasing private insurance. We also examine the relationship between insurance and utilization of hospital in-patient services. The positive effect of private insurance appears less than that of entitlement to full free health care from the state, although the latter is means-tested, and may partly represent health status. Copyright 2001 John Wiley & Sons, Ltd.

Role of market information in gaining public acceptance

International Nuclear Information System (INIS)

Berman, A.B.

1992-01-01

The nuclear energy industry challenge to gain acceptance for its next generation of nuclear power plants is immense. If not the majority, then a vocal minority, has doubts about the technology, its need, or those who implement it. Perceptions about the nuclear industry are complex. These are due to the difficulty in understanding the technology itself, the trade-offs of benefits against repercussions, and well-publicized plant problems. The industry requires a continual flow of actionable and comprehensive market information as input for decision making. The cost of implementing misdirected strategies is high. If not sensitive to public needs, the cost is opposition to nuclear development based on faulty or unsubstantiated reasoning. This paper addresses the required market information flow. It is suggested that a market information system is necessary for timely and usable information to ensure understanding of industry developmental efforts

The Volume Of TV Advertisements During The ACA's First Enrollment Period Was Associated With Increased Insurance Coverage.

Science.gov (United States)

Karaca-Mandic, Pinar; Wilcock, Andrew; Baum, Laura; Barry, Colleen L; Fowler, Erika Franklin; Niederdeppe, Jeff; Gollust, Sarah E

2017-04-01

The launch of the Affordable Care Act was accompanied by major insurance information campaigns by government, nonprofit, political, news media, and private-sector organizations, but it is not clear to what extent these efforts were associated with insurance gains. Using county-level data from the Census Bureau's American Community Survey and broadcast television airings data from the Wesleyan Media Project, we examined the relationship between insurance advertisements and county-level health insurance changes between 2013 and 2014, adjusting for other media and county- and state-level characteristics. We found that counties exposed to higher volumes of local insurance advertisements during the first open enrollment period experienced larger reductions in their uninsurance rates than other counties. State-sponsored advertisements had the strongest relationship with declines in uninsurance, and this relationship was driven by increases in Medicaid enrollment. These results support the importance of strategic investment in advertising to increase uptake of health insurance but suggest that not all types of advertisements will have the same effect on the public. Project HOPE—The People-to-People Health Foundation, Inc.

Healthcare.gov Insurance Finder Tool

Data.gov (United States)

U.S. Department of Health & Human Services — This tool will help you find the health insurance best suited to your needs, whether its private insurance for individuals, families, and small businesses, or public...

Performance Measurement Of Public Sector Insurance Units After De-Tariffication

OpenAIRE

Sharma, Seema; Sikidar, Dr. Sujit

2014-01-01

Insurance sector in India was privatised to publicise insurance products. After privatisation of this industry in India in the year 2000, the next important step taken in the general insurance industry was the removal of tariffs on the non-life insurance products with effect from January1, 2007. The introduction of the free price regime has provided an impetus to the non-life sector. Before the introduction of de-tariffication almost 70% of the business of the non-life sector was driven by va...

Public health emergencies and the public health/managed care challenge.

Science.gov (United States)

Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

2002-01-01

The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

Health Insurance and the Labor Supply Decisions of Older Workers: Evidence from a U.S. Department of Veterans Affairs Expansion.

Science.gov (United States)

Boyle, Melissa A; Lahey, Joanna N

2010-08-01

This paper exploits a major mid-1990s expansion in the U.S. Department of Veterans Affairs health care system to provide evidence on the labor market effects of expanding health insurance availability. Using data from the Current Population Survey, we employ a difference-in-differences strategy to compare the labor market behavior of older veterans and non-veterans before and after the VA health benefits expansion to test the impact of public health insurance on labor supply. We find that older workers are significantly more likely to decrease work both on the extensive and intensive margins after receiving access to non-employer based insurance. Workers with some college education or a college degree are more likely to transition into self-employment, a result consistent with "job-lock" effects. However, less-educated workers are more likely to leave self-employment, a result suggesting that the positive income effect from receiving public insurance dominates the "job-lock" effect for these workers. Some relatively disadvantaged sub-populations may also increase their labor supply after gaining greater access to public insurance, consistent with complementary positive health effects of health care access or decreased work disincentives for these groups. We conclude that this reform has affected employment and retirement decisions, and suggest that future moves toward universal coverage or expansions of Medicare are likely to have significant labor market effects.

76 FR 7767 - Student Health Insurance Coverage

Science.gov (United States)

2011-02-11

... Student Health Insurance Coverage AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION... health insurance coverage under the Public Health Service Act and the Affordable Care Act. The proposed rule would define ``student health insurance [[Page 7768

[Does public health insurance improve health care? The case of prenatal care for adolescents in Mexico].

Science.gov (United States)

Saavedra-Avendaño, Biani; Darney, Blair G; Reyes-Morales, Hortensia; Serván-Mori, Edson

2016-01-01

To test the association between public health insurance and adequate prenatal care among female adolescents in Mexico. Cross-sectional study, using the National Health and Nutrition Survey 2000, 2006, and 2012.We included 3 978 (N=4 522 296) adolescent (12-19) women who reported a live birth.We used logistic regression models to test the association of insurance and adequate (timeliness, frequency and content) prenatal care. The multivariable predicted probability of timely and frequent prenatal care improved over time, from 0.60 (IC95%:0.56;0.64) in 2000 to 0.71 (IC95%:0.66;0.76) in 2012. In 2012, the probability of adequate prenatal care was 0.54 (IC95%:0.49;0.58); women with Social Security had higher probability than women with Seguro Popular and without health insurance. Having Social Security is associated with receipt of adequate prenatal care among adolescents in Mexico.

Health Insurance for Cancer Care in Asia: Thailand

OpenAIRE

Pongpak Pittayapan

2016-01-01

Thailand has a universal multi-payer system with two main types of health insurance: National Health Security Office or public health insurance and private insurance. National health insurance is designed for people who are not eligible to be members of any employment-based health insurance program. Although private health insurance is also available, all Thai citizens are required to be enrolled in either national health insurance or employees? health insurance. There are many differences be...

Rajiv Aarogyasri Community Health Insurance Scheme in Andhra Pradesh, India: a comprehensive analytic view of private public partnership model.

Science.gov (United States)

Reddy, Sunita; Mary, Immaculate

2013-01-01

The Rajiv Aarogyasri Community Health Insurance (RACHI) in Andhra Pradesh (AP) has been very popular social insurance scheme with a private public partnership model to deal with the problems of catastrophic medical expenditures at tertiary level care for the poor households. A brief analysis of the RACHI scheme based on officially available data and media reports has been undertaken from a public health perspective to understand the nature and financing of partnership and the lessons it provides. The analysis of the annual budget spent on the surgeries in private hospitals compared to tertiary public hospitals shows that the current scheme is not sustainable and pose huge burden on the state exchequers. The private hospital association's in AP, further acts as pressure groups to increase the budget or threaten to withdraw services. Thus, profits are privatized and losses are socialized.

Nuclear insurance fire risk

International Nuclear Information System (INIS)

Dressler, E.G.

2001-01-01

Nuclear facilities operate under the constant risk that radioactive materials could be accidentally released off-site and cause injuries to people or damages to the property of others. Management of this nuclear risk, therefore, is very important to nuclear operators, financial stakeholders and the general public. Operators of these facilities normally retain a portion of this risk and transfer the remainder to others through an insurance mechanism. Since the nuclear loss exposure could be very high, insurers usually assess their risk first-hand by sending insurance engineers to conduct a nuclear insurance inspection. Because a serious fire can greatly increase the probability of an off-site release of radiation, fire safety should be included in the nuclear insurance inspection. This paper reviews essential elements of a facility's fire safety program as a key factor in underwriting nuclear third-party liability insurance. (author)

Bariatric surgery insurance requirements independently predict surgery dropout.

Science.gov (United States)

Love, Kaitlin M; Mehaffey, J Hunter; Safavian, Dana; Schirmer, Bruce; Malin, Steven K; Hallowell, Peter T; Kirby, Jennifer L

2017-05-01

Many insurance companies have considerable prebariatric surgery requirements despite a lack of evidence for improved clinical outcomes. The hypothesis of this study is that insurance-specific requirements will be associated with a decreased progression to surgery and increased delay in time to surgery. Retrospective data collection was performed for patients undergoing bariatric surgery evaluation from 2010-2015. Patients who underwent surgery (SGY; n = 827; mean body mass index [BMI] 49.1) were compared with those who did not (no-SGY; n = 648; mean BMI: 49.4). Univariate and multivariate analysis were performed to identify specific co-morbidity and insurance specific predictors of surgical dropout and time to surgery. A total of 1475 patients using 12 major insurance payors were included. Univariate analysis found insurance requirements associated with surgical drop out included longer median diet duration (no-SGY = 6 mo; SGY = 3 mo; Psurgery dropout. Additionally, surgical patients had an average interval between initial visit and surgery of 5.8±4.6 months with significant weight gain (2.1 kg, Psurgery insurance requirements were associated with lack of patient progression to surgery in this study. In addition, delays in surgery were associated with preoperative weight gain. Although prospective and multicenter studies are needed, these findings have major policy implications suggesting insurance requirements may need to be reconsidered to improve medical care. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Social Insurance in Romania - Concern for Governors

Directory of Open Access Journals (Sweden)

Manuela Panaitescu

2011-05-01

Full Text Available Objectives: the comparative research of the public and private insurance systems is important as itprovides financial benefits to the individuals who have lost their income due to their old age, along with theirdecreased labour ability caused by disabilities, disease, motherhood, work related accidents orunemployment, and the resulting benefits are conditioned by the due contributions; Prior Work: this workcontinues previous research conducted for the PhD thesis called “Improving Management in the Public andPrivate Insurance Systems in the Market Economy”; Approach: the main methods that have been used insurveys and observation of the population’s behaviour; Results: in order to reduce the financial restraints thatthe public insurance system has to cope with, the concrete implementation of a social insurance system basedon the needs and value scales of the Romanian state is necessary; Implications: academics and researchersinterested in the Romanian social insurance system management and its long run effects on the population;Value: the insurance systems determins the quality of life for most of the population and strongly influencethe economy, especially the labour market and the capital market. This is why social security is a commonchallenge for all European countries.

42 CFR 403.220 - Supplemental Health Insurance Panel.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Supplemental Health Insurance Panel. 403.220... Programs § 403.220 Supplemental Health Insurance Panel. (a) Membership. The Supplemental Health Insurance... determines whether or not a State regulatory program for Medicare supplemental health insurance policies...

Making Better Re/Insurance Underwriting and Capital Management Decisions with Public-Private-Academic Partnerships

Science.gov (United States)

Michel, G.; Gunasekera, R.; Werner, A.; Galy, H.

2012-04-01

Similar to 2001, 2004, and 2005, 2011 was another year of unexpected international catastrophe events, in which insured losses were more than twice the expected long-term annual average catastrophe losses of USD 30 to 40bn. Key catastrophe events that significantly contributed these losses included the Mw 9.0 Great Tohoku earthquake and tsunami, the Jan. 2011 floods in Queensland, the October 2011 floods in Thailand, the Mw 6.1 Christchurch earthquake and Convective system (Tornado) in United States. However, despite considerable progress in catastrophe modelling, the advent of global catastrophe models, increasing risk model coverage and skill in the detailed modelling, the above mentioned events were not satisfactorily modelled by the current mainstream Re/Insurance catastrophe models. This presentation therefore address problems in models and incomplete understanding identified from recent catastrophic events by considering: i) the current modelling environment, and ii) how the current processes could be improved via: a) the understanding of risk within science networks such as the Willis Research Network, and b) the integration of risk model results from available insurance catastrophe models and tools. This presentation aims to highlight the needed improvements in decision making and market practices, thereby advancing the current management of risk in the Re/Insurance industry. This also increases the need for better integration of Public-Private-Academic partnerships and tools to provide better estimates of not only financial loss but also humanitarian and infrastructural losses as well.

Risk Aversion, Loss Aversion, and the Demand for Insurance

Directory of Open Access Journals (Sweden)

Louis Eeckhoudt

2018-05-01

Full Text Available In this paper we analyze insurance demand when the utility function depends both upon final wealth and the level of losses or gains relative to a reference point. Besides some comparative statics results, we discuss the links with first-order risk aversion, with the Omega measure, and with a tendency to over-insure modest risks that has been been extensively documented in real insurance markets.

Relationship between office-based provider visits and emergency department encounters among publicly-insured adults with epilepsy.

Science.gov (United States)

Lekoubou, Alain; Bishu, Kinfe G; Ovbiagele, Bruce

2018-03-01

The proportion of adults with epilepsy using the emergency department (ED) is high. Among this patient population, increased frequency of office-based provider visits may be associated with lesser frequency of ED encounters, and key patient features may be linked to more ED encounters. We analyzed the Medical Expenditure Panel Survey Household Component (MEPS-HC) dataset for years 2003-2014, which represents a weighted sample of 842,249 publicly-insured US adults aged ≥18years. The Hurdle Poisson model that accommodates excess zeros was used to estimate the association between office-based and ED visits. Annual mean ED and office-based visits for publicly-insured adults with epilepsy were 0.70 and 10.8 respectively. Probability of at least one ED visit was 0.4% higher for every unit of office-based visit. Individuals in the high income category were less likely to visit the ED at least once while women with epilepsy had a higher likelihood of visiting the ED at least once. Among those who visited the ED at least once, there was a 0.3% higher likelihood of visiting the ED for every unit of office-based visit. Among individuals who visited the ED at least once, being aged 45-64years, residing in the West, and the year 2011/14 were associated with higher ED visits. In this representative sample of publicly-insured adults with epilepsy, higher frequency of office visits was not associated with lower ED utilization, which may be due to underlying greater disease severity or propensity for more treatment complications. Copyright © 2018 Elsevier Inc. All rights reserved.

Gaining Public Acceptance: A Critical Strategic Priority of the World Commission on Dams

Directory of Open Access Journals (Sweden)

John Dore

2010-06-01

To earn legitimacy and more likely acceptance of important public decisions we suggest a comprehensive set of 'gold standard' state-society attributes for improving governance. Multi-stakeholder platforms (MSPs can help deliberation to become routine, enabling complex water issues to be more rigorously examined. The combination of increased public trust, earned by the state, and high-quality MSPs to assist more informed negotiations, we see as being key to the gaining of public acceptance.

The case for risk-based premiums in public health insurance.

Science.gov (United States)

Zweifel, Peter; Breuer, Michael

2006-04-01

Uniform, risk-independent insurance premiums are accepted as part of 'managed competition' in health care. However, they are not compatible with optimality of health insurance contracts in the presence of both ex ante and ex post moral hazard. They have adverse effects on insurer behaviour even if risk adjustment is taken into account. Risk-based premiums combined with means-tested, tax-financed transfers are advocated as an alternative.

Life and health insurance industry investments in fast food.

Science.gov (United States)

Mohan, Arun V; McCormick, Danny; Woolhandler, Steffie; Himmelstein, David U; Boyd, J Wesley

2010-06-01

Previous research on health and life insurers' financial investments has highlighted the tension between profit maximization and the public good. We ascertained health and life insurance firms' holdings in the fast food industry, an industry that is increasingly understood to negatively impact public health. Insurers own $1.88 billion of stock in the 5 leading fast food companies. We argue that insurers ought to be held to a higher standard of corporate responsibility, and we offer potential solutions.

Japanese and American public health approaches to preventing population weight gain: A role for paternalism?

Science.gov (United States)

Borovoy, Amy; Roberto, Christina A

2015-10-01

Controlling population weight gain is a major concern for industrialized nations because of associated health risks. Although Japan is experiencing rising prevalence of obesity and overweight, historically they have had and continue to maintain a low prevalence relative to other developed countries. Therefore, Japan provides an interesting case study of strategies to curb population weight gain. In this paper we explore Japanese approaches to obesity and diet through observational and ethnographic interviews conducted between June 2009 and September 2013. Nineteen interviews were conducted at four companies and three schools in Tokyo, as well as at a central Tokyo community health care center and school lunch distribution center. Interviewees included physicians, a Ministry of Health bureaucrat, human resources managers, welfare nurses employed by health insurance organizations, school nurses (also government employees), school nutritionists, and a school counselor. We highlight the role of culture and social norms in encouraging healthful behavior in Japan, focusing on the Ministry of Health, Labor, and Welfare's metabolic syndrome screening program (implemented in 2005) and the Japanese national school lunch program. The Japanese government prescribes optimal body metrics for all Japanese citizens and relies on institutions such as schools and health insurance organizations that are in some instances closely affiliated with the workplace to carry out education. Japan's socio-cultural approach leads us reflect on the cultural and social conditions that make different policy prescriptions more politically feasible and potentially effective. It also provokes us to question whether limited behavioral modifications and "nudging" can lead to broader change in an environment like the United States where there are fewer broadly shared socio-cultural norms regarding acceptable health behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.

Private health insurance and access to healthcare.

Science.gov (United States)

Duggal, Ravi

2011-01-01

The health insurance business in India has seen a growth of over 25% per annum in the last few years with the expansion of the private health insurance sector. The premium incomes of health insurance have crossed the Rs 8,000 crore mark with the share of private companies increasing to over 41%. This is despite the fact that from the perspective of patients, health insurance is not a good deal, especially when they need it most. This raises a number of ethical issues regarding how the health insurance business runs and how medical practice adjusts to it for profiteering. This article uses the personal experience of the author to argue that health insurance in an unregulated environment can only lead to unethical practices, further victimising the patient. Further, publicly financed healthcare which operates in an environment regulating both public and private healthcare provisioning is the only way to assure access to ethical and equitable healthcare to people.

Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-Risk Consumers.

Science.gov (United States)

Cornell, Portia Y; Grabowski, David C; Cohen, Marc; Shi, Xiaomei; Stevenson, David G

2016-08-01

A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance. Project HOPE—The People-to-People Health Foundation, Inc.

The Impact of Children's Public Health Insurance Expansions on Educational Outcomes. NBER Working Paper No. 14671

Science.gov (United States)

Levine, Phillip B.; Schanzenbach, Diane Whitmore

2009-01-01

This paper examines the impact of public health insurance expansions through both Medicaid and SCHIP on children's educational outcomes, measured by 4th and 8th grade reading and math test scores, available from the National Assessment of Educational Progress (NAEP). We use a triple difference estimation strategy, taking advantage of the…

School Superintendents' Perceptions of Schools Assisting Students in Obtaining Public Health Insurance

Science.gov (United States)

Rickard, Megan L.; Price, James H.; Telljohann, Susan K.; Dake, Joseph A.; Fink, Brian N.

2011-01-01

Background: Superintendents' perceptions regarding the effect of health insurance status on academics, the role schools should play in the process of obtaining health insurance, and the benefits/barriers to assisting students in enrolling in health insurance were surveyed. Superintendents' basic knowledge of health insurance, the link between…

Confidence in public institutions: A focus group study on views on the Swedish Social Insurance Agency.

Science.gov (United States)

Holmgren, K; Rosstorp, F; Rohdén, H

2016-09-27

From a public health perspective among the working population, it is very important that confidence in the welfare system is high, ensuring the citizens economic security and protecting them from economic stress when falling ill. The aim of this study was to explore how people with experience of health insurance perceive their confidence in the Swedish Social Insurance Agency (SSIA). Eight focus groups (n = 41) were conducted and each group met on one occasion. The participants described a systemic change in the work of the SSIA where the rule-of-law was disregarded, with arbitrary assessment, and no transparency. The reception by the SSIA shaped the image of the SSIA. The participants described vulnerability in relation to the SSIA. They felt mistrusted, which left a feeling of impotence that worsened their health. Experiencing vulnerability left a strong impression and affected the participants' confidence negatively. The following has to be acknowledged to prevent clients from experiencing impaired health, promote return-to-work possibilities, and to push public confidence in the institution in a more positive direction: Politicians and public administrators need to clarify the regulations. The decision-making process needs to be transparent and just. The entire procedure, including continuity as well as a personal, nice reception, has to be ensured.

Does autonomization of public hospitals and exposure to market pressure complement or debilitate social health insurance systems? Evidence from a low-income country.

Science.gov (United States)

Sepehri, Ardeshir

2014-01-01

Granting public hospitals greater autonomy and creating organizational arrangements that mimic the private sector and encourage competition is often promoted as a way to increase efficiency and public accountability and to improve quality of care at these facilities. The existence of good-quality health infrastructure, in turn, encourages the population to join and support the social health insurance system and achieve universal coverage. This article provides a critical review of hospital autonomization, using Vietnam's experience to assess the influence of hospital autonomy on the sustainability of Vietnam's social health insurance. The evidence suggests that a reform process based on greater autonomy of resource mobilization and on the retention and use of own-source revenues can create perverse incentives among managers and health care providers, leading to the development of a two-tiered provision of clinical care, provider-induced supply of an inefficient service mix, a high degree of duplication, wasteful investment, and cost escalation. Rather than complementing social health insurance and helping the country to achieve universal coverage, granting public hospitals greater autonomy that mimics the private sector may indeed undermine the legitimacy and sustainability of social health insurance as health care costs escalate and higher quality of care remains elusive.

Nuclear liability insurance: a resume of recent years

International Nuclear Information System (INIS)

Marrone, J.

1975-01-01

The nuclear liability-insurance pools have steadily increased nuclear liability insurance available to the nuclear industry to its present $125 million, which is more than double the $60 million first provided in 1957. The insurance pools also provide an additional $175 million of all-risk property insurance to protect against loss of property at a nuclear facility, for a total of $300 million. This amount of liability and property insurance available for nuclear risks exceeds the coverage the insurance industry has at risk anywhere on a single unit of risk, thus attesting to the confidence in nuclear safety. The extraordinary safety achieved and recorded by the loss experience of the nuclear pools is described. The insurance pools have proposed a change in the Price--Anderson Act which would provide substantial additional sums of nuclear liability insurance to protect the public and which is likely to be the subject of examination by Congress during 1975. The proposal, if implemented, will gradually increase the protection afforded to the public and virtually eliminate the role of government indemnity. (auth)

Understanding the Political Economy of the Evolution and Future of Single-Payer Public Health Insurance in Canada (Technical Paper

Directory of Open Access Journals (Sweden)

J.C. Herbert Emery

2010-02-01

Full Text Available Surprisingly little attention has been paid to how we pay for health care affects how much we spend on health care. In this paper, the author discusses how non-contributory finance and effective subsidization of public health care spending with federal cost sharing crowded out demand for private insurance as voters opted for high levels of public health spending.

Investigating the risk reduction potential of disaster insurance across Europe

NARCIS (Netherlands)

Surminski, Swenja; Hudson, Paul

2017-01-01

The notion that insurance can play a significant role in risk reduction has recently gained increasing attention in the wake of rising losses from natural disasters. While this notion is accepted in theory, we notice that, in practice, little is known about if and how insurance promotes efforts to

MANAGEMENT ACCOUNTING SYSTEM OF PUBLIC OFF-BUDGET FUNDS AS AN INFORMATIONAL BASIS FOR PUBLIC INSURANCE MECHANISMS FORMATION (CASE STUDY OF FEDERAL COMPULSORY MEDICAL INSURANCE FUND

Directory of Open Access Journals (Sweden)

Anatoly A. Kozlov

2014-01-01

Full Text Available The article justifies the introduced proposals for a management accounting of theFederal Compulsory Medical InsuranceFund formation and the characteristics and principles of management accounting forms for the analysis of the territorialcompulsory medical insurance programs.

Examining the potential of information technology to improve public insurance application processes: enrollee assessments from a concurrent mixed method analysis.

Science.gov (United States)

Mishra, Abhay Nath; Ketsche, Patricia; Marton, James; Snyder, Angela; McLaren, Susan

2014-01-01

To assess the perceived readiness of Medicaid and Children's Health Insurance Program (CHIP) enrollees to use information technologies (IT) in order to facilitate improvements in the application processes for these public insurance programs. We conducted a concurrent mixed method study of Medicaid and CHIP enrollees in a southern state. We conducted focus groups to identify enrollee concerns regarding the current application process and their IT proficiency. Additionally, we surveyed beneficiaries via telephone about their access to and use of the Internet, and willingness to adopt IT-enabled processes. 2013 households completed the survey. We used χ(2) analysis for comparisons across different groups of respondents. A majority of enrollees will embrace IT-enabled enrollment, but a small yet significant group continues to lack access to facilitating technologies. Moreover, a segment of beneficiaries in the two programs continues to place a high value on personal interactions with program caseworkers. IT holds the promise of improving efficiency and reducing barriers for enrollees, but state and federal agencies managing public insurance programs need to ensure access to traditional processes and make caseworkers available to those who require and value such assistance, even after implementing IT-enabled processes. The use of IT-enabled processes is essential for effectively managing eligibility and enrollment determinations for public programs and private plans offered through state or federally operated exchanges. However, state and federal officials should be cognizant of the technological readiness of recipients and provide offline help to ensure broad participation in the insurance market. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The effect of copayments for prescriptions on adherence to prescription medicines in publicly insured populations; a systematic review and meta-analysis.

Science.gov (United States)

Sinnott, Sarah-Jo; Buckley, Claire; O'Riordan, David; Bradley, Colin; Whelton, Helen

2013-01-01

Copayments are intended to decrease third party expenditure on pharmaceuticals, particularly those regarded as less essential. However, copayments are associated with decreased use of all medicines. Publicly insured populations encompass some vulnerable patient groups such as older individuals and low income groups, who may be especially susceptible to medication non-adherence when required to pay. Non-adherence has potential consequences of increased morbidity and costs elsewhere in the system. To quantify the risk of non-adherence to prescribed medicines in publicly insured populations exposed to copayments. The population of interest consisted of cohorts who received public health insurance. The intervention was the introduction of, or an increase, in copayment. The outcome was non-adherence to medications, evaluated using objective measures. Eight electronic databases and the grey literature were systematically searched for relevant articles, along with hand searches of references in review articles and the included studies. Studies were quality appraised using modified EPOC and EHPPH checklists. A random effects model was used to generate the meta-analysis in RevMan v5.1. Statistical heterogeneity was assessed using the I(2) test; p>0.1 indicated a lack of heterogeneity. Seven out of 41 studies met the inclusion criteria. Five studies contributed more than 1 result to the meta-analysis. The meta-analysis included 199,996 people overall; 74,236 people in the copayment group and 125,760 people in the non-copayment group. Average age was 71.75 years. In the copayment group, (verses the non-copayment group), the odds ratio for non-adherence was 1.11 (95% CI 1.09-1.14; P = medicines in publicly insured populations where copayments for medicines are necessary. Policy-makers should be wary of potential negative clinical outcomes resulting from non-adherence, and also possible knock-on economic repercussions.

The Inequity of Bariatric Surgery: Publicly Insured Patients Undergo Lower Rates of Bariatric Surgery with Worse Outcomes.

Science.gov (United States)

Hennings, Dietric L; Baimas-George, Maria; Al-Quarayshi, Zaid; Moore, Rachel; Kandil, Emad; DuCoin, Christopher G

2018-01-01

Bariatric surgery has been shown to be the most effective method of achieving weight loss and alleviating obesity-related comorbidities. Yet, it is not being used equitably. This study seeks to identify if there is a disparity in payer status of patients undergoing bariatric surgery and what factors are associated with this disparity. We performed a case-control analysis of National Inpatient Sample. We identified adults with body mass index (BMI) greater than or equal to 25 kg/m 2 who underwent bariatric surgery and matched them with overweight inpatient adult controls not undergoing surgery. The sample was analyzed using multivariate logistic regression. We identified 132,342 cases, in which the majority had private insurance (72.8%). Bariatric patients were significantly more likely to be privately insured than any other payer status; Medicare- and Medicaid-covered patients accounted for a low percentage of cases (Medicare 5.1%, OR 0.33, 95% CI 0.29-0.37, p bariatric surgery had an increased risk of complications compared to privately insured patients. Publicly insured patients are significantly less likely to undergo bariatric surgery. As a group, these patients experience higher rates of obesity and related complications and thus are most in need of bariatric surgery.

Distribution channels of insurance and reinsurance services

Directory of Open Access Journals (Sweden)

Njegomir Vladimir

2007-01-01

Full Text Available Insurance and reinsurance industry is famous for its traditionalism, that is uninventiveness and neglecting of marketing as business concept and function and by doing so, neglecting opportunities for optimal combination of different distribution channels. However, having in mind Drucker's thesis that only marketing and innovations produce results and that everything else are costs, that applies to all businesses including insurance and reinsurance companies, it is clear that they need to change their way of managing business. Keeping current and attracting new customers, by using optimal combination of marketing mix elements and within its scope by creating optimal mix of distribution channels, as business requirement and objective of insurance and reinsurance companies with strong marketing orientation that leads them to fulfillment of primary objective of their existence - making profit, is becoming specially emphasized with opening of domestic insurance and reinsurance market to foreign competitors with long history of gaining high level of customers' loyalty. Besides that, issues of successful distribution channels' management of insurance and reinsurance services are not treated holistically in domestic literature. Distribution channels of insurance and reinsurance services, as this study shows, are of critical importance for business success of insurance and reinsurance companies.

Predictors of Language Gains among School-Age Children with Language Impairment in the Public Schools

Science.gov (United States)

Justice, Laura M.; Jiang, Hui; Logan, Jessica A.; Schmitt, Mary Beth

2017-01-01

Purpose: This study aimed to identify child-level characteristics that predict gains in language skills for children with language impairment who were receiving therapy within the public schools. The therapy provided represented business-as-usual speech/language treatment provided by speech-language pathologists in the public schools. Method: The…

The role of retiree health insurance in the early retirement of public sector employees.

Science.gov (United States)

Shoven, John B; Slavov, Sita Nataraj

2014-12-01

Most government employees have access to retiree health coverage, which provides them with group health coverage even if they retire before Medicare eligibility. We study the impact of retiree health coverage on the labor supply of public sector workers between the ages of 55 and 64. We find that retiree health coverage raises the probability of stopping full time work by 4.3 percentage points (around 38 percent) over two years among public sector workers aged 55-59, and by 6.7 percentage points (around 26 percent) over two years among public sector workers aged 60-64. In the younger age group, retiree health insurance mostly seems to facilitate transitions to part-time work rather than full retirement. However, in the older age group, it increases the probability of stopping work entirely by 4.3 percentage points (around 22 percent). Copyright © 2014 Elsevier B.V. All rights reserved.

Social Security Disability Insurance: Essential Protection when Work Incapacity Strikes

Science.gov (United States)

Reno, Virginia P.; Ekman, Lisa D.

2012-01-01

Social Security Disability Insurance (SSDI) is an essential lifeline for millions of Americans. Without it, many families would be in deep financial distress. SSDI is insurance that workers pay for through premiums deducted from their pay. In return, workers gain the right to monthly benefits if a disabling condition ends their capacity to earn a…

The insurance of climatic risks

International Nuclear Information System (INIS)

Pauthier, Alice

2015-06-01

The United Nations Environment Programme assesses that the cost of adaptation to climate change could reach 150 billions dollars per year by 2025-2030 and 500 billions dollars by 2050. This raises the issues of financing of adaptation measures, and of compensations in case of natural disaster, and insurance companies here seem to have a major role to play. However, the modification of the climatic risk puts the viability of conventional insurance mechanisms into question again. While discussing these issues, the author outlines that a sustainable insurance against these evolving risks may threaten insurance companies to go to bankrupt, but also all their policyholders who are, for most of them, unable to cope by themselves with the consequences of an extreme climatic event. The author also discusses related aspects such as risk modelling, risk mutualization, a securing of insurance companies based on the financial market, the implementation of public-private partnership, and ways to insure climate anomalies. She also comments the commitment of the insurance sector in adaptation and mitigation policies

7 CFR 762.123 - Insurance and farm inspection requirements.

Science.gov (United States)

2010-01-01

... requirements. (a) Insurance. (1) Lenders must require borrowers to maintain adequate property, public liability, and crop insurance to protect the lender and Government's interests. (2) By loan closing, applicants must either: (i) Obtain at least the catastrophic risk protection (CAT) level of crop insurance...

Public and private health-care financing with alternate public rationing rules.

Science.gov (United States)

Cuff, Katherine; Hurley, Jeremiah; Mestelman, Stuart; Muller, Andrew; Nuscheler, Robert

2012-02-01

We develop a model to analyze parallel public and private health-care financing under two alternative public sector rationing rules: needs-based rationing and random rationing. Individuals vary in income and severity of illness. There is a limited supply of health-care resources used to treat individuals, causing some individuals to go untreated. Insurers (both public and private) must bid to obtain the necessary health-care resources to treat their beneficiaries. Given individuals' willingnesses-to-pay for private insurance are increasing in income, the introduction of private insurance diverts treatment from relatively poor to relatively rich individuals. Further, the impact of introducing parallel private insurance depends on the rationing mechanism in the public sector. We show that the private health insurance market is smaller when the public sector rations according to need than when allocation is random. Copyright © 2010 John Wiley & Sons, Ltd.

Price--Anderson Act: the insurance industry's view

International Nuclear Information System (INIS)

Marrone, J.

1977-01-01

The insurance industry feels the expense of providing insurance coverage under the Price-Anderson Act is justified because it encouraged development of nuclear power and assured protection for the public in the event of an accident. Insurance pools have been instituted in about 20 countries in order to distribute the risk on a worldwide basis. Changes in the original Act allow an off-site claimant to get compensation with defense waived and provide for the transition of financial responsibility from the public to the private sector. To date the pools have refunded $9.7 of $12.7 million (73 percent) of the premiums to the insured and the remainder has grown into a $45 million fund, which reflects the success of the nuclear industry and the regulatory agencies in establishing a safe record. This record covers 60 power reactors, 50 research and development reactors, waste disposal sites, and about 50 nuclear facilities. With the exception of reactor operators and fuel reprocessors, the insurance is voluntary at premiums ranging from $1000 to $260,000. A total of $600,000 has been paid in claims

Willingness to pay for National Health Insurance Fund among public servants in Juba City, South Sudan: a contingent evaluation.

Science.gov (United States)

Basaza, Robert; Alier, Paul Kon; Kirabira, Peter; Ogubi, David; Lako, Richard Lino Loro

2017-08-30

This study assessed willingness to pay for National Health Insurance Fund (NHIF) among public servants in Juba City. NHIF is the proposed health insurance scheme for South Sudan and aims at achieving universal health coverage for the entire nation's population. One compounding issue is that over the years, governments' spending on healthcare has been decreasing from 8.4% of national budget in 2007 to only 2.2% in 2012. A cross-sectional study design using contingent evaluation was employed; data on willingness to pay was collected from 381 randomly selected respondents and 13 purposively selected key informants working for the national, state and Juba County in September 2015. Qualitative data were analysed using conceptual content analysis. T-tests and linear regressions were performed to determine association between WTP for NHIF and independent variables. Up to 381 public servants were interviewed, of which 68% indicated willingness to pay varying percentages of total monthly individual income for NHIF. Over two-thirds (67.8%) of those willing to pay could pay up to 5% of their total monthly income, 22.9% could pay up to 10% and the rest could pay 25%. Over 80% were willing to pay up to 50 SSP (1 USD = 10 SSP) premiums for medical consultation, laboratory services and drugs. The main factors influencing the respondents' decisions were awareness, alternative sources of income, household size, insurance cover and religion. Willingness to pay is mainly influenced by awareness, alternative sources of individual income, household size, insurance cover and religion. Most of the public servants were aware of and willing to pay for NHIF and prefer a premium of up to 5% of total monthly income. There is need to create awareness and reach out to those who do not know about the scheme in addition to a detailed analysis of other stakeholders. Consideration could be made by the Government of South Sudan to start the scheme at the earliest opportunity since the majority of

School Insurance: Managing the Local Program. Bulletin, 1959, No. 23

Science.gov (United States)

Finchum, R. N.; Viles, N. E.

1959-01-01

This study is the second in a series of publications by the Office of Education on school insurance. Data for this study were adapted from many sources. Among these sources were books of a technical nature, professional magazine articles, State insurance guides, research studies, insurance rating schedules, insurance company bulletins, and…

Incentive and insurance effects of income taxation

DEFF Research Database (Denmark)

Andersen, Torben M.

2015-01-01

the sensitivity of labour supply to taxes, which tends to reduce tax distortions and lower the marginal costs of public funds. The relation between incentives and insurance and thus efficiency and equity is flattened by the insurance effect and it may even be non-monotone. However, the optimal utilitarian policy......Tax distortions cause a trade-off between efficiency and equity. However, taxes not only affect incentives; they also provide implicit insurance, and this may critically affect the efficiency–equity relationship. For a standard labour supply problem it is shown that the insurance effect mutes...

45 CFR 148.122 - Guaranteed renewability of individual health insurance coverage.

Science.gov (United States)

2010-10-01

... insurance coverage. 148.122 Section 148.122 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE INDIVIDUAL HEALTH INSURANCE MARKET... health insurance coverage. (a) Applicability. This section applies to all health insurance coverage in...

Evaluating the influential priority of the factors on insurance loss of public transit

Science.gov (United States)

Su, Yongmin; Chen, Xinqiang

2018-01-01

Understanding correlation between influential factors and insurance losses is beneficial for insurers to accurately price and modify the bonus-malus system. Although there have been a certain number of achievements in insurance losses and claims modeling, limited efforts focus on exploring the relative role of accidents characteristics in insurance losses. The primary objective of this study is to evaluate the influential priority of transit accidents attributes, such as the time, location and type of accidents. Based on the dataset from Washington State Transit Insurance Pool (WSTIP) in USA, we implement several key algorithms to achieve the objectives. First, K-means algorithm contributes to cluster the insurance loss data into 6 intervals; second, Grey Relational Analysis (GCA) model is applied to calculate grey relational grades of the influential factors in each interval; in addition, we implement Naive Bayes model to compute the posterior probability of factors values falling in each interval. The results show that the time, location and type of accidents significantly influence the insurance loss in the first five intervals, but their grey relational grades show no significantly difference. In the last interval which represents the highest insurance loss, the grey relational grade of the time is significant higher than that of the location and type of accidents. For each value of the time and location, the insurance loss most likely falls in the first and second intervals which refers to the lower loss. However, for accidents between buses and non-motorized road users, the probability of insurance loss falling in the interval 6 tends to be highest. PMID:29298337

The effect of copayments for prescriptions on adherence to prescription medicines in publicly insured populations; a systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Sarah-Jo Sinnott

Full Text Available INTRODUCTION: Copayments are intended to decrease third party expenditure on pharmaceuticals, particularly those regarded as less essential. However, copayments are associated with decreased use of all medicines. Publicly insured populations encompass some vulnerable patient groups such as older individuals and low income groups, who may be especially susceptible to medication non-adherence when required to pay. Non-adherence has potential consequences of increased morbidity and costs elsewhere in the system. OBJECTIVE: To quantify the risk of non-adherence to prescribed medicines in publicly insured populations exposed to copayments. METHODS: The population of interest consisted of cohorts who received public health insurance. The intervention was the introduction of, or an increase, in copayment. The outcome was non-adherence to medications, evaluated using objective measures. Eight electronic databases and the grey literature were systematically searched for relevant articles, along with hand searches of references in review articles and the included studies. Studies were quality appraised using modified EPOC and EHPPH checklists. A random effects model was used to generate the meta-analysis in RevMan v5.1. Statistical heterogeneity was assessed using the I(2 test; p>0.1 indicated a lack of heterogeneity. RESULTS: Seven out of 41 studies met the inclusion criteria. Five studies contributed more than 1 result to the meta-analysis. The meta-analysis included 199,996 people overall; 74,236 people in the copayment group and 125,760 people in the non-copayment group. Average age was 71.75 years. In the copayment group, (verses the non-copayment group, the odds ratio for non-adherence was 1.11 (95% CI 1.09-1.14; P = <0.00001. An acceptable level of heterogeneity at I(2 = 7%, (p = 0.37 was observed. CONCLUSION: This meta-analysis showed an 11% increased odds of non-adherence to medicines in publicly insured populations where copayments

Hospital-insurer bargaining: an empirical investigation of appendectomy pricing.

Science.gov (United States)

Brooks, J M; Dor, A; Wong, H S

1997-08-01

Employers' increased sensitivity to health care costs has forced insurers to seek ways to lower costs through effective bargaining with providers. What factors determine the prices negotiated between hospitals and insurers? The hospital-insurer interaction is captured in the context of a bargaining model, in which the gains from bargaining are explicitly defined. Appendectomy was chosen because it is a well-defined procedure with little clinical variation. Our results show that certain hospital institutional arrangements (e.g. hospital affiliations), HMO penetration, and greater hospital concentration improve hospitals' bargaining position. Furthermore, hospitals' bargaining effectiveness has diminished over time and varies across states.

Measuring colorectal cancer care quality for the publicly insured in New York State

International Nuclear Information System (INIS)

Sinclair, Amber H; Schymura, Maria J; Boscoe, Francis P; Yung, Rachel L; Chen, Kun; Roohan, Patrick; Tai, Eric; Schrag, Deborah

2012-01-01

The extent to which concordance with colorectal cancer treatment quality metrics varies by patient characteristics in the publicly insured is not well understood. Our objective was to evaluate the quality of colorectal cancer care for publicly insured residents of New York State (NYS). NYS cancer registry data were linked to Medicaid and Medicare claims and hospital discharge data. We identified colorectal cancer cases diagnosed from 2004 through 2006 and evaluated three treatment quality measures: adjuvant chemotherapy within 4 months of diagnosis for American Joint Cancer Committee (AJCC) stage III colon cancer, adjuvant radiation within 6 months of diagnosis for AJCC stage IIB or III rectal cancer, and adjuvant chemotherapy within 9 months of diagnosis for AJCC stage II–III rectal cancer. Concordance with guidelines was evaluated separately for Medicaid-enrollees under age 65 years and Medicare-enrollees aged 65–79 years. For adjuvant chemotherapy for colon cancer, 79.4% (274/345) of the Medicaid cohort and 71.8% (585/815) of the Medicare cohort were guideline concordant. For adjuvant radiation for rectal cancer, 72.3% (125/173) of the Medicaid cohort and 66.9% (206/308) of the Medicare cohort were concordant. For adjuvant chemotherapy for rectal cancer, 89.5% (238/266) of the Medicaid cohort and 76.0% (392/516) of the Medicare cohort were concordant. Younger age was associated with higher adjusted odds of concordance for all three measures in the Medicare cohort. Racial differences were not evident in either cohort. There is room for improvement in concordance with accepted metrics of cancer care quality. Feedback about performance may assist in targeting efforts to improve care

Sustainability of recurrent expenditure on public social welfare programmes: expenditure analysis of the free maternal care programme of the Ghana National Health Insurance Scheme.

Science.gov (United States)

Ankrah Odame, Emmanuel; Akweongo, Patricia; Yankah, Ben; Asenso-Boadi, Francis; Agyepong, Irene

2014-05-01

Sustainability of public social welfare programmes has long been of concern in development circles. An important aspect of sustainability is the ability to sustain the recurrent financial costs of programmes. A free maternal care programme (FMCP) was launched under the Ghana National Health Insurance Scheme (NHIS) in 2008 with a start-up grant from the British Government. This article examines claims expenditure under the programme and the implications for the financial sustainability of the programme, and the lessons for donor and public financing of social welfare programmes. Records of reimbursement claims for services and medicines by women benefitting from the policy in participating facilities in one sub-metropolis in Ghana were analysed to gain an understanding of the expenditure on this programme at facility level. National level financial inflow and outflow (expenditure) data of the NHIS, related to implementation of this policy for 2008 and 2009, were reviewed to put the facility-based data in the national perspective. A total of US$936 450.94 was spent in 2009 by the scheme on FMCP in the sub-metropolis. The NHIS expenditure on the programme for the entire country in 2009 was US$49.25 million, exceeding the British grant of US$10.00 million given for that year. Subsequently, the programme has been entirely financed by the National Health Insurance Fund. The rapidly increasing, recurrent demands on this fund from the maternal delivery exemption programme-without a commensurate growth on the amounts generated annually-is an increasing threat to the sustainability of the fund. Provision of donor start-up funding for programmes with high recurrent expenditures, under the expectation that government will take over and sustain the programme, must be accompanied by clear long-term analysis and planning as to how government will sustain the programme.

American nuclear insurers

International Nuclear Information System (INIS)

Oliveira, R.A.

1988-01-01

Nuclear liability insurance covers liability for damages directly caused by the nuclear energy hazard. This coverage includes offsite bodily injury and property damage sustained by members of the general public, and bodily injury to onsite third party personnel. Recent nuclear liability claims allege bodily injury and property damage resulting from releases or radioactive materials to the environmental and occupational radiation worker exposures. Routine reactor operations involving radioactive waste have the potential to result in such claims. The nuclear insurance Pools believe that one way such claims can be minimized is through the implementation of an effective radioactive waste management program

How Does Retiree Health Insurance Influence Public Sector Employee Saving?

OpenAIRE

Robert Clark; Olivia S. Mitchell

2013-01-01

Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided r...

75 FR 58468 - Terrorism Risk Insurance Program; Program Loss Reporting

Science.gov (United States)

2010-09-24

... DEPARTMENT OF THE TREASURY Terrorism Risk Insurance Program; Program Loss Reporting AGENCY: Departmental Offices, Terrorism Risk Insurance Program Office, Treasury. ACTION: Notice and request for... 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A)). Currently, the Terrorism Risk Insurance Program...

42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).

Science.gov (United States)

2010-10-01

... Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b... coordination between a State child health program and other public health insurance programs. (b) Obligations...

An extended cost-effectiveness analysis of schizophrenia treatment in India under universal public finance.

Science.gov (United States)

Raykar, Neha; Nigam, Aditi; Chisholm, Dan

2016-01-01

Schizophrenia remains a priority condition in mental health policy and service development because of its early onset, severity and consequences for affected individuals and households. This paper reports on an 'extended' cost-effectiveness analysis (ECEA) for schizophrenia treatment in India, which seeks to evaluate through a modeling approach not only the costs and health effects of intervention but also the consequences of a policy of universal public finance (UPF) on health and financial outcomes across income quintiles. Using plausible values for input parameters, we conclude that health gains from UPF are concentrated among the poorest, whereas the non-health gains in the form of out-of-pocket private expenditures averted due to UPF are concentrated among the richest income quintiles. Value of insurance is the highest for the poorest quintile and declines with income. Universal public finance can play a crucial role in ameliorating the adverse economic and social consequences of schizophrenia and its treatment in resource-constrained settings where health insurance coverage is generally poor. This paper shows the potential distributional and financial risk protection effects of treating schizophrenia.

Should Governments engage health insurance intermediaries? A comparison of benefits with and without insurance intermediary in a large tax funded community health insurance scheme in the Indian state of Andhra Pradesh.

Science.gov (United States)

Nagulapalli, Srikant; Rokkam, Sudarsana Rao

2015-09-10

A peculiar phenomenon of engaging insurance intermediaries for government funded health insurance schemes for the poor, not usually found globally, is gaining ground in India. Rajiv Aarogyasri Scheme launched in the Indian state of Andhra Pradesh, is first largest tax funded community health insurance scheme in the country covering more than 20 million poor families. Aarogyasri Health Care Trust (trust), the scheme administrator, transfers funds to hospitals through two routes one, directly and the other through an insurance intermediary. The objective of this paper is to find out if engaging an insurance intermediary has any effect on cost efficiency of the insurance scheme. We used payment data of RAS for the period 2007-12, to find out the influence of insurance intermediary on the two variables, benefit cost ratio defined as benefit payment divided by premium payment, and claim denial ratio defined as benefit payment divided by treatment cost. Relationship between scheme expenditure and number of beds empanelled under the scheme is examined. OLS regression is used to perform all analyses. We found that adding an additional layer of insurance intermediary between the trust and hospitals reduced the benefit cost ratio under the scheme by 12.2% (p-value = 0.06). Every addition of 100 beds under the scheme increases the scheme payments by US$ 0.75 million (p-value insurance and trust modes narrowed down from 2.84% in government hospitals to 0.41% in private hospitals (p-value insurance intermediary has the twin effects of reduction in benefit payments to beneficiaries, and chocking fund flow to government hospitals. The idea of engaging insurance intermediary should be abandoned.

Evaluating the Impact of Health Insurance Industry Consolidation: Learning from Experience.

Science.gov (United States)

Dafny, Leemore S

2015-11-01

Research shows consolidation in the private health insurance industry leads to premium increases, even though insurers with larger local market shares generally obtain lower prices from health care providers. Additional research is needed to understand how to protect against harms and unlock benefits from scale. Data on enrollment, premiums, and costs of commercial health insurance--by insurer, plan, customer segment, and local market--would help us understand whether, when, and for whom consolidation is harmful or beneficial. Such transparency is common where there is a strong public interest and substantial public regulation, both of which characterize this vital sector.

Risk segmentation in Chilean social health insurance.

Science.gov (United States)

Hidalgo, Hector; Chipulu, Maxwell; Ojiako, Udechukwu

2013-01-01

The objective of this study is to identify how risk and social variables are likely to be impacted by an increase in private sector participation in health insurance provision. The study focuses on the Chilean health insurance industry, traditionally dominated by the public sector. Predictive risk modelling is conducted using a database containing over 250,000 health insurance policy records provided by the Superintendence of Health of Chile. Although perceived with suspicion in some circles, risk segmentation serves as a rational approach to risk management from a resource perspective. The variables that have considerable impact on insurance claims include the number of dependents, gender, wages and the duration a claimant has been a customer. As shown in the case study, to ensure that social benefits are realised, increased private sector participation in health insurance must be augmented by regulatory oversight and vigilance. As it is clear that a "community-rated" health insurance provision philosophy impacts on insurance firm's ability to charge "market" prices for insurance provision, the authors explore whether risk segmentation is a feasible means of predicting insurance claim behaviour in Chile's private health insurance industry.

Global warming and the insurance industry

Science.gov (United States)

Berz, G. A.

1992-06-01

In the last few decades, the international insurance industry has been confronted with a drastic increase in the scope and frequency of great natural disasters. The trend is primarily attributable to the continuing steady growth of the world population and the increasing concentration of people and economic values in urban areas. An additional factor is the global migration of populations and industries into areas like the coastal regions which are particularly exposed to natural hazards. The natural hazards themselves, on the other hand, have not yet shown any significant increase. In addition to the problems the insurance industry has with regard to pricing, capacity and loss reserves, the assessment of insured liabilities, preventive planning and the proper adjustment of catastrophe losses are gaining importance. The present problems will be dramatically aggravated if the greenhouse predictions come true. The increased intensity of all convective processes in the atmosphere will force up the frequency and severity of tropical cyclones, tornados, hailstorms, floods and storm surges in many parts of the world with serious consequences for all types of property insurance. Rates will have to be raised and in certain coastal areas insurance coverage will only be available after considerable restrictions have been imposed, e.g., significant deductibles and/or liability or loss limits. In areas of high insurance density the loss potential of individual catastrophes can reach a level where the national and international insurance industries run into serious capacity problems. Recent disasters showed the disproportionately high participation of reinsurers in extreme disaster losses and the need for more risk transparency if the insurance industry is to fulfill its obligations in an increasingly hostile environment.

Earthquake insurance pricing: a risk-based approach.

Science.gov (United States)

Lin, Jeng-Hsiang

2018-04-01

Flat earthquake premiums are 'uniformly' set for a variety of buildings in many countries, neglecting the fact that the risk of damage to buildings by earthquakes is based on a wide range of factors. How these factors influence the insurance premiums is worth being studied further. Proposed herein is a risk-based approach to estimate the earthquake insurance rates of buildings. Examples of application of the approach to buildings located in Taipei city of Taiwan were examined. Then, the earthquake insurance rates for the buildings investigated were calculated and tabulated. To fulfil insurance rating, the buildings were classified into 15 model building types according to their construction materials and building height. Seismic design levels were also considered in insurance rating in response to the effect of seismic zone and construction years of buildings. This paper may be of interest to insurers, actuaries, and private and public sectors of insurance. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

The Changing Dynamics Of US Health Insurance And Implications For The Future Of The Affordable Care Act.

Science.gov (United States)

Graves, John A; Nikpay, Sayeh S

2017-02-01

The introduction of Medicaid expansions and state Marketplaces under the Affordable Care Act (ACA) have reduced the uninsurance rate to historic lows, changing the choices Americans make about coverage. In this article we shed light on these changing dynamics. We drew upon multistate transition models fit to nationally representative longitudinal data to estimate coverage transition probabilities between major insurance types in the years leading up to and including 2014. We found that the ACA's unprecedented coverage changes increased transitions to Medicaid and nongroup coverage among the uninsured, while strengthening the existing employer-sponsored insurance system and improving retention of public coverage. However, our results suggest possible weakness of state Marketplaces, since people gaining nongroup coverage were disproportionately older than other potential enrollees. We identified key opportunities for policy makers and insurers to improve underlying Marketplace risk pools by focusing on people transitioning from employer-sponsored coverage; these people are disproportionately younger and saw almost no change in their likelihood of becoming uninsured in 2014 compared to earlier years. Project HOPE—The People-to-People Health Foundation, Inc.

45 CFR 86.39 - Health and insurance benefits and services.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Health and insurance benefits and services. 86.39... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 86.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service...

Survey of social health insurance structure in selected countries; providing framework for basic health insurance in Iran.

Science.gov (United States)

Mohammadi, Effat; Raissi, Ahmad Reza; Barooni, Mohsen; Ferdoosi, Massoud; Nuhi, Mojtaba

2014-01-01

Health system reforms are the most strategic issue that has been seriously considered in healthcare systems in order to reduce costs and increase efficiency and effectiveness. The costs of health system finance in our country, lack of universal coverage in health insurance, and related issues necessitate reforms in our health system financing. The aim of this research was to prepare a structure of framework for social health insurance in Iran and conducting a comparative study in selected countries with social health insurance. This comparative descriptive study was conducted in three phases. The first phase of the study examined the structure of health social insurance in four countries - Germany, South Korea, Egypt, and Australia. The second phase was to develop an initial model, which was designed to determine the shared and distinguishing points of the investigated structures, for health insurance in Iran. The third phase was to validate the final research model. The developed model by the Delphi method was given to 20 professionals in financing of the health system, health economics and management of healthcare services. Their comments were collected in two stages and its validity was confirmed. The study of the structure of health insurance in the selected countries shows that health social insurance in different countries have different structures. Based on the findings of the present study, the current situation of the health system, and the conducted surveys, the following framework is suitable for the health social insurance system in Iran. The Health Social Insurance Organization has a unique service by having five funds of governmental employees, companies and NGOs, self-insured, villagers, and others, which serves as a nongovernmental organization under the supervision of public law and by decision- and policy-making of the Health Insurance Supreme Council. Membership in this organization is based on the nationality or residence, which the insured by

44 CFR 59.22 - Prerequisites for the sale of flood insurance.

Science.gov (United States)

2010-10-01

... AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program... public inspection and furnish upon request, for the determination of applicable flood insurance risk... Federal, State, and local agencies and private firms which undertake to study, survey, map, and identify...

Duty to provide pre-contractual information of crop insurance

Directory of Open Access Journals (Sweden)

Ivančević Katarina

2016-01-01

Full Text Available Crop insurance is one of the most important types of agricultural insurance. From the aspect of insurance technique, this insurance is very challenging and requires careful drafting of insurance terms and tariffs. This type of insurance can provide security to farmers in case of financial losses caused by numerous risks which they are exposed to. Insufficient knowledge of the opportunities that the insurance provides is caused in part by inaccurate and vague explanations that have been offered by insurers in negotiation stage to interested farmers. In this regard, an important novelty in Serbian law is the obligation of contractual information which was introduced by the new Insurance Law (IL. In this way, additional protection to users of the service of insurance in relation to the provisions of the obligation law is provided. The goal of this obligation is to allow a negotiator to gain a clear idea of the essential elements of the insurance contract, to consider the proposed coverage and make a reasonable decision whether to accept the conclusion of the insurance contract or not, i.e. under what conditions it should be concluded. Sanctions for failure in the obligation to inform act preventively and repressively on insurers. The aim of this study is analyse the legal and factual position of the service beneficiaries in terms of obligation of economically and experientially superior contractor of lawful and full information of a policyholder prior to the conclusion of an insurance contract in a very specific branch of insurance, such as crop insurance. The application of inductive-deductive and comparative-legal research method, points to certain doctrinal and normative solutions from other legal systems, legal provisions applicable in the law of the Republic of Serbia are critically set out, as well as the daily practice of insurance companies.

Flood risk and insurance loss potential in the Thames Gateway

Science.gov (United States)

Eldridge, J.; Horn, D.

2009-04-01

The Thames Gateway, currently Europe's largest regeneration project, is an area of redevelopment located in the South East of England, with Government plans to create up to 160,000 new homes and 180,000 new jobs by 2016. Although the new development is intended to contribute £12bn annually to the economy, the potential flood risk is high, with much of the area situated on Thames tidal floodplain and vulnerable to both storm surges and peak river flows. This poses significant hazard to those inhabiting the area and has raised concern amongst the UK insurance industry, who would be liable for significant financial claims if a large flood event were to occur, particularly with respect to the number of new homes and businesses being built in flood risk areas. Flood risk and the potential damage to both lives and assets in vulnerable areas have gained substantial recognition, in light of recent flooding events, from both governmental agencies and in the public's awareness of flood hazard. This has resulted in a change in UK policy with planning policy for flood risk (PPS25, Planning Policy Statement 25) adopting a more strategic approach to development, as well as a new Flooding and Water Bill which is due for consultation in 2009. The Government and the Association of British Insurers, who represent the UK insurance industry, have also recently changed their Statement of Principles which guides provision of flood insurance in the future. This PhD research project aims to quantify flood risk in the Thames Gateway area with a view to evaluating the insurance loss potential under different insurance and planning scenarios. Using current sources of inundation extent, and incorporating varying insurance penetration rates and degrees of adoption of planning policy and guidance, it focuses on estimating flood risk under these different scenarios. This presentation introduces the development of the project and the theory and methodology which will be used to address the

The impact of CHIP premium increases on insurance outcomes among CHIP eligible children.

Science.gov (United States)

Nikolova, Silviya; Stearns, Sally

2014-03-03

Within the United States, public insurance premiums are used both to discourage private health policy holders from dropping coverage and to reduce state budget costs. Prior research suggests that the odds of having private coverage and being uninsured increase with increases in public insurance premiums. The aim of this paper is to test effects of Children's Health Insurance Program (CHIP) premium increases on public insurance, private insurance, and uninsurance rates. The fact that families just below and above a state-specific income cut-off are likely very similar in terms of observable and unobservable characteristics except the premium contribution provides a natural experiment for estimating the effect of premium increases. Using 2003 Medical Expenditure Panel Survey (MEPS) merged with CHIP premiums, we compare health insurance outcomes for CHIP eligible children as of January 2003 in states with a two-tier premium structure using a cross-sectional regression discontinuity methodology. We use difference-in-differences analysis to compare longitudinal insurance outcomes by December 2003. Higher CHIP premiums are associated with higher likelihood of private insurance. Disenrollment from CHIP in response to premium increases over time does not increase the uninsurance rate. When faced with higher CHIP premiums, private health insurance may be a preferable alternative for CHIP eligible families with higher incomes. Therefore, competition in the insurance exchanges being formed under the Affordable Care Act could enhance choice.

45 CFR 618.440 - Health and insurance benefits and services.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Health and insurance benefits and services. 618....440 Health and insurance benefits and services. Subject to § 618.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

36 CFR 1211.440 - Health and insurance benefits and services.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Health and insurance benefits... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

45 CFR 2555.440 - Health and insurance benefits and services.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

43 CFR 41.440 - Health and insurance benefits and services.

Science.gov (United States)

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Health and insurance benefits and services... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 41.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

PARAMETRIC INSURANCE COVER FOR NATURAL CATASTROPHE RISKS

Directory of Open Access Journals (Sweden)

Serghei Margulescu

2013-11-01

Full Text Available With economic losses of over USD 370 bn caused by 325 catastrophic events, 2011 ranks as the worst ever year in terms of costs to society due to natural catastrophes and man-made disasters. Inthe same time, 2011 is the second most expensive year in the history for the insurance industry, with insured losses from catastrophic events amounting to USD 116 bn. Both the high level of damages and insured losses, as well as the unprecedented gap between the two values, made insurers and reinsurers worldwide to understand that some risks had so far been underestimated and they have to be better integrated in the catastrophes modelling.On the other hand, governments have to protect themselves against the financial impact of natural catastrophes and new forms of cooperation between the public and private sectors can help countries finance disaster risks. Viewed in a country’s wider risk management context, the purchase of parametric insurance cover, which transfers natural catastrophe risk to the private sector using an index- based trigger, is a necessary shift towards a pre-emptive risk management strategy. This kind of approach can be pursued by central governments or at the level of provincial or municipal governments, and a number of case studies included in the publication “Closing the financial gap” by Swiss Re (2011 illustrates how new forms of parametric insurance can help countries finance disaster risks.

Gaining public acceptance for nuclear power: the Philippine approach

International Nuclear Information System (INIS)

Ibe, L.D.; Remedios, A.; Savelano, M.P.A.

1977-01-01

This article describes the strategy adopted by the Philippine Atomic Energy Commisssion (PAEC) to gain acceptance for the country's nuclear power program. It explores the various dimensions of Philippine society that affects the attainment of this objective, including cultural obstacles typical of a developing nation. Points of controversy regarding the introduction of nuclear power are identified as are likely change agents in the process of transformation of public reactions of hostility and indifference to general acceptance. The PAEC outreach information program for the nuclear power project has been directed at - the policy makers to persuade them to give maximum support to the project through its integration into the country's development strategy; - the facilitating administrative agencies to provide adequate resources for the project; - the implementing agencies including those in supportive technology, research and training to recognize the top priority ranking of nuclear power for their work plans and programs; and; - the end-users and beneficiaries of an adequate power supply. The time frame for the PAEC information campaign spans three stages of the project: Phase I. Planning (including site selection); Phase II. Construction; and Phase III. Operation. The strategy reaches out to all sectors and involves linkages with educational institutions, scientific societies, technological and civic organizations, and such publics as the studentry, professionals and the community as a whole. It utilizes thought leaders and the mass media, both print and broadcast, in addition to PAEC resources, in the generation of favorable public opinion under a planned and systematic effort at mass appeal. Finally, the article describes in detail the PAEC public information delivery system, its organizational structure, components, linkages and activities within the framework of another PAEC mandated function to regulate nuclear facilities

12 CFR Part 745 - SHARE INSURANCE AND APPENDIX

Science.gov (United States)

2010-01-01

... beneficiary includes a natural person as well as a charitable organization and other non-profit entity... government depositors. (a) Public funds invested in Federal credit unions and federally-insured state credit... funds of the United States lawfully investing the same in a federally-insured credit union will be...

20 CFR 404.467 - Nonpayment of benefits; individual entitled to disability insurance benefits or childhood...

Science.gov (United States)

2010-04-01

... type of substantial gainful activity. (b) Childhood disability benefits. An individual who has attained... Nonpayments of Benefits § 404.467 Nonpayment of benefits; individual entitled to disability insurance benefits... definition of disability for disability insurance benefits purposes based on statutory blindness, as defined...

Should Australia Ban the Use of Genetic Test Results in Life Insurance?

Science.gov (United States)

Tiller, Jane; Otlowski, Margaret; Lacaze, Paul

2017-01-01

Under current Australian regulation, life insurance companies can require applicants to disclose all genetic test results, including results from research or direct-to-consumer tests. Life insurers can then use this genetic information in underwriting and policy decisions for mutually rated products, including life, permanent disability, and total income protection insurance. Over the past decade, many countries have implemented moratoria or legislative bans on the use of genetic information by life insurers. The Australian government, by contrast, has not reviewed regulation since 2005 when it failed to ensure implementation of recommendations made by the Australian Law Reform Commission. In that time, the Australian life insurance industry has been left to self-regulate its use of genetic information. As a result, insurance fears in Australia now are leading to deterred uptake of genetic testing by at-risk individuals and deterred participation in medical research, both of which have been documented. As the potential for genomic medicine grows, public trust and engagement are critical for successful implementation. Concerns around life insurance may become a barrier to the development of genomic health care, research, and public health initiatives in Australia, and the issue should be publicly addressed. We argue a moratorium on the use of genetic information by life insurers should be enacted while appropriate longer term policy is determined and implemented.

Should Australia Ban the Use of Genetic Test Results in Life Insurance?

Directory of Open Access Journals (Sweden)

Jane Tiller

2017-12-01

Full Text Available Under current Australian regulation, life insurance companies can require applicants to disclose all genetic test results, including results from research or direct-to-consumer tests. Life insurers can then use this genetic information in underwriting and policy decisions for mutually rated products, including life, permanent disability, and total income protection insurance. Over the past decade, many countries have implemented moratoria or legislative bans on the use of genetic information by life insurers. The Australian government, by contrast, has not reviewed regulation since 2005 when it failed to ensure implementation of recommendations made by the Australian Law Reform Commission. In that time, the Australian life insurance industry has been left to self-regulate its use of genetic information. As a result, insurance fears in Australia now are leading to deterred uptake of genetic testing by at-risk individuals and deterred participation in medical research, both of which have been documented. As the potential for genomic medicine grows, public trust and engagement are critical for successful implementation. Concerns around life insurance may become a barrier to the development of genomic health care, research, and public health initiatives in Australia, and the issue should be publicly addressed. We argue a moratorium on the use of genetic information by life insurers should be enacted while appropriate longer term policy is determined and implemented.

Cancer insurance policies in Japan and the United States.

Science.gov (United States)

Bennett, C L; Weinberg, P D; Lieberman, J J

1998-01-01

Cancer care in the United States often results in financial hardship for patients and their families. Standard health insurance covers most medical costs, but nonmedical costs (such as lost wages, deductibles, copayments, and travel to and from caregivers) are paid out of pocket. Over the course of treatment, these costs can become substantial. Insurance companies have addressed the burden of these out-of-pocket costs by offering supplemental cancer insurance policies that, upon diagnosis of cancer, pay cash benefits for items that usually require out-of-pocket expenditures and are distinct from reimbursements made by traditional health insurance. Limitations associated with managed care have fostered increased consumer awareness and interest in the United States for cancer insurance and its ability to defray treatment expenditures that usually require out-of-pocket payments. Marketing campaigns are becoming more aggressive, and the number of cancer insurance policies sold has been steadily rising. While cancer insurance is only recently gaining popularity in the United States, it has been a successful product in Japan for over twenty years. In Japan, approximately one-quarter of the population own cancer insurance, and ten-year retention rates are estimated at 75%. As a result, individuals are afforded good access to nonmedical cancer services. Understanding the factors that led to the success of cancer insurance in Japan may assist policymakers in evaluating cancer insurance policies as they become more prevalent in the United States.

Impact of community-based health insurance in rural India on self-medication & financial protection of the insured

Directory of Open Access Journals (Sweden)

David M Dror

2016-01-01

Full Text Available Background & objectives: The evidence-base of the impact of community-based health insurance (CBHI on access to healthcare and financial protection in India is weak. We investigated the impact of CBHI in rural Uttar Pradesh and Bihar s0 tates of India on insured households′ self-medication and financial position. Methods: Data originated from (i household surveys, and (ii the Management Information System of each CBHI. Study design was "staggered implementation" cluster randomized controlled trial with enrollment of one-third of the treatment group in each of the years 2011, 2012 and 2013. Around 40-50 per cent of the households that were offered to enroll joined. The benefits-packages covered outpatient care in all three locations and in-patient care in two locations. To overcome self-selection enrollment bias, we constructed comparable control and treatment groups using Kernel Propensity Score Matching (K-PSM. To quantify impact, both difference-in-difference (DiD, and conditional-DiD (combined K-PSM with DiD were used to assess robustness of results. Results: Post-intervention (2013, self-medication was less practiced by insured HHs. Fewer insured households than uninsured households reported borrowing to finance care for non-hospitalization events. Being insured for two years also improved the HH′s location along the income distribution, namely insured HHs were more likely to experience income quintile-upgrade in one location, and less likely to experience a quintile-downgrade in two locations. Interpretation & conclusions: The realized benefits of insurance included better access to healthcare, reduced financial risks and improved economic mobility, suggesting that in our context health insurance creates welfare gains. These findings have implications for theoretical, ethical, policy and practice considerations.

Individual Savings Accounts and the Life-Cycle Approach to Social Insurance

DEFF Research Database (Denmark)

Sørensen, Peter Birch; Hansen, Martin Ino; Bovenberg, A. Lans

Using Danish data, we find that about three fourths of the taxes levied to finance public transfers actually finance benefits that do not redistribute between people but redistribute income over the life cycle of individual taxpayers. This provides a rationale for financing part of social insurance...... via mandatory individual savings accounts. An account system that offers liquidity insurance and a lifetime income guarantee helps to alleviate the dilemma between insurance and incentives. To illustrate this, we analyse a specific proposal for reform of the Danish system of social insurance......, involving the use of individual accounts. We estimate how the reform would affect the distribution of lifetime incomes, the public budget, and economic efficiency...

Gaining Momentum: How Media Influences Public Opinion To Push Civil-Military Decision Makers Into Formulating Foreign Policy

Science.gov (United States)

2016-02-09

1 AIR WAR COLLEGE AIR UNIVERSITY GAINING MOMENTUM: HOW MEDIA INFLUENCES PUBLIC OPINION TO PUSH CIVIL-MILITARY DECISION MAKERS INTO...engagements from the past, evidence suggest the media or press does have an influence over public opinion, especially during times of war and humanitarian...changes and that leaders must take into consideration that public opinion and the media may provide a large amount of influence over how the nation

Public-private sector interactions and the demand for supplementary health insurance in the United Kingdom.

Science.gov (United States)

Bíró, Anikó; Hellowell, Mark

2016-07-01

We examine the demand for private health insurance (PHI) in the United Kingdom and relate this to changes in the supply of public and private healthcare. Using a novel collection of administrative, private sector and survey data, we re-assess the relationships between the quality and availability of public and private sector inpatient care, and the demand for PHI. We find that PHI coverage in the United Kingdom is positively related to the median of the region- and year-specific public sector waiting times. We find that PHI prevalence ceteris paribus increases with being self-employed and employed, while it decreases with having financial difficulties. In addition, we highlight the complexities of inter-sectoral relations and their impact on PHI demand. Within a region, we find that an increase in private healthcare supply is associated with a decrease in public sector waiting times, implying lower PHI demand. This may be explained by the usage of private facilities by NHS commissioners. These results have important implications for policymakers interested in the role of private healthcare supply in enhancing the availability of and equitable access to acute inpatient care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Optimal Taxation and Social Insurance in a Lifetime Perspective

DEFF Research Database (Denmark)

Bovenberg, A. Lans; Sørensen, Peter Birch

Advances in information technology have improved the administrative feasibility of redistribution based on lifetime earnings recorded at the time of retirement. We study optimal lifetime income taxation and social insurance in an economy in which redistributive taxation and social insurance serve......-transfer system does not provide full disability insurance. By offering imperfect insurance and structuring disability benefits so as to enable workers to insure against disability by working harder, social insurance is designed to offset the distortionary impact of the redistributive labor income tax on labor...... to insure (ex ante) against skill heterogeneity as well as disability risk. Optimal disability benefits rise with previous earnings so that public transfers depend not only on current earnings but also on earnings in the past. Hence, lifetime taxation rather than annual taxation is optimal. The optimal tax...

Conceptualising the lack of health insurance coverage.

Science.gov (United States)

Davis, J B

2000-01-01

This paper examines the lack of health insurance coverage in the US as a public policy issue. It first compares the problem of health insurance coverage to the problem of unemployment to show that in terms of the numbers of individuals affected lack of health insurance is a problem comparable in importance to the problem of unemployment. Secondly, the paper discusses the methodology involved in measuring health insurance coverage, and argues that the current method of estimation of the uninsured underestimates the extent that individuals go without health insurance. Third, the paper briefly introduces Amartya Sen's functioning and capabilities framework to suggest a way of representing the extent to which individuals are uninsured. Fourth, the paper sketches a means of operationalizing the Sen representation of the uninsured in terms of the disability-adjusted life year (DALY) measure.

STATE AND PROBLEMS OF DEVELOPMENT OF INSURANCE MARKET OF UKRAINE

Directory of Open Access Journals (Sweden)

L. V. Martseniuk

2016-04-01

Full Text Available Purpose. The insurance market of Ukraine is still interesting for foreign investors. However, there is a range of negative factors. They are: 1 the old regulatory framework, public access and transparency of the insurance market for population; 2 low profitability of certain types of insurance; 3 low competitiveness of the insurance companies in comparison with commercial banks in attraction drive of free funds of legal entities and individuals; 4 insufficient state regulation and control does not allow the insurance market to develop effectively. Therefore, the purpose of the article is to analyze and identify the causes that hinder the development of insurance business in Ukraine, as well as to determine the directions of insurance market development. Methodology. To achieve this purpose the article determines the total number of insurance companies, composes the gross payment rating of the largest of them, presents the dynamics of net insurance premiums for basic insurance. This analysis allows you to identify problematic issues and activities of the insurance market. Findings. The analysis of the article revealed a number of factors that prevent successful development of insurance in Ukraine. The authors suggest priority areas for improving the situation in the insurance market. It was found that the main tasks of the development of insurance are: 1 legal framework reform; 2 improving competitiveness, investment attractiveness of the insurance companies; 3 development of modern infrastructure of the insurance market; 4 expanding the range of services and their compliance with international standards; 5 personnel development; 6 improvement of insurance activity licensing; 7 building of culture and public trust. At the same time the increase in the population solvency, economic and political stability in the country will contribute to the stabilization and intensive development of the insurance market. Originality. The article firstly

Disability, Health Insurance and Psychological Distress among US Adults: An Application of the Stress Process.

Science.gov (United States)

Alang, Sirry M; McAlpine, Donna D; Henning-Smith, Carrie E

2014-11-01

Structural resources, including access to health insurance, are understudied in relation to the stress process. Disability increases the likelihood of mental health problems, but health insurance may moderate this relationship. We explore health insurance coverage as a moderator of the relationship between disability and psychological distress. A pooled sample from 2008-2010 (N=57,958) was obtained from the Integrated Health Interview Series. Chow tests were performed to assess insurance group differences in the association between disability and distress. Results indicated higher levels of distress associated with disability among uninsured adults compared to their peers with public or private insurance. The strength of the relationship between disability and distress was weaker for persons with public compared to private insurance. As the Affordable Care Act is implemented, decision-makers should be aware of the potential for insurance coverage, especially public, to ameliorate secondary conditions such as psychological distress among persons who report a physical disability.

41 CFR 101-4.440 - Health and insurance benefits and services.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Health and insurance... insurance benefits and services. Subject to § 101-4.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not...

42 CFR 411.51 - Beneficiary's responsibility with respect to no-fault insurance.

Science.gov (United States)

2010-10-01

...-fault insurance. 411.51 Section 411.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PAYMENT Limitations on Medicare Payment for Services Covered Under Liability or No-Fault Insurance § 411.51 Beneficiary's responsibility with respect to no-fault insurance. (a) The beneficiary is...

RISK CORRIDORS AND REINSURANCE IN HEALTH INSURANCE MARKETPLACES: Insurance for Insurers

OpenAIRE

LAYTON, TIMOTHY J.; MCGUIRE, THOMAS G.; SINAIKO, ANNA D.

2016-01-01

In order to encourage entry and lower prices, most regulated markets for health insurance include policies that seek to reduce the uncertainty faced by insurers. In addition to risk adjustment of premiums paid to plans, the Health Insurance Marketplaces established by the Affordable Care Act implement reinsurance and risk corridors. Reinsurance limits insurer costs associated with specific individuals, while risk corridors protect against aggregate losses. Both tighten the insurer's distribut...

42 CFR 457.80 - Current State child health insurance coverage and coordination.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Current State child health insurance coverage and... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies...

Chinese nuclear insurance and Chinese nuclear insurance pool

International Nuclear Information System (INIS)

Gong Zhiqi

2000-01-01

Chinese Nuclear Insurance Started with Daya Bay Nuclear Power Station, PICC issued the insurance policy. Nuclear insurance cooperation between Chinese and international pool's organizations was set up in 1989. In 1996, the Chinese Nuclear Insurance Pool was prepared. The Chinese Nuclear Insurance Pool was approved by The Chinese Insurance Regulatory Committee in May of 1999. The principal aim is to centralize maximum the insurance capacity for nuclear insurance from local individual insurers and to strengthen the reinsurance relations with international insurance pools so as to provide the high quality insurance service for Chinese nuclear industry. The Member Company of Chinese Nuclear Pool and its roles are introduced in this article

HOUSING INSURANCE IN ROMANIA

Directory of Open Access Journals (Sweden)

FLOREA IANC MARIA MIRABELA

2014-12-01

Full Text Available Last few years have shown that Romania is not protected from the consequences of climate change. It is clear that type flood events may cause social problems and losses is difficult financing from public resources, especially in the context of the existence of budget constraints. The only viable system to cope with such disasters is insurance system that has the ability to spread risks by reinsurance Natural disasters - earthquakes, floods, landslides - are just some of the risks that may threaten your home. And if natural disasters can seem distant danger, think as fires, floods caused by broken pipes or theft of household goods are trouble can happen anytime to anyone. To protect yourself in such unpleasant situations, whose frequency is unfortunately on the rise, it is necessary to be assured. Thus, you will be able to recover losses in the event that they occur. The house is undoubtedly one of the most important assets we own. Therefore, the Romans began to pay increasingly more attention to domestic insurance products. Since 2011, voluntary home insurance, life insurance with, were the most dynamic segments of the market.

42 CFR 100.2 - Average cost of a health insurance policy.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Average cost of a health insurance policy. 100.2... VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of determining..., less certain deductions. One of the deductions is the average cost of a health insurance policy, as...

Why not private health insurance? 2. Actuarial principles meet provider dreams.

Science.gov (United States)

Deber, R; Gildiner, A; Baranek, P

1999-09-07

What do insurers and employers feel about proposals to expand Canadian health care financing through private insurance, in either a parallel stream or a supplementary tier? The authors conducted 10 semistructured, open-ended interviews in the autumn and early winter of 1996 with representatives of the insurance industry and benefits managers working with large employers; respondents were identified using a snowball sampling technique. The respondents felt that proposals for parallel private plans within a competitive market are incompatible with insurance principles, as long as a well-functioning and relatively comprehensive public system continues to exist; the maintenance of a strong public system was both socially and economically desirable. With the exception of serving the niche market for the private management of return-to-work strategies, respondents showed little interest in providing parallel coverage. They were receptive to a larger role for supplementary insurance but cautioned that they are not willing to cover all delisted services. As business executives they stated that they are willing to insure only services and clients that will be profitable.

Health insurance and health care in India: a supply-demand perspective

OpenAIRE

Perianayagam, Arokiasamy; Goli, Srinivas

2013-01-01

India’s health care and health financing provision is characterized by too little Government spending on health, meager health insurance coverage, declining public health care use contrasted by highest levels of private out-of-pocket health spending in the world. To understand the interconnectedness of these disturbing outcomes, this paper envisions a theoretical framework of health insurance and health care revisits the existing health insurance schemes and assesses the health insurance cove...

Impact of a private health insurance mandate on public sector autism service use in Pennsylvania.

Science.gov (United States)

Stein, Bradley D; Sorbero, Mark J; Goswami, Upasna; Schuster, James; Leslie, Douglas L

2012-08-01

Many states have implemented regulations (commonly referred to as waivers) to increase access to publicly insured services for autism spectrum disorders (ASD). In recent years, several states have passed legislation requiring improved coverage for ASD services by private insurers. This study examines the impact of such legislation on use of Medicaid-funded ASD services. We used Medicaid claims data from July 1, 2006, through June 30, 2010, to identify children with ASD and to assess their use of behavioral health services and psychotropic medications. Service and medication use were examined in four consecutive 12-month periods: the 2 years preceding passage of the legislation, the year after passage but before implementation, and the year after implementation. We examined differences in use of services and medications, and used growth rates from nonwaiver children to estimate the impact of the legislation on Medicaid spending for waiver-eligible children with ASD. The number of children with ASD receiving Medicaid services increased 20% from 2006-2007 to 2009-2010. The growth rate among children affected by the legislation was comparable to that of other groups before passage of the legislation but decreased after the legislation's passage. We project that, without the legislation, growth in this population would have been 46% greater in 2009-2010 than observed, associated with spending of more than $8 million in 2009-2010. Passage of legislation increasing private insurance coverage of ASD services may decrease the number of families seeking eligibility to obtain Medicaid-funded services, with an associated substantial decrease in Medicaid expenditures. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Premium inflation in the Irish private health insurance market: drivers and consequences.

Science.gov (United States)

Turner, B

2013-12-01

Nearly half of the Irish population is covered by private health insurance. In recent years, premium inflation has been significantly ahead of overall inflation and has been accelerating. This has contributing to a drop in the numbers insured since the peak in 2008. The fall in the numbers with private health insurance also has implications for the public health system. Factors behind this premium inflation include rising charges for beds in public hospitals, increasing volume of treatments and increasing quality of service and cover. While some progress has been made by insurers on reducing fees paid to consultants and private hospitals, unless the quantity or quality of care are addressed then premium inflation is unlikely to abate.

Insurance Companies Adapting to Trends by Adopting Medical Tourism.

Science.gov (United States)

Paul, David P; Barker, Tyler; Watts, Angela L; Messinger, Ashley; Coustasse, Alberto

Health care costs in the United States are rising every year, and patients are seeking new ways to control their expenditures and save money. Going abroad to receive health care is a cheaper alternative than receiving the same or similar care at home. Insurance companies are beginning to realize the benefits of medical tourism for both themselves and their beneficiaries and have therefore started to introduce medical tourism plans for their clients as an option for their beneficiaries. This research study explores the benefits and risks of medical tourism and examines the US insurance market's reaction to the trend of increasing medical tourism. The US medical tourism industry mirrors that of the United Kingdom in recent years, with more patients seeking care abroad than in the United States. Insurance companies have introduced new plans providing the option of traveling abroad to countries such as India and Costa Rica. Medical tourism is gaining popularity with US residents, and insurance companies are recognizing this trend.

People's willingness to pay for health insurance in rural Vietnam.

Science.gov (United States)

Lofgren, Curt; Thanh, Nguyen X; Chuc, Nguyen Tk; Emmelin, Anders; Lindholm, Lars

2008-08-11

The inequity caused by health financing in Vietnam, which mainly relies on out-of-pocket payments, has put pre-payment reform high on the political agenda. This paper reports on a study of the willingness to pay for health insurance among a rural population in northern Vietnam, exploring whether the Vietnamese are willing to pay enough to sufficiently finance a health insurance system. Using the Epidemiological Field Laboratory for Health Systems Research in the Bavi district (FilaBavi), 2070 households were randomly selected for the study. Existing FilaBavi interviewers were trained especially for this study. The interview questionnaire was developed through a pilot study followed by focus group discussions among interviewers. Determinants of households' willingness to pay were studied through interval regression by which problems such as zero answers, skewness, outliers and the heaping effect may be solved. Households' average willingness to pay (WTP) is higher than their costs for public health care and self-treatment. For 70-80% of the respondents, average WTP is also sufficient to pay the lower range of premiums in existing health insurance programmes. However, the average WTP would only be sufficient to finance about half of total household public, as well as private, health care costs. Variables that reflect income, health care need, age and educational level were significant determinants of households' willingness to pay. Contrary to expectations, age was negatively related to willingness to pay. Since WTP is sufficient to cover household costs for public health care, it depends to what extent households would substitute private for public care and increase utilization as to whether WTP would also be sufficient enough to finance health insurance. This study highlights potential for public information schemes that may change the negative attitude towards health insurance, which this study has uncovered. A key task for policy makers is to win the trust of the

Nonprofit health insurers: the story Wall Street doesn't tell.

Science.gov (United States)

Johnson, Susan R

2003-01-01

For several years, Wall Street investment firms have campaigned for conversion of nonprofit health insurers to investor ownership, arguing that an infusion of equity capital is critical to insurers' survival. However, closer examination of the financial performance and capital position of not-for-profit health plans shows that: The lower operating margins reported by not-for-profit health plans very likely reflect the organizations' corporate missions to serve their communities by minimizing the cost of coverage and their ability to invest all gains back into the company for the future benefit of their customers. Their investor-owned counterparts must generate higher margins to give shareholders a return on their investment. Compared with investor-owned insurers, not-for-profit health plans use a significantly higher percentage of the customers' premium dollar to pay health care claims. A lower percentage goes for administrative expenses. Over the past 10 years, not-for-profit health plans have succeeded in using operational and investment gains to build and retain a strong capital position--stronger than that of investor-owned companies--while investing heavily in infrastructure, product development, and market growth.

Individual savings accounts for social insurance

DEFF Research Database (Denmark)

Bovenberg, Lans; Hansen, Martin Ino; Sørensen, Peter Birch

2008-01-01

Using Danish data, we find that about three-fourths of the taxes levied to finance public transfers actually finance benefits that redistribute income over the life cycle of individual taxpayers rather than redistribute resources across people. This finding and similar results for other countries...... provide a rationale for financing part of social insurance via mandatory individual savings accounts. We discuss the advantages and disadvantages of mandatory individual savings accounts for social insurance and survey some recent alternative proposals for such accounts...

Is drug insurance status an effect modifier in epidemiologic database studies? The case of maternal asthma and major congenital malformations.

Science.gov (United States)

Blais, Lucie; Kettani, Fatima-Zohra; Forget, Amélie; Beauchesne, Marie-France; Lemière, Catherine

2015-12-01

Our previous work on the association between maternal asthma and congenital malformations was based on cohorts formed by women with public drug insurance, i.e., over-represented by women with lower socioeconomic status, questioning the generalizability of our findings. This study aimed to evaluate whether or not drug insurance status, as a proxy of socioeconomic status, is an effect modifier for the association between maternal asthma and major congenital malformations. A cohort of 36,587 pregnancies from asthmatic women and 198,935 pregnancies from nonasthmatic women selected independently of their drug insurance status was reconstructed with Québec administrative databases (1998-2009). Asthmatic women were identified using a validated case definition of asthma. Cases of major congenital malformations were identified using diagnostic codes recorded in the hospitalization database. Drug insurance status at the beginning of pregnancy was classified into three groups: publicly insured with social welfare, publicly insured without social welfare, and privately insured. Adjusted odds ratios were estimated with generalized estimation equations, including an interaction term between maternal asthma and drug insurance status. The prevalence of congenital malformations was 6.8% among asthmatic women and 5.8% among nonasthmatics. The impact of asthma on the prevalence of congenital malformations was significantly greater in women publicly insured with social welfare (odds ratio = 1.42; 95% confidence interval, 1.25-1.61) than in the other two groups ([odds ratio = 1.10; 1.00-1.21] in the publicly insured without social welfare and [odds ratio = 1.13; 1.07-1.20] in the privately insured group). The increased risk of major congenital malformation associated with asthma was significantly higher among pregnant women publicly insured with social welfare than among those privately insured. As a result of this effect modification by drug insurance status, findings

METHODICAL BASES OF MANAGEMENT OF INSURANCE PORTFOLIO

Directory of Open Access Journals (Sweden)

Serdechna Yulia

2018-01-01

Full Text Available Introduction. Despite the considerable arsenal of developments in the issues of assessing the management of the insurance portfolio remains unresolved. In order to detail, specify and further systematize the indicators for the indicated evaluation, the publications of scientists are analyzed. The purpose of the study is to analyze existing methods by which it is possible to formulate and manage the insurance portfolio in order to achieve its balance, which will contribute to ensuring the financial reliability of the insurance company. Results. The description of the essence of the concept of “management of insurance portfolio”, as the application of actuarial methods and techniques to the combination of various insurance risks offered for insurance or are already part of the insurance portfolio, allowing to adjust the size and structure of the portfolio in order to ensure its financial stability, achievement the maximum level of income of an insurance organization, preservation of the value of its equity and financial security of insurance liabilities. It is determined that the main methods by which the insurer’s insurance portfolio can be formed and managed is the selection of risks; reinsurance operations that ensure diversification of risks; formation and placement of insurance reserves, which form the financial basis of insurance activities. The method of managing an insurance portfolio, which can be both active and passive, is considered. Conclusions. It is determined that the insurance portfolio is the basis on which all the activities of the insurer are based and which determines its financial stability. The combination of methods and technologies applied to the insurance portfolio is a management method that can be both active and passive and has a number of specific methods through which the insurer’s insurance portfolio can be formed and managed. It is substantiated that each insurance company aims to form an efficient and

UK nuclear terrorism insurance arrangements: an overview

International Nuclear Information System (INIS)

Tetley, M. G.

2004-01-01

The risk of terrorism in the UK is not new, but since the New York World Trade Centre attacks in 2001, the potential scale of any terrorist attack has required a considerable reassessment. With UK foreign policy closely aligned to that of the USA, the UK security services now consider it is simply a matter of when and no longer if the UK is attacked. For insurers of any type this fact would cause concern; for insurers involved in high profile and potentially catastrophic loss targets such as nuclear power plants, any attack could have a severe impact on solvency and shareholder's funds. This paper's objective is to describe the terrorism insurance arrangements put in place in the U.K. both before and after the September 2001 attacks. These arrangements have been designed both to safeguard insurers' solvency and to ensure that the nuclear industry and general public can continue to be reassured by the availability of insurance should an attack ever occur.(author)

Universal public finance of tuberculosis treatment in India: an extended cost-effectiveness analysis.

Science.gov (United States)

Verguet, Stéphane; Laxminarayan, Ramanan; Jamison, Dean T

2015-03-01

Universal public finance (UPF)-government financing of an intervention irrespective of who is receiving it-for a health intervention entails consequences in multiple domains. First, UPF increases intervention uptake and hence the extent of consequent health gains. Second, UPF generates financial consequences including the crowding out of private expenditures. Finally, UPF provides insurance either by covering catastrophic expenditures, which would otherwise throw households into poverty or by preventing diseases that cause them. This paper develops a method-extended cost-effectiveness analysis (ECEA)-for evaluating the consequences of UPF in each of these domains. It then illustrates ECEA with an evaluation of UPF for tuberculosis treatment in India. Using plausible values for key parameters, our base case ECEA concludes that the health gains and insurance value of UPF would accrue primarily to the poor. Reductions in out-of-pocket expenditures are more uniformly distributed across income quintiles. A variant on our base case suggests that lowering costs of borrowing for the poor could potentially achieve some of the health gains of UPF, but at the cost of leaving the poor more deeply in debt. © 2014 The Authors. Health Economics published by John Wiley Ltd.

The underwriting process of liability insurance in South Africa

Directory of Open Access Journals (Sweden)

Anderson, S. E.

2014-03-01

Full Text Available Liability risks may embody far-reaching financial consequences for individuals, business enterprises and professional people. This paper focuses on the underwriting process which should be taken into consideration by short-term insurers when they are underwriting the main types of liability insurance, which include employer’s, householder’s, personal, product, professional and public liability insurance. The improvement of financial decision-making by short-term insurers when underwriting liability insurance represents the objective of this research. A study of secondary data was done to identify the existing literature, which formed the basis for compiling a questionnaire to obtain primary data. The top 10 short-term insurers which are the market leaders of liability insurance in South Africa and who received more than 85% of the annual gross written premiums for liability insurance in South Africa, represented the sample of the empirical study. This paper highlights the importance of the underwriting factors concerning liability insurance, how often the stipulations of insurance policies should be adjusted by the short-term insurers to account for the underwriting factors, as well as the problem areas which the underwriters may experience when they are underwriting liability insurance. Possible solutions to solve the problem areas were also addressed

Economic and demographic assumptions of the public pension insurance system functioning

Directory of Open Access Journals (Sweden)

Đukić Gordana

2016-01-01

Full Text Available The demographic transition is characterized by a decline in birth rates and fertility on the one hand, and an intense increase in the number of old people on the other hand. The intensity of demographic ageing is characteristic of certain countries, being more expressed in developed countries. In such a situation, negative economic consequences arise in the context of unemployment, due to a decreased number of young population and lower participation in the labour market, as well as in the domains of savings, capital market, health protection, pension system and institutional development. These consequences can be mitigated by the application of appropriate economic transition and macroeconomic policy. Demographic tendencies have a great impact on changes in the values of the pension system parameters. The dependence rate indicating the relation between the number of employed people and the number of pensioners, and the average replacement rate representing the relation between the average wage and average pension, are directly dependent on demographic changes and they directly affect the sustainability of the public pension insurance system.

CHIP premiums, health status, and the insurance coverage of children.

Science.gov (United States)

Marton, James; Talbert, Jeffery C

2010-01-01

This study uses the introduction of premiums into Kentucky's Children's Health Insurance Program (KCHIP) to examine whether the enrollment impact of new premiums varies by child health type. We also examine the extent to which children find alternative coverage after premium nonpayment. Public insurance claims data suggest that those with chronic health conditions are less likely to leave public coverage. We find little evidence of a differential impact of premiums on enrollment among the chronically ill. Our survey of nonpayers shows that 56% of responding families found alternative private or public health coverage for their children after losing CHIP.

Paying for individual health insurance through tax-sheltered cafeteria plans.

Science.gov (United States)

Hall, Mark A; Monahan, Amy B

2010-01-01

When employees without group health insurance buy individual coverage, they do so using after-tax income--costing them from 20% to 50% more than others pay for equivalent coverage. Prior to the passage of the Patient Protection and Affordable Care Act (PPACA), several states promoted a potential solution that would allow employees to buy individual insurance through tax-sheltered payroll deduction. This technical but creative approach would allow insurers to combine what is known as "list-billing" with a Section 125 "cafeteria plan." However, these state-level reform attempts have failed to gain significant traction because state small-group reform laws and federal restrictions on medical underwriting cloud the legality of tax-sheltered list-billing. Several authorities have taken the position that insurance paid for through a cafeteria plan must meet the nondiscrimination requirements of the Health Insurance Portability and Accountability Act with respect to eligibility, premiums, and benefits. The recently enacted Patient Protection and Affordable Care Act addresses some of the legal uncertainty in this area, but much remains. For health reform to have its greatest effect, federal regulators must clarify whether individual health insurance can be purchased on a pre-tax basis through a cafeteria plan.

Child outpatient mental health service use: why doesn't insurance matter?

Science.gov (United States)

Glied, Sherry; Bowen Garrett, A.; Hoven, Christina; Rubio-Stipec, Maritza; Regier, Darrel; Moore, Robert E.; Goodman, Sherryl; Wu, Ping; Bird, Hector

1998-12-01

BACKGROUND: Several recent studies of child outpatient mental health service use in the US have shown that having private insurance has no effect on the propensity to use services. Some studies also find that public coverage has no beneficial effect relative to no insurance. AIMS: This study explores several potential explanations, including inadequate measurement of mental health status, bandwagon effects, unobservable heterogeneity and public sector substitution for private services, for the lack of an effect of private insurance on service use. METHODS: We use secondary analysis of data from the three mainland US sites of NIMH's 1992 field trial of the Cooperative Agreement for Methodological Research for Multi-Site Surveys of Mental Disorders in Child and Adolescent Populations (MECA) Study. We examine whether or not a subject used any mental health service, school-based mental health services or outpatient mental health services, and the number of outpatient visits among users. We also examine use of general medical services as a check on our results. We conduct regression analysis; instrumental variables analysis, using instruments based on employment and parental history of mental health problems to identify insurance choice, and bivariate probit analysis to examine multiservice use. RESULTS: We find evidence that children with private health insurance have fewer observable (measured) mental health problems. They also appear to have a lower unobservable (latent) propensity to use mental health services than do children without coverage and those with Medicaid coverage. Unobserved differences in mental health status that relate to insurance choice are found to contribute to the absence of a positive effect for private insurance relative to no coverage in service use regressions. We find no evidence to suggest that differences in attitudes or differences in service availability in children's census tracts of residence explain the non-effect of insurance

Redistribution through social health insurance: evidence on citizen preferences.

Science.gov (United States)

Pfarr, Christian; Schmid, Andreas

2016-06-01

The extent of social health insurance (SHI) and supplementary private insurance is frequently analyzed in public choice. Most of these analyses build on the model developed by Gouveia (1997), who defines the extent of SHI as consequence of a choice by self-interested voters. In this model, an indicator reflecting individuals' relative income position and relative risk of falling ill determines the voting decision. Up to now, no empirical evidence for this key assumption has been available. We test the effect of this indicator on individuals' preferences for the extent of SHI in a setting with mandatory SHI that can be supplemented by private insurance. The data is based on a DCE conducted in the field with a representative sample of 1538 German citizens in 2012. Conditional logit and latent class models are used to analyze preference heterogeneity. Our findings strongly support the assumptions of the models. Individuals likely to benefit from public coverage show a positive marginal willingness to pay (MWTP) for both a shift away from other beneficiary groups toward the sick and an expansion of publicly financed resources, and the expected net payers have a negative MWTP and prefer lower levels of public coverage.

The Antecedents of Customer Loyalty: An Empirical Investigation in Life Insurance Context

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Srivastava Medha

2013-06-01

Full Text Available The present paper seeks to offer the most decipherable and widely applicable antecedents of customer loyalty. It explores the extant literature on customer loyalty and brings out seven variableswhich are responsible for formation of customer loyalty. Further, the relative importance of these variables has been ascertained through Multiple Regression Analysis which revealed that service quality and commitment are the strongest predictors of customer loyalty in theIndian life insurance industry. The paper also attempts to assess the loyalty status of life insurance customers in India and draw a comparison between public and private sector life insurancecompanies in order to provide significant insights to the life insurance companies that may assist them in devising better loyalty practices. The findings suggest that Indian customers do care about the public sector status of a financial service provider as it entails a sense of security and stability and thus creates a difference between customer loyalty of public sector life insurerand that of private sector life insurer. The paper holds significant implications for academicians interested in dynamics of customer loyalty as well as the marketers of life insurance services whoare concerned with customer relationships.

42 CFR 457.618 - Ten percent limit on certain Children's Health Insurance Program expenditures.

Science.gov (United States)

2010-10-01

... Insurance Program expenditures. 457.618 Section 457.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... Children's Health Insurance Program expenditures. (a) Expenditures. (1) Primary expenditures are...

Insurability and mitigation of flood losses in private households in Germany.

Science.gov (United States)

Thieken, Annegret H; Petrow, Theresia; Kreibich, Heidi; Merz, Bruno

2006-04-01

In Germany, flood insurance is provided by private insurers as a supplement to building or contents insurance. This article presents the results of a survey of insurance companies with regard to eligibility conditions for flood insurance changes after August 2002, when a severe flood caused 1.8 billion euro of insured losses in the Elbe and the Danube catchment areas, and the general role of insurance in flood risk management in Germany. Besides insurance coverage, governmental funding and public donations played an important role in loss compensation after the August 2002 flood. Therefore, this article also analyzes flood loss compensation, risk awareness, and mitigation in insured and uninsured private households. Insured households received loss compensation earlier. They also showed slightly better risk awareness and mitigation strategies. Appropriate incentives should be combined with flood insurance in order to strengthen future private flood loss mitigation. However, there is some evidence that the surveyed insurance companies do little to encourage precautionary measures. To overcome this problem, flood hazards and mitigation strategies should be better communicated to both insurance companies and property owners.

PROVIDER CHOICE FOR OUTPATIENT HEALTH CARE SERVICES IN INDONESIA: THE ROLE OF HEALTH INSURANCE

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Budi Hidayat

2012-11-01

Full Text Available Background: Indonesian's health care system is characterized by underutilized of the health-care infrastructure. One of the ways to improve the demand for formal health care is through health insurance. Responding to this potentially effective policy leads the Government of Indonesia to expand health insurance coverage by enacting the National Social Security Act in 2004. In this particular issue, understanding provider choice is therefore a key to address the broader policy question as to how the current low uptake of health care services could be turned in to an optimal utilization. Objective:To estimate a model of provider choice for outpatient care in Indonesia with specific attention being paid to the role of health insurance. Methods: A total of 16485 individuals were obtained from the second wave of the Indonesian Family Life survey. A multinomial logit regression model was applied to a estimate provider choice for outpatient care in three provider alternative (public, private and self-treatment. A policy simulation is reported as to how expanding insurance benefits could change the patterns of provider choice for outpatient health care services. Results: Individuals who are covered by civil servant insurance (Askes are more likely to use public providers, while the beneficiaries of private employees insurance (Jamsostek are more likely to use private ones compared with the uninsured population. The results also reveal that less healthy, unmarried, wealthier and better educated individuals are more likely to choose private providers than public providers. Conclusions: Any efforts to improve access to health care through health insurance will fail if policy-makers do not accommodate peoples' preferences for choosing health care providers. The likely changes in demand from public providers to private ones need to be considered in the current social health insurance reform process, especially in devising premium policies and benefit packages

Racial and ethnic disparities in dental care for publicly insured children.

Science.gov (United States)

Pourat, Nadereh; Finocchio, Len

2010-07-01

Poor oral health has important implications for the healthy development of children. Children in Medicaid, especially Latinos and African Americans, experience high rates of tooth decay, yet they visit dentists less often than privately insured children. Even Latino and African American children with private insurance are less likely than white children to visit dentists and have longer intervals between dental visits. Furthermore, Latino and African American children in Medicaid are more likely than white children in Medicaid to have longer intervals between visits. These findings raise concerns about Medicaid's ability to address disparities in dental care access and, more broadly, in health care.

Insurance choice and tax-preferred health savings accounts.

Science.gov (United States)

Cardon, James H; Showalter, Mark H

2007-03-01

We develop an infinite horizon utility maximization model of the interaction between insurance choice and tax-preferred health savings accounts. The model can be used to examine a wide range of policy options, including flexible spending accounts, health savings accounts, and health reimbursement accounts. We also develop a 2-period model to simulate various implications of the model. Key results from the simulation analysis include the following: (1) with no adverse selection, use of unrestricted health savings accounts leads to modest welfare gains, after accounting for the tax revenue loss; (2) with adverse selection and an initial pooling equilibrium comprised of "sick" and "healthy" consumers, introducing HSAs can, but does not necessarily, lead to a new pooling equilibrium. The new equilibrium results in a higher coinsurance rate, an increase in expected utility for healthy consumers, and a decrease in expected utility for sick consumers; (3) with adverse selection and a separating equilibrium, both sick and healthy consumers are better off with a health savings account; (4) efficiency gains are possible when insurance contracts are explicitly linked to tax-preferred health savings accounts.

Nuclear safety and nuclear insurance

International Nuclear Information System (INIS)

Abramovitz, A.

1983-01-01

To an extent, public opinion is against Koeberg, inspite of the fact that Escom, Koeberg's prospective licensee, are liable for damages caused in the event of an accident, that they carry public liability insurance bought in the market place to the maximum of ten million rand, and if that is not enough the government will take over responsibility for the rest. A question is put that if this kind of protection carries on, won't there always be a minority of the public who will find nuclear power socially, psychologically and politically unacceptable

78 FR 38483 - Area Risk Protection Insurance Regulations and Area Risk Protection Insurance Crop Provisions

Science.gov (United States)

2013-06-26

... premium rates for ARPI that are sufficient to cover expected losses plus a reasonable reserve. The premium... that maximize net benefits (including potential economic, environmental, public health and safety... establish their insurance guarantees, and compute premium amounts. Whether a producer has 10 acres or 1000...

77 FR 70374 - Servicemembers' Group Life Insurance-Stillborn Child Coverage

Science.gov (United States)

2012-11-26

... is the biological mother of a stillborn and if both the surrogate and the stillborn's biological... the coverage of the child's SGLI-insured biological mother. This final rule will provide consistency... proceeds would be paid to the child's SGLI- insured mother. We provided a 60-day public-comment period...

Monopolistic Insurance and the Value of Information

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Arthur Snow

2015-07-01

Full Text Available The value of information regarding risk class for a monopoly insurer and its customers is examined in both symmetric and asymmetric information environments. A monopolist always prefers contracting with uninformed customers as this maximizes the rent extracted under symmetric information while also avoiding the cost of adverse selection when information is held asymmetrically. Although customers are indifferent to symmetric information when they are initially uninformed, they prefer contracting with hidden knowledge rather than symmetric information since the monopoly responds to adverse selection by sharing gains from trade with high-risk customers when low risks are predominant in the insurance pool. However, utilitarian social welfare is highest when customers are uninformed, and is higher when information is symmetric rather than asymmetric.

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran.

Science.gov (United States)

Bazyar, Mohammad; Rashidian, Arash; Kane, Sumit; Vaez Mahdavi, Mohammad Reza; Akbari Sari, Ali; Doshmangir, Leila

2016-02-11

There are fragmentations in Iran's health insurance system. Multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. Multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. Also fragmentation might have contributed to inefficiency in the health insurance systems, a low financial protection against healthcare expenditures for the insured persons, high coinsurance rates, a notable rate of insurance coverage duplication, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and reliable data and statistics for policy-making. We have conducted a policy analysis study, including qualitative interviews of key informants and document analysis. As a result we introduce three policy options: keeping the existing structural fragmentations of social health insurance (SHI)schemes but implementing a comprehensive "policy integration" strategy; consolidation of existing health insurance funds and creating a single national health insurance scheme; and reducing fragmentation by merging minor well-resourced funds together and creating two or three large insurance funds under the umbrella of the existing organizations. These policy options with their advantages and disadvantages are explained in the paper. © 2016 by Kerman University of Medical Sciences.

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

Science.gov (United States)

Bazyar, Mohammad; Rashidian, Arash; Kane, Sumit; Vaez Mahdavi, Mohammad Reza; Akbari Sari, Ali; Doshmangir, Leila

2016-01-01

There are fragmentations in Iran’s health insurance system. Multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. Multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. Also fragmentation might have contributed to inefficiency in the health insurance systems, a low financial protection against healthcare expenditures for the insured persons, high coinsurance rates, a notable rate of insurance coverage duplication, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and reliable data and statistics for policy-making. We have conducted a policy analysis study, including qualitative interviews of key informants and document analysis. As a result we introduce three policy options: keeping the existing structural fragmentations of social health insurance (SHI)schemes but implementing a comprehensive "policy integration" strategy; consolidation of existing health insurance funds and creating a single national health insurance scheme; and reducing fragmentation by merging minor well-resourced funds together and creating two or three large insurance funds under the umbrella of the existing organizations. These policy options with their advantages and disadvantages are explained in the paper. PMID:27239868

Can decision biases improve insurance outcomes? An experiment on status quo bias in health insurance choice.

Science.gov (United States)

Krieger, Miriam; Felder, Stefan

2013-06-19

Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure.

24 CFR 266.602 - Mortgage insurance premium: Insured advances.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

Optimal Taxation and Social Insurance in a Lifetime Perspective

DEFF Research Database (Denmark)

Bovenberg, A. Lans; Sørensen, Peter Birch

Advances in information technology have improved the administrative feasibility of redistribution based on lifetime earnings recorded at the time of retirement. We study optimal lifetime income taxation and social insurance in an economy in which redistributive taxation and social insurance serve...... to insure (ex ante) against skill heterogeneity as well as disability risk. Optimal disability benefits rise with previous earnings so that public transfers depend not only on current earnings but also on earnings in the past. Hence, lifetime taxation rather than annual taxation is optimal. The optimal tax...

Nigeria; Publication of Financial Sector Assessment Program Documentation––Detailed Assessment of Observance of Insurance Core Principles

OpenAIRE

International Monetary Fund

2013-01-01

Nigeria undertook a Financial Sector Assessment Program (FSAP), which included a review of the structure of Nigeria’s insurance market and the supervisory framework. The assessment was benchmarked against the Insurance Core Principles (ICPs) issued by the International Association of Insurance Supervisors (IAISs). It is advised that the National Insurance Commission (NAICOM) of Nigeria can expand the objective to include the creation of a fair, safe, and stable insurance sector for the benefi...

Strikes in the public sector in Denmark – assessing the economic gains and losses of collective action

DEFF Research Database (Denmark)

Scheuer, Steen; Ibsen, Flemming; Høgedahl, Laust Kristian

2016-01-01

and losses, ranging from a slightly positive result to a negative result from which it will take eight to ten years to recover. This is of great importance because the challenge facing public sector unions is different from that of their counterparts: private sector unions struggle with the owners of capital......This article looks at strikes by employees in the public sector, discusses the theoretical background to these conflicts and shows – based on a case study of three strikes in the Danish public sector – how different union strategies lead to very different outcomes in terms of economic gains......, while public sector unions trying to move up the wage hierarchy cannot expect much help from fellow public sector unions, often quite the reverse....

Neonatal outcomes after preterm birth by mothers’ health insurance status at birth: a retrospective cohort study

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Einarsdóttir Kristjana

2013-02-01

Full Text Available Abstract Background Publicly insured women usually have a different demographic background to privately insured women, which is related to poor neonatal outcomes after birth. Given the difference in nature and risk of preterm versus term births, it would be important to compare adverse neonatal outcomes after preterm birth between these groups of women after eliminating the demographic differences between the groups. Methods The study population included 3085 publicly insured and 3380 privately insured, singleton, preterm deliveries (32–36 weeks gestation from Western Australia during 1998–2008. From the study population, 1016 publicly insured women were matched with 1016 privately insured women according to the propensity score of maternal demographic characteristics and pre-existing medical conditions. Neonatal outcomes were compared in the propensity score matched cohorts using conditional log-binomial regression, adjusted for antenatal risk factors. Outcomes included Apgar scores less than 7 at five minutes after birth, time until establishment of unassisted breathing (>1 minute, neonatal resuscitation (endotracheal intubation or external cardiac massage and admission to a neonatal special care unit. Results Compared with infants of privately insured women, infants of publicly insured women were more likely to receive a low Apgar score (ARR = 2.63, 95% CI = 1.06-6.52 and take longer to establish unassisted breathing (ARR = 1.61, 95% CI = 1.25-2.07, yet, they were less likely to be admitted to a special care unit (ARR = 0.84, 95% CI = 0.80-0.87. No significant differences were evident in neonatal resuscitation between the groups (ARR = 1.20, 95% CI = 0.54-2.67. Conclusions The underlying reasons for the lower rate of special care admissions in infants of publicly insured women compared with privately insured women despite the higher rate of low Apgar scores is yet to be determined. Future research is

What Legislators Need to Know about Long-Term Care Insurance.

Science.gov (United States)

Landes, David

This booklet discusses the potential importance to states of long-term care insurance, describes general policy characteristics, and summarizes state actions to both regulate and promote long-term care insurance. It is intended as a resource for legislators and others involved in long-term care financing and public policy formulation. Long-term…

Disparities in Private Health Insurance Coverage of Skilled Care

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Stacey A. Tovino

2017-10-01

Full Text Available This article compares and contrasts public and private health insurance coverage of skilled medical rehabilitation, including cognitive rehabilitation, physical therapy, occupational therapy, speech-language pathology, and skilled nursing services (collectively, skilled care. As background, prior scholars writing in this area have focused on Medicare coverage of skilled care and have challenged coverage determinations limiting Medicare coverage to beneficiaries who are able to demonstrate improvement in their conditions within a specific period of time (the Improvement Standard. By and large, these scholars have applauded the settlement agreement approved on 24 January 2013, by the U.S. District Court for the District of Vermont in Jimmo v. Sebelius (Jimmo, as well as related motions, rulings, orders, government fact sheets, and Medicare program manual statements clarifying that Medicare covers skilled care that is necessary to prevent or slow a beneficiary’s deterioration or to maintain a beneficiary at his or her maximum practicable level of function even though no further improvement in the beneficiary’s condition is expected. Scholars who have focused on beneficiaries who have suffered severe brain injuries, in particular, have framed public insurance coverage of skilled brain rehabilitation as an important civil, disability, and educational right. Given that approximately two-thirds of Americans with health insurance are covered by private health insurance and that many private health plans continue to require their insureds to demonstrate improvement within a short period of time to obtain coverage of skilled care, scholarship assessing private health insurance coverage of skilled care is important but noticeably absent from the literature. This article responds to this gap by highlighting state benchmark plans’ and other private health plans’ continued use of the Improvement Standard in skilled care coverage decisions and

The Progressive Insurance Automotive X PRIZE Education Program

Energy Technology Data Exchange (ETDEWEB)

Robyn Ready

2011-12-31

The Progressive Insurance Automotive X PRIZE Education Program conducted education and outreach activities and used the competition's technical goals and vehicle demonstrations as a means of attracting students and the public to learn more about advanced vehicle technologies, energy efficiency, climate change, alternative fuels, and the science and math behind efficient vehicle development. The Progressive Insurance Automotive X PRIZE Education Program comprised three integrated components that were designed to educate the general public and create a multi-tiered initiative to engage students and showcase the 21st century skills students will need to compete in our global economy: teamwork, creativity, strong literacy, math and science skills, and innovative thinking. The elements included an Online Experience, a National Student Contest, and in person education events and activites. The project leveraged online connections, strategic partnerships, in-classroom, and beyond-the-classroom initiatives, as well as mainstream media. This education program supported by the U.S. Department of Energy (DOE) also funded the specification of vehicle telemetry and the full development and operation of an interactive online experience that allowed internet users to follow the Progressive Insurance Automotive X PRIZE vehicles as they performed in real-time during the Progressive Insurance Automotive X PRIZE competition events.

To What Extent Does Non Profit Private Micro Health Insurance Help Improve Public Health Care?

Directory of Open Access Journals (Sweden)

Aurore Duffau

2009-12-01

Full Text Available Based on the SKY micro health insurance project that GRET has been developing in Cambodia for ten years, this article reflects on how non-profit private micro health insurance can help improve public health care.The medical situation in Cambodia is particularly interesting to study insomuch as the population multiplies their sources of care (self-medication, visits to private practitioners, traditional therapists, doctors in public facilities, etc., which leads to high costs and mediocre care.Using the SKY project’s internal database and four qualitative studies conducted between 2007 and 2008 in the project’s areas of intervention, we show that the SKY project, which is conducted in agreement with the Khmer authorities, has enabled greater utilisation of public health care, a better perception of the quality of care, and a better capacity for financial anticipation both in health care facilities and among the insured. Nevertheless, the limitations of and obstacles facing such systems are numerous: self-medication among the insured persists, the attitude of poorly paid health care workers does not favour rational use of medicines, and the orientation of Ministerial financing of health care is not always consistent with the project’s objectives. Ultimately, the synergies between non profit private micro health insurance and public health care will be all the more effective when insurance accounts for a large share of health care facilities’ revenues—that is to say when the subscriber base is large.Basé sur le projet de micro-assurance santé SKY que le GRET développe au Cambodge depuis dix ans, cet article explique comment la micro-assurance santé privée à but non lucratif peut contribuer à améliorer les soins de santé publique.La situation médicale au Cambodge est particulièrement intéressante à étudier car la population multiplie les sources de soins (auto-médication, consultations en cabinet, médecine traditionnelle

Switching gains and health plan price elasticities: 20 years of managed competition reforms in The Netherlands.

Science.gov (United States)

Douven, Rudy; Katona, Katalin; T Schut, Frederik; Shestalova, Victoria

2017-11-01

In this paper we estimate health plan price elasticities and financial switching gains for consumers over a 20-year period in which managed competition was introduced in the Dutch health insurance market. The period is characterized by a major health insurance reform in 2006 to provide health insurers with more incentives and tools to compete, and to provide consumers with a more differentiated choice of products. Prior to the reform, in the period 1995-2005, we find a low number of switchers, between 2 and 4% a year, modest average total switching gains of 2 million euros per year and short-term health plan price elasticities ranging from -0.1 to -0.4. The major reform in 2006 resulted in an all-time high switching rate of 18%, total switching gains of 130 million euros, and a high short-term price elasticity of -5.7. During 2007-2015 switching rates returned to lower levels, between 4 and 8% per year, with total switching gains in the order of 40 million euros per year on average. Total switching gains could have been 10 times higher if all consumers had switched to one of the cheapest plans. We find short-term price elasticities ranging between -0.9 and -2.2. Our estimations suggest substantial consumer inertia throughout the entire period, as we find degrees of choice persistence ranging from about 0.8 to 0.9.

National health insurance reform in South Africa: estimating the implications for demand for private health insurance.

Science.gov (United States)

Okorafor, Okore Apia

2012-05-01

A recent health reform proposal in South Africa proposes universal access to a comprehensive package of healthcare services in the public sector, through the implementation of a national health insurance (NHI) scheme. Implementation of the scheme is likely to involve the introduction of a payroll tax. It is implied that the introduction of the payroll tax will significantly reduce the size of the private health insurance market. The objective of this study was to estimate the impact of an NHI payroll tax on the demand for private health insurance in South Africa, and to explore the broader implications for health policy. The study applies probit regression analysis on household survey data to estimate the change in demand for private health insurance as a result of income shocks arising from the proposed NHI. The introduction of payroll taxes for the proposed NHI was estimated to result in a reduction to private health insurance membership of 0.73%. This suggests inelasticity in the demand for private health insurance. In the literature on the subject, this inelasticity is usually due to quality differences between alternatives. In the South African context, there may be other factors at play. An NHI tax may have a very small impact on the demand for private health insurance. Although additional financial resources will be raised through a payroll tax under the proposed NHI reform, systemic problems within the South African health system can adversely affect the ability of the NHI to translate additional finances into better quality healthcare. If these systemic challenges are not adequately addressed, the introduction of a payroll tax could introduce inefficiencies within the South African health system.

Optimum amount of an insurance sum in life insurance

Directory of Open Access Journals (Sweden)

Janez Balkovec

2001-01-01

Full Text Available Personal insurance represents one of the sources of personal social security as a category of personal property. How to get a proper life insurance is a frequently asked question. When insuring material objects (car, house..., the problem is usually not in the amount of the taken insurance. With life insurance (abstract goods, problems as such occur. In this paper, we wish to present a model that, according to the financial situation and the anticipated future, makes it possible to calculate the optimum insurance sum in life insurance.

The Selection of an Appropriate Count Data Model for Modelling Health Insurance and Health Care Demand: Case of Indonesia

Directory of Open Access Journals (Sweden)

Budi Hidayat

2009-12-01

Full Text Available We apply several estimators to Indonesian household data to estimate the relationship between health insurance and the number of outpatient visits to public and private providers. Once endogeneity of insurance is taken into account, there is a 63 percent increase in the average number of public visits by the beneficiaries of mandatory insurance for civil servants. Individuals' decisions to make first contact with private providers is affected by private insurance membership. However, insurance status does not make any difference for the number of future outpatient visits.

The design of long term care insurance contracts.

Science.gov (United States)

Cremer, Helmuth; Lozachmeur, Jean-Marie; Pestieau, Pierre

2016-12-01

This paper studies the design of long term care (LTC) insurance contracts in the presence of ex post moral hazard. While this problem bears some similarity with the study of health insurance (Blomqvist, 1997) the significance of informal LTC affects the problem in several crucial ways. It introduces the potential crowding out of informal care by market care financed through insurance coverage. Furthermore, the information structure becomes more intricate. Informal care is not publicly observable and, unlike the insurer, caregivers know the true needs of their relatives. We determine the optimal second-best contract and show that the optimal reimbursement rate can be written as an A-B-C expression à la Diamond (1998). These terms respectively reflect the efficiency loss as measured by the inverse of the demand elasticity, the distribution of needs and the preferences for risk sharing. Interestingly, informal care directly affects only the first term. More precisely the first term decreases with the presence and significance of informal care. Roughly speaking this means that an efficient LTC insurance contract should offer lower (marginal) reimbursement rates than its counterpart in a health insurance context. Copyright © 2016 Elsevier B.V. All rights reserved.

75 FR 63480 - Medicaid Program: Implementation of Section 614 of the Children's Health Insurance Program...

Science.gov (United States)

2010-10-15

... Children's Health Insurance Program Reauthorization Act of 2009 for Adjustments to the Federal Medical... section 614 of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law... Medicaid program and required by Section 614 of the Children's Health Insurance Program Reauthorization Act...

Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice

Science.gov (United States)

Krieger, Miriam; Felder, Stefan

2013-01-01

Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure. PMID:23783222

Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice

Directory of Open Access Journals (Sweden)

Stefan Felder

2013-06-01

Full Text Available Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure.

Premium Forecasting of an Insurance Company: Automobile Insurance

OpenAIRE

Fouladvand, M. Ebrahim; Darooneh, Amir H.

2002-01-01

We present an analytical study of an insurance company. We model the company's performance on a statistical basis and evaluate the predicted annual income of the company in terms of insurance parameters namely the premium, total number of the insured, average loss claims etc. We restrict ourselves to a single insurance class the so-called automobile insurance. We show the existence a crossover premium p_c below which the company is loss-making. Above p_c, we also give detailed statistical ana...

42 CFR 403.201 - State regulation of insurance policies.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false State regulation of insurance policies. 403.201 Section 403.201 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Medicare Supplemental Policies General Provisions...

Index-based Crop Insurance for Climate Adaptation in the Developing World

Science.gov (United States)

Brown, M. E.; Osgood, D. E.; Carriquiry, M. A.

2011-12-01

Weather has always presented a challenge to small-scale farmers, particularly in regions where poverty and lack of infrastructure has restricted the development of financial instruments to limit risk. New 'index' insurance innovations in agriculture are beginning to enable even the poorest farmers to unlock major productivity gains (e.g. insuring loans for improved seeds). Although index insurance has the potential to greatly improve productivity in developing country agriculture, the principal technical challenge to up-scaling this product is "data poverty," the absence of weather data in low-income areas needed to design robust and affordable insurance products. Earth science, particularly remote sensing, has the potential to ameliorate data poverty. However, raw use of earth science model output leads to non-optimal indexes and many obstacles remain to transform earth science products into insurance solutions. Estimation uncertainty, limited availability of consistent time series, and difficulties of predicting loses based on remote observations are reviewed in this article. The importance of multidisciplinary approaches addressing the needs of stakeholders in simple to understand indexes is highlighted. The successful use of Earth science data to support the index insurance industry in currently poor and isolated communities in the developing world would transform the ability of small farmers to increase yields, household incomes and regional economies, if the growing gap between earth science and index insurance can be closed.

75 FR 74863 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient...

Science.gov (United States)

2010-12-01

... Part III Department of Health and Human Services 45 CFR Part 158 Health Insurance Issuers... 0950-AA06 Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient... health insurance issuers under the Public Health Service Act, as added by the Patient Protection and...

Defining the key-parameters of insurance product in Islamic insurance

Directory of Open Access Journals (Sweden)

Galim Zaribzyanovich Vakhitov

2015-06-01

Full Text Available Objective to define the range of actuarial calculations in Islamic insurance to study the main differences of the traditional and Islamic insurance to define what changes in calculations entail the above differences. Methods mathematical modeling probabilistic analysis of insurance risks adaptation of methods of actuarial mathematics to the principles of Islamic insurance. Results the mathematical form of the takafulfund models is presented the distribution is analyzed of a random variable of the resulting insurance fund or the insurance company balance in a particular fixed insurance portfolio. Scientific novelty calculation are presented of the optimal tariff rate in takaful. Islamic insurance is an innovative area of insurance industry. Actuarial calculations that meet the Sharia rules are still being developed. The authors set the new tasks of actuarial calculations including the specified changes in the calculation of the optimal tariff rate imposed by the Islamic insurance principles. Practical value the results obtained can be used in the actuarial calculations of the Islamic insurance companies. nbsp

Assuring Adequate Health Insurance for Children With Special Health Care Needs: Progress From 2001 to 2009-2010.

Science.gov (United States)

Ghandour, Reem M; Comeau, Meg; Tobias, Carol; Dworetzky, Beth; Hamershock, Rose; Honberg, Lynda; Mann, Marie Y; Bachman, Sara S

2015-01-01

To report on coverage and adequacy of health insurance for children with special health care needs (CSHCN) in 2009-2010 and assess changes since 2001. Data were from the National Survey of Children with Special Health Care Needs (NS-CSHCN), a random-digit telephone survey with 40,243 (2009-2010) and 38,866 (2001) completed interviews. Consistency and adequacy of insurance was measured by: 1) coverage status, 2) gaps in coverage, 3) coverage of needed services, 4) reasonableness of uncovered costs, and 5) ability to see needed providers, as reported by parents. Bivariate and multivariable analyses were conducted to assess factors associated with adequate insurance coverage in 2009-2010. Unadjusted and adjusted prevalence estimates were examined to identify changes in the type of insurance coverage and the proportion of CSHCN with adequate coverage by insurance type. The proportion of CSHCN with private coverage decreased from 64.7% to 50.7% between 2001 and 2009-2010, while public coverage increased from 21.7% to 34.7%; the proportion of CSHCN without any insurance declined from 5.2% to 3.5%. The proportion of CSHCN with adequate coverage varied over time and by insurance type: among privately covered CSHCN, the proportion with adequate coverage declined (62.6% to 59.6%), while among publicly covered CSHCN, the proportion with adequate insurance increased (63.0% to 70.7%). Publicly insured CSHCN experienced improvements in each of the 3 adequacy components. There has been a continued shift from private to public coverage, which is more affordable, offers benefits that are more likely to meet CSHCN needs, and allowed CSHCN to see necessary providers. Published by Elsevier Inc.

78 FR 13399 - Open Meeting of the Federal Advisory Committee on Insurance

Science.gov (United States)

2013-02-27

....treasury.gov/about/organizational-structure/offices/Pages/Federal-Insurance.aspx without change, including any business or personal information provided such as names, addresses, email addresses, or telephone...: Members of the public wishing to comment on the business of the Federal Advisory Committee on Insurance...

78 FR 54371 - Open Meeting of the Federal Advisory Committee on Insurance

Science.gov (United States)

2013-09-03

... into the building: first and last name, organization, date of birth, social security number, and...: Members of the public wishing to comment on the business of the Federal Advisory Committee on Insurance....treasury.gov/about/organizational-structure/offices/Pages/Federal-Insurance.aspx without change, including...

Underutilization of social insurance among the poor: evidence from the Philippines.

Directory of Open Access Journals (Sweden)

Stella Quimbo

Full Text Available Many developing countries promote social health insurance as a means to eliminate unmet health needs. However, this strategy may be ineffective if there are barriers to fully utilizing insurance.We analyzed the utilization of social health insurance in 30 hospital districts in the central regions of the Philippines between 2003 and 2007. Data for the study came from the Quality Improvement Demonstration Study (QIDS and included detailed patient information from exit interviews of children under 5 years of age conducted in seven waves among public hospital districts located in the four central regions of the Philippines. These data were used to estimate and identify predictors of underutilization of insurance benefits--defined as the likelihood of not filing claims despite having legitimate insurance coverage--using logistic regression.Multivariate analyses using QIDS data from 2004 to 2007 reveal that underutilization averaged about 15% throughout the study period. Underutilization, however, declined over time. Among insured hospitalized children, increasing length of stay in the hospital and mother's education, were associated with less underutilization. Being in a QIDS intervention site was also associated with less underutilization and partially accounts for the downward trend in underutilization over time.The surprisingly high level of insurance underutilization by insured patients in the QIDS sites undermines the potentially positive impact of social health insurance on the health of the marginalized. In the Philippines, where the largest burden of health care spending falls on households, underutilization suggests ineffective distribution of public funds, failing to reach a significant proportion of households which are by and large poor. Interventions that improve benefit awareness may combat the problem of underutilization and should be the focus of further research in this area.

Business Storytelling and Leadership in the Insurance Companies from Romania

Directory of Open Access Journals (Sweden)

Viorica Păuș

2013-12-01

Full Text Available The research addresses a new concept introduced into the managerial practice of the insurance industry from Romania and it aims to test the hypothesis that success, performance and competitiveness of the organizations in the insurance industry depend also on the quality of the leadership and the leaders’ ability to use storytelling, taking into account the intangibility of the insurance products. The main tool that this exploratory, qualitative research has used is the structured interview with three target groups, which we considered to be relevant: CEOs/managers of insurance companies and insurance brokerage firms, public relations specialists and economic journalists. The results of our research endeavours may be of interest for both the managers, employees and communication specialists in the insurance industry and the business world in general, for which the introduction of storytelling in the leadership practices might increase the attractiveness not only for employees, but also for stakeholders and customers.

Tuberculosis Prevention in the Private Sector: Using Claims-Based Methods to Identify and Evaluate Latent Tuberculosis Infection Treatment With Isoniazid Among the Commercially Insured.

Science.gov (United States)

Stockbridge, Erica L; Miller, Thaddeus L; Carlson, Erin K; Ho, Christine

Targeted identification and treatment of people with latent tuberculosis infection (LTBI) are key components of the US tuberculosis elimination strategy. Because of recent policy changes, some LTBI treatment may shift from public health departments to the private sector. To (1) develop methodology to estimate initiation and completion of treatment with isoniazid for LTBI using claims data, and (2) estimate treatment completion rates for isoniazid regimens from commercial insurance claims. Medical and pharmacy claims data representing insurance-paid services rendered and prescriptions filled between January 2011 and March 2015 were analyzed. Four million commercially insured individuals 0 to 64 years of age. Six-month and 9-month treatment completion rates for isoniazid LTBI regimens. There was an annual isoniazid LTBI treatment initiation rate of 12.5/100 000 insured persons. Of 1074 unique courses of treatment with isoniazid for which treatment completion could be assessed, almost half (46.3%; confidence interval, 43.3-49.3) completed 6 or more months of therapy. Of those, approximately half (48.9%; confidence interval, 44.5-53.3) completed 9 months or more. Claims data can be used to identify and evaluate LTBI treatment with isoniazid occurring in the commercial sector. Completion rates were in the range of those found in public health settings. These findings suggest that the commercial sector may be a valuable adjunct to more traditional venues for tuberculosis prevention. In addition, these newly developed claims-based methods offer a means to gain important insights and open new avenues to monitor, evaluate, and coordinate tuberculosis prevention.

Exploring health insurance services in Sudan from the perspectives of insurers.

Science.gov (United States)

Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

2018-01-01

It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers' affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social

Health insurance coverage and racial disparities in breast reconstruction after mastectomy.

Science.gov (United States)

Shippee, Tetyana P; Kozhimannil, Katy B; Rowan, Kathleen; Virnig, Beth A

2014-01-01

Breast reconstruction after mastectomy offers clinical, cosmetic, and psychological benefits compared with mastectomy alone. Although reconstruction rates have increased, racial/ethnic disparities in breast reconstruction persist. Insurance coverage facilitates access to care, but few studies have examined whether health insurance ameliorates disparities. We used the Nationwide Inpatient Sample for 2002 through 2006 to examine the relationships between health insurance coverage, race/ethnicity, and breast reconstruction rates among women who underwent mastectomy for breast cancer. We examined reconstruction rates as a function of the interaction of race and the primary payer (self-pay, private health insurance, government) while controlling for patient comorbidity, and we used generalized estimating equations to account for clustering and hospital characteristics. Minority women had lower breast reconstruction rates than White women (adjusted odds ratio [AOR], 0.57 for African American; AOR, 0.70 for Hispanic; AOR, 0.45 for Asian; p women (AOR, 0.33) and those with public coverage were less likely to undergo reconstruction (AOR, 0.35; p women. Racial/ethnic disparities were less prominent within insurance types. Minority women, whether privately or publicly insured, had lower odds of undergoing reconstruction than White women. Among those without insurance, reconstruction rates did not differ by race/ethnicity. Insurance facilitates access to care, but does not eliminate racial/ethnic disparities in reconstruction rates. Our findings-which reveal persistent health care disparities not explained by patient health status-should prompt efforts to promote both access to and use of beneficial covered services for women with breast cancer. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Reimbursement for Supportive Cancer Medications Through Private Insurance in Saskatchewan

Science.gov (United States)

Forte, Lindy; Olson, Colleen; Atchison, Carolyn; Gesy, Kathy

2009-01-01

Background: As demand for cancer treatment grows, and newer, more expensive drugs become available, public payers in Canada are finding it increasingly difficult to fund the full range of available cancer drugs. Objective: To determine the extent of private drug coverage for supportive cancer treatments in Saskatchewan, preparatory to exploring the potential for cost-sharing. Methods: Patients who presented for chemotherapy and who provided informed consent for participation were surveyed regarding their access to private insurance. Insurers were contacted to verify patients' level of coverage for supportive cancer medications. Groups with specified types of insurance were compared statistically in terms of age, income bracket, time required to assess insurance status, and amount of deductible. Logistic regression was used to determine the effect of patients' age and income on the probability of having insurance. Results: Of 169 patients approached to participate, 156 provided consent and completed the survey. Their mean age was 58.5 years. About two-fifths of all patients (64 or 41%) were in the lowest income bracket (up to $30 000). Sixty-three (40%) of the patients had private insurance for drugs, and 36 (57%) of these plans included reimbursement for supportive cancer medications. A deductible was in effect in 31 (49%) of the plans, a copayment in 28 (44%), and a maximum payment in 8 (13%). Income over $50 000 was a significant predictor of access to drug insurance (p = 0.003), but age was not significantly related to insurance status. Conclusions: A substantial proportion of cancer patients in this study had access to private insurance for supportive cancer drugs for which reimbursement is currently provided by the Saskatchewan Cancer Agency. Cost-sharing and optimal utilization of the multipayer environment might offer a greater opportunity for public payers to cover future innovative and supportive therapies for cancer, but further study is required to

24 CFR 266.600 - Mortgage insurance premium: Insurance upon completion.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium... MULTIFAMILY PROJECT LOANS Contract Rights and Obligations Mortgage Insurance Premiums § 266.600 Mortgage insurance premium: Insurance upon completion. (a) Initial premium. For projects insured upon completion, on...

Strengthening insurance partnerships in the face of climate change - Insights from an agent-based model of flood insurance in the UK.

Science.gov (United States)

Crick, Florence; Jenkins, Katie; Surminski, Swenja

2018-04-25

Multisectoral partnerships are increasingly cited as a mechanism to deliver and improve disaster risk management. Yet, partnerships are not a panacea and more research is required to understand the role that they can play in disaster risk management and particularly disaster risk reduction. This paper investigates how partnerships can incentivise flood risk reduction by focusing on the UK public-private partnership on flood insurance. Developing the right flood insurance arrangements to incentivise flood risk reduction and adaptation to climate change is a key challenge. In the face of rising flood risks due to climate change and socio-economic development insurance partnerships can no longer afford to focus only on the risk transfer function. However, while expectations of the insurance industry have traditionally been high when it comes to flood risk management, the insurance industry alone will not provide the solution to the challenge of rising risks. The case of flood insurance in the UK illustrates this: even national government and industry together cannot fully address these risks and other actors need to be involved to create strong incentives for risk reduction. Using an agent-based model focused on surface water flood risk in London we analyse how other partners could strengthen the insurance partnership by reducing flood risk and thus helping to maintain affordable insurance premiums. Our findings are relevant for wider discussions on the potential of insurance schemes to incentivise flood risk management and climate adaptation in the UK and also internationally. Copyright © 2018. Published by Elsevier B.V.

What are the factors predictive of hysterosalpingogram compliance after female sterilization by the Essure procedure in a publicly insured population?

Science.gov (United States)

Howard, David L; Wall, Jeffrey; Strickland, Julie L

2013-12-01

To determine what factors are predictive of post-Essure hysterosalpingogram (HSG) compliance. We conducted a retrospective chart review of all patients who underwent the Essure procedure at the two campuses of the Truman Medical Center, Kansas City, Missouri, from January 1, 2005 through December 31, 2010. Our study population consisted primarily of women who were publicly insured (89.0 %) and unmarried (76.7 %). Of 132 patients referred for HSG, 70 (53.0 %) complied. In adjusted analyses women 35 years and older had an almost fourfold higher odds of HSG compliance (OR = 3.72, 95 % CI 1.35-10.23) and women with 3 or more living children had a 64 % lower odds of HSG compliance (OR = 0.36, 95 % CI 0.16-0.82). Women younger than 35 who had 3 or more children had the lowest compliance rate (36.4 %) suggesting an interaction between age and parity. Women undergoing the Essure procedure at the campus with a dedicated protocol to ensure compliance had an almost fourfold higher odds of HSG compliance (OR = 3.67, 95 % CI 1.01-13.40). In a population consisting largely of publicly insured, unmarried women, several factors are predictive of post-Essure HSG compliance. These include age, parity and the presence or absence of an institutional protocol to keep track of patients after their Essure procedure.

The effect of private health insurance on medical care utilization and self-assessed health in Germany

NARCIS (Netherlands)

Hullegie, P.G.J.; Klein, T.J.

2010-01-01

In Germany, employees are generally obliged to participate in the public health insurance system, where coverage is universal, co-payments and deductibles are moderate, and premia are based on income. However, they may buy private insurance instead if their income exceeds the compulsory insurance

76 FR 77442 - Mutual Insurance Holding Company Treated as Insurance Company

Science.gov (United States)

2011-12-13

... insurance industry traces its roots back to England, where, in 1696, the first mutual fire insurer was... FEDERAL DEPOSIT INSURANCE CORPORATION 12 CFR Part 380 RIN 3064-AD89 Mutual Insurance Holding Company Treated as Insurance Company AGENCY: Federal Deposit Insurance Corporation (FDIC). ACTION: Notice...

Dynamics of social health insurance development: examining the determinants of Chinese basic health insurance coverage with panel data.

Science.gov (United States)

Liu, Jun-Qiang

2011-08-01

Social health insurance (SHI) is gaining popularity in many developing countries, but there are few systematic empirical studies on the dynamics of SHI development. This study investigates the determinants of coverage of the Basic Healthcare Insurance for Urban Employees (BHI) in China. Using a panel database ranging from 1999 to 2007, the study finds that: (1) economic development plays a valuable role in BHI development; (2) strong financial capacity and administrative capacity in the government contributes to BHI progress; (3) higher trade union density is closely related to more rapid BHI expansion; and (4) taxation agencies are better at collecting SHI premiums. These findings provide evidence-based lessons for new and ongoing SHI programs. In addition, this article aims to make a more general contribution to the study of social policy development by expanding the scope of current theories on social policy development. Copyright © 2011 Elsevier Ltd. All rights reserved.

Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

Science.gov (United States)

Fang, Hai; Jin, Yinzi; Zhao, Miaomiao; Zhang, Huyang; A Rizzo, John; Zhang, Donglan; Hou, Zhiyuan

2017-10-20

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants' probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management.

Health Insurance for Government Employees in Bangladesh: A Concept Paper

OpenAIRE

Hamid, Syed Abdul

2014-01-01

Introducing compulsory health insurance for government employees bears immense importance for stepping towards universal healthcare coverage in Bangladesh. Lack of scientific study on designing such scheme, in the Bangladesh context, motivates this paper. The study aims at designing a comprehensive insurance package simultaneously covering health, life and accident related disability risks of the public employees, where the health component would extend to all dependent family members. ...

Sociodemographic disparities in survival for adolescents and young adults with cancer differ by health insurance status.

Science.gov (United States)

DeRouen, Mindy C; Parsons, Helen M; Kent, Erin E; Pollock, Brad H; Keegan, Theresa H M

2017-08-01

To investigate associations of sociodemographic factors-race/ethnicity, neighborhood socioeconomic status (SES), and health insurance-with survival for adolescents and young adults (AYAs) with invasive cancer. Data on 80,855 AYAs with invasive cancer diagnosed in California 2001-2011 were obtained from the California Cancer Registry. We used multivariable Cox proportional hazards regression to estimate overall survival. Associations of public or no insurance with greater risk of death were observed for 11 of 12 AYA cancers examined. Compared to Whites, Blacks experienced greater risk of death, regardless of age or insurance, while greater risk of death among Hispanics and Asians was more apparent for younger AYAs and for those with private/military insurance. More pronounced neighborhood SES disparities in survival were observed among AYAs with private/military insurance, especially among younger AYAs. Lacking or having public insurance was consistently associated with shorter survival, while disparities according to race/ethnicity and neighborhood SES were greater among AYAs with private/military insurance. While health insurance coverage associates with survival, remaining racial/ethnic and socioeconomic disparities among AYAs with cancer suggest additional social factors also need consideration in intervention and policy development.

Neighborhood Deprivation and Childhood Asthma Outcomes, Accounting for Insurance Coverage.

Science.gov (United States)

Nkoy, Flory L; Stone, Bryan L; Knighton, Andrew J; Fassl, Bernhard A; Johnson, Joseph M; Maloney, Christopher G; Savitz, Lucy A

2018-01-09

Collecting social determinants data is challenging. We assigned patients a neighborhood-level social determinant measure, the area of deprivation index (ADI), by using census data. We then assessed the association between neighborhood deprivation and asthma hospitalization outcomes and tested the influence of insurance coverage. A retrospective cohort study of children 2 to 17 years old admitted for asthma at 8 hospitals. An administrative database was used to collect patient data, including hospitalization outcomes and neighborhood deprivation status (ADI scores), which were grouped into quintiles (ADI 1, the least deprived neighborhoods; ADI 5, the most deprived neighborhoods). We used multivariable models, adjusting for covariates, to assess the associations and added a neighborhood deprivation status and insurance coverage interaction term. A total of 2270 children (median age 5 years; 40.6% girls) were admitted for asthma. We noted that higher ADI quintiles were associated with greater length of stay, higher cost, and more asthma readmissions ( P < .05 for most quintiles). Having public insurance was independently associated with greater length of stay (β: 1.171; 95% confidence interval [CI]: 1.117-1.228; P < .001), higher cost (β: 1.147; 95% CI: 1.093-1.203; P < .001), and higher readmission odds (odds ratio: 1.81; 95% CI: 1.46-2.24; P < .001). There was a significant deprivation-insurance effect modification, with public insurance associated with worse outcomes and private insurance with better outcomes across ADI quintiles ( P < .05 for most combinations). Neighborhood-level ADI measure is associated with asthma hospitalization outcomes. However, insurance coverage modifies this relationship and needs to be considered when using the ADI to identify and address health care disparities. Copyright © 2018 by the American Academy of Pediatrics.

Stability of children's insurance coverage and implications for access to care: evidence from the Survey of Income and Program Participation.

Science.gov (United States)

Buchmueller, Thomas; Orzol, Sean M; Shore-Sheppard, Lara

2014-06-01

Even as the number of children with health insurance has increased, coverage transitions--movement into and out of coverage and between public and private insurance--have become more common. Using data from 1996 to 2005, we examine whether insurance instability has implications for access to primary care. Because unobserved factors related to parental behavior and child health may affect both the stability of coverage and utilization, we estimate the relationship between insurance and the probability that a child has at least one physician visit per year using a model that includes child fixed effects to account for unobserved heterogeneity. Although we find that unobserved heterogeneity is an important factor influencing cross-sectional correlations, conditioning on child fixed effects we find a statistically and economically significant relationship between insurance coverage stability and access to care. Children who have part-year public or private insurance are more likely to have at least one doctor's visit than children who are uninsured for a full year, but less likely than children with full-year coverage. We find comparable effects for public and private insurance. Although cross-sectional analyses suggest that transitions directly between public and private insurance are associated with lower rates of utilization, the evidence of such an effect is much weaker when we condition on child fixed effects.

Deposit Insurance Coverage, Credibility of Non-insurance, and Banking Crises

DEFF Research Database (Denmark)

Angkinand, Apanard; Wihlborg, Clas

2005-01-01

level require analyses of institutional factors affecting the credibility of non-insurance. In particular, the implementation of effective distress resolution procedures for banks would allow governments to reduce explicit deposit insurance coverage and, thereby, to strengthen market discipline......The ambiguity in existing empirical work with respect to effects of deposit insurance schemes on banks' risk-taking can be resolved if it is recognized that absence of deposit insurance is rarely credible and that the credibility of non-insurance can be enhanced by explicit deposit insurance...... schemes. We show that under reasonable conditions for effects on risk-taking of creditor protection in banking, and for effects on credibility of non-insurance of explicit coverage of deposit insurance schemes, there exists a partial level of coverage that maximizes market discipline and minimizes moral...

Nuclear insurance

International Nuclear Information System (INIS)

Anon.

1992-01-01

The yearbook contains among others the figures of the nuclear insurance line. According to these these the DKVG (German nuclear power plant insurance association) has 102 member insurance companies all registered in the Federal Republic of Germany. By using reinsurance capacities of the other pools at present property insurance amounts to 1.5 billion DM and liability insurance to 200 million DM. In 1991 the damage charges on account of DKV amounted to 3.1 (1990 : 4.3) million DM. From these 0.6 million DM are apportioned to payments and 2.5 million DM to reserves. One large damage would cost a maximum gross sum of 2.2 billion DM property and liability insurance; on account of DKVG 750 million DM. (orig./HSCH) [de

77 FR 28788 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Under the Patient Protection and...

Science.gov (United States)

2012-05-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES 45 CFR Part 158 [CMS-9998-IFC3] Health Insurance Issuers..., entitled ``Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient...) requirements for health insurance issuers under section 2718 of the Public Health Service Act, as added by the...

Health seeking behavior in karnataka: does micro-health insurance matter?

Science.gov (United States)

Savitha, S; Kiran, Kb

2013-10-01

Health seeking behaviour in the event of illness is influenced by the availability of good health care facilities and health care financing mechanisms. Micro health insurance not only promotes formal health care utilization at private providers but also reduces the cost of care by providing the insurance coverage. This paper explores the impact of Sampoorna Suraksha Programme, a micro health insurance scheme on the health seeking behaviour of households during illness in Karnataka, India. The study was conducted in three randomly selected districts in Karnataka, India in the first half of the year 2011. The hypothesis was tested using binary logistic regression analysis on the data collected from randomly selected 1146 households consisting of 4961 individuals. Insured individuals were seeking care at private hospitals than public hospitals due to the reduction in financial barrier. Moreover, equity in health seeking behaviour among insured individuals was observed. Our finding does represent a desirable result for health policy makers and micro finance institutions to advocate for the inclusion of health insurance in their portfolio, at least from the HSB perspective.

Can Health Insurance Reduce School Absenteeism?

Science.gov (United States)

Yeung, Ryan; Gunton, Bradley; Kalbacher, Dylan; Seltzer, Jed; Wesolowski, Hannah

2011-01-01

Enacted in 1997, the State Children's Health Insurance Program (SCHIP) represented the largest expansion of U.S. public health care coverage since the passage of Medicare and Medicaid 32 years earlier. Although the program has recently been reauthorized, there remains a considerable lack of thorough and well-designed evaluations of the program. In…

Multilevel predictors of colorectal cancer testing modality among publicly and privately insured people turning 50

Directory of Open Access Journals (Sweden)

Stephanie B. Wheeler

2017-06-01

Both colonoscopy and FOBT/FIT are widely used in North Carolina among insured persons newly age-eligible for screening. The high level of FOBT/FIT use among privately insured persons and women suggests that renewed emphasis on FOBT/FIT as a viable screening alternative to colonoscopy may be important.

Report on the Observance of Standards and Codes, Accounting and Auditing : Module B - Institutional Framework for Corporate Financial Reporting, B.4 Financial Sector - Insurance

OpenAIRE

World Bank

2017-01-01

The purpose of this report is to gain an understanding of the financial reporting requirements for insurance companies in a jurisdiction in addition to or instead of the requirements for commercial enterprises in general. Unless otherwise stated, the term insurance company refers to both insurance and reinsurance companies. There are also questions in relation to the monitoring and enforce...

Comparison of health literacy in privately insured and public hospital orthopaedic patients.

Science.gov (United States)

Cosic, Filip; Porter, Tabitha; Norsworthy, Cameron; Price, Rohan; Bedi, Harvinder

2018-05-14

Objective The aim of the present study was to quantify and compare patient health literacy between privately insured and public orthopaedic patients. Methods As part of the present cross-sectional study, elective postoperative orthopaedic patients across two sites were recruited and asked to complete a questionnaire at the first postoperative out-patient review. Patients were divided into three groups: (1) a public group (Public); (2) a private group (Private-pre); and (3) a private group that completed the questionnaire immediately after the out-patient review (Private-post). The questionnaire consisted of six questions regarding surgical management, expected recovery time and postoperative instructions. Patients were further asked to grade their satisfaction regarding information received throughout their management. Results In all, 150 patients completed the questionnaire, 50 in each of the three groups. Patients in the Public, Private-pre and Private-post groups answered a mean 2.74, 3.24 and 4.70 of 6 questions correctly respectively. The Private-pre group was 1.46-fold more likely to demonstrate correct health literacy than the Public group, whereas the Private-post group was 2.44-fold more likely to demonstrate improved health literacy than the Private-pre group. Patient satisfaction with information received was not associated with health literacy. Conclusion Limited health literacy in orthopaedic patients continues to be an area of concern. Both private and public orthopaedic patients demonstrated poor health literacy, but private patients demonstrated significant improvement after the out-patient review. What is known about the topic? Limited health literacy is a growing public health issue worldwide, with previous literature demonstrating a prevalence of low health literacy of 26% and marginal health literacy of 20% among all patient populations. Of concern, limited health literacy has been shown to result in a range of adverse health outcomes, including

State of emergency preparedness for US health insurance plans.

Science.gov (United States)

Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

2015-01-01

Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

ROMANIA’S PRIVATE HEALTH INSURANCE MARKET POTENTIAL

Directory of Open Access Journals (Sweden)

GHEORGHE MATEI

2012-10-01

Full Text Available The significant gap between the quality of life and the level of health expenditure has led to the need to reconsider the modalities and the sources of collecting and redirecting the funds of the sanitary sector in such a way that sustainable medical results are generated for the entire population of the globe. Under these circumstances, the role of private health insurance is constantly increasing, even though its importance is still being influenced by the types of social policy and the dimension of the public health sector at national level. Due to the impact of these factors, the actual dimension of private health insurance market varies significantly across countries. In order to be able to realistically assess the level of development of the private health insurance market in Romania, the analysis has to be taken further than the simplistic measurement of indicators such as income and expenditure.

78 FR 7484 - Insurer Reporting Requirements; Reports Under 49 U.S.C. on Section 33112(c)

Science.gov (United States)

2013-02-01

.... SUMMARY: This notice announces publication by NHTSA of the annual insurer report on motor vehicle theft... information on theft and recovery of vehicles; rating rules and plans used by motor vehicle insurers to reduce premiums due to a reduction in motor vehicle thefts; and actions taken by insurers to assist in deterring...

Insurance crisis

International Nuclear Information System (INIS)

Williams, P.L.

1996-01-01

The article discusses the effects of financing and technology advances on the availability of insurance for independent power producers operating gas turbines. Combined cycle units which require new materials and processes make it difficult to assess risk. Insurers are denying coverage, or raising prices and deductibles. Many lenders, however, are requiring insurance prior to financing. Some solutions proposed include information sharing by industry participants and insurers and increased risk acceptance by plant owners/operators

Exogenous factors and market value: an appraisal model of capital gains in urban redevelopment programs in public/ private partnerships

Directory of Open Access Journals (Sweden)

Francesco Calabrò

2013-08-01

Full Text Available The proposed article aims to illustrate an experimental model applicable, in the planning stage, to an appraisal of the capital gains in a residential requalification in public/ private partnership. The model develops a method using a conventional cost value through a multicriteria model which evaluates the influence of qualitative exogenous variables to the market value of the property. The aim is to develop a synthetic procedure, transparent, shared and easy to use by the public authorities, in determining the total benefits associated with urban transformations, in order to achieve a fair sharing of profits between public and private entities.

Universal health insurance through incentives reform.

Science.gov (United States)

Enthoven, A C; Kronick, R

1991-05-15

Roughly 35 million Americans have no health care coverage. Health care expenditures are out of control. The problems of access and cost are inextricably related. Important correctable causes include cost-unconscious demand, a system not organized for quality and economy, market failure, and public funds not distributed equitably or effectively to motivate widespread coverage. We propose Public Sponsor agencies to offer subsidized coverage to those otherwise uninsured, mandated employer-provided health insurance, premium contributions from all employers and employees, a limit on tax-free employer contributions to employee health insurance, and "managed competition". Our proposed new government revenues equal proposed new outlays. We believe our proposal will work because efficient managed care does exist and can provide satisfactory care for a cost far below that of the traditional fee-for-service third-party payment system. Presented with an opportunity to make an economically responsible choice, people choose value for money; the dynamic created by these individual choices will give providers strong incentives to render high-quality, economical care. We believe that providers will respond to these incentives.

Nuclear liability insurance in the United States: an insurer's perspective

International Nuclear Information System (INIS)

Quattrocchi, J.

2000-01-01

By the mid-1950's the United States recognised that it was in the interest to promote commercial development of nuclear energy. But the uncertainties of the technology and the potential for severe accidents were clear obstacles to commercial development. Exposure to potentially serious uninsured liability inhibited the private sector. These impediments led Congress to enact the Price-Anderson Act in 1957. The Act had several purposes: the first was to encourage private development of nuclear power; the second was to establish a legal framework for handling potential liability claims; and the third was to provide a ready source of funds to compensate injured victims of a nuclear accident. Insurers chose the pooling technique by creating in the US the American Nuclear Insurers. ANI acts as a managing agent for its members insurance companies. The accident of three Miles Island occurred on 28 March 1979 and with came the claims experience in US. The 1988 amendments to the Price-Anderson Act directed the President to establish a Commission for the purpose of developing a means to assure full compensation of victims of a catastrophic nuclear accident that exceeds the limitation on aggregate public liability, or currently just over US$ 9.7 billion. The Presidential Commission issued its report in August 1990, in which it reached a number of conclusions and offered a number of recommendations.The US Congress has not acted on the Commission's report, but may revisit its recommendations as debate begins this year (1999) or next on the renewal of the Price-Anderson Act. (N.C.)

Economic reforms and health insurance in China.

Science.gov (United States)

Du, Juan

2009-08-01

During the 1990s, Chinese state-owned enterprises (SOEs) and collective enterprises continually decreased coverage of public health insurance to their employees. This paper investigates this changing pattern of health insurance coverage in China using panel data from the China Nutrition and Health Survey (1991-2000). It is the first attempt in this literature that tries to identify precisely the effects of specific policies and reforms on health insurance coverage in the transitional period of China. The fixed effects linear model clustering at the province level is used for estimation, and results are compared to alternative models, including pooled OLS, random effects GLS model and fixed effects logit model. Strong empirical evidence is found that unemployment as a side effect of the Open Door Policy, and the deregulation of SOE and collective enterprises were the main causes for the decreasing trend. For example, urban areas that were highly affected by the Open Door Policy were associated with 17 percentage points decrease in the insurance coverage. Moreover, I found evidence that the gaps between SOE and non-SOE employees, collective and non-collective employees, urban and rural employees have considerably decreased during the ten years.

Value-based insurance design: consumers' views on paying more for high-cost, low-value care.

Science.gov (United States)

Ginsburg, Marjorie

2010-11-01

Value-based insurance designs frequently lower consumers' cost sharing to motivate healthy behavior, such as adhering to medication regimens. Few health care purchasers have followed the more controversial approach of using increased cost sharing to temper demand for high-cost, low-value medical care. Yet there is evidence that when health care's affordability is at stake, the public may be willing to compromise on coverage of certain medical problems and less effective treatments. Businesses should engage employees in discussions about if and how this type of value-based insurance design should apply to their own insurance coverage. A similar process could also be used for Medicare and other public-sector programs.

Health insurance trends point to an increase in uninsured children in New York and New Jersey

OpenAIRE

Carol Rapaport; Reagan Murray

2000-01-01

Between 1988 and 1997, the percentage of children in New York and New Jersey receiving public health insurance increased modestly, while the percentage of children with private insurance showed a sharp decline. The net effect of these changes has been a marked rise in the share of Second District children without any health insurance.

Mitigation Index Insurance for Developing Countries: Insure the Loss or Insure the Signal?

OpenAIRE

Li, Yiting; Miranda, Mario J.

2015-01-01

Conventional agricultural index insurance indemnifies based on the observed value of a specified variable, such as rainfall, that is correlated with agricultural production losses. Typically, indemnities are paid to the policyholder after the losses have been experienced. This paper explores alternate timing for index insurance payouts. In particular, we explore the potential benefits of what we call “mitigation index insurance” in which the payouts of the insurance contract arrive before los...

Body weight gain during adulthood and uterine myomas: Pró-Saúde Study

Directory of Open Access Journals (Sweden)

Karine de Lima Sírio Boclin

2015-01-01

Full Text Available This study intended to investigate whether body weight gain during adulthood is associated with uterine myomas. 1,560 subjects were evaluated in a Pró-Saúde Study. Weight gain was evaluated in a continuous fashion and also in quintiles. Odds ratios and 95% confidence intervals were estimated through logistic regression models that were adjusted for education levels, color/race, body mass indices at age 20, age of menarche, parity, use of oral contraceptive methods, smoking, health insurance, and the Papanicolaou tests. No relevant differences were observed regarding the presence of uterine myomas among weight gain quintiles in that studied population.

Disability Insurance and Health Insurance Reform: Evidence from Massachusetts

OpenAIRE

Nicole Maestas; Kathleen J. Mullen; Alexander Strand

2014-01-01

As health insurance becomes available outside of the employment relationship as a result of the Affordable Care Act (ACA), the cost of applying for Social Security Disability Insurance (SSDI)–potentially going without health insurance coverage during a waiting period totaling 29 months from disability onset–will decline for many people with employer-sponsored health insurance. At the same time, the value of SSDI and Supplemental Security Income (SSI) participation will decline for individuals...

Insurance of professional responsibility at medical aid rendering

Directory of Open Access Journals (Sweden)

Abyzova N.V.

2011-12-01

Full Text Available The article discusses the necessity of adoption of professional responsibility insurance act into the public health service. It is considered as the basic mechanism of compensation in case of damage to a patient at medical aid rendering

Probabilistic Insurance

NARCIS (Netherlands)

Wakker, P.P.; Thaler, R.H.; Tversky, A.

1997-01-01

Probabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in premium to compensate for a 1% default risk. These observations cannot be

Probabilistic Insurance

NARCIS (Netherlands)

P.P. Wakker (Peter); R.H. Thaler (Richard); A. Tversky (Amos)

1997-01-01

textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these

The role of unemployment insurance during the economic and financial crisis

Directory of Open Access Journals (Sweden)

Anca-Stefania SAVA

2010-08-01

Full Text Available The aim of this paper is to discuss the role of unemployment insurance during recession. Firstly, it presents a brief literature review, according to which unemployment insurance works as a built-in stabilizer for the economy. Secondly, it highlights certain characteristics of these programs in developed and developing countries, in recession periods. Also, it analyzes the evolution of Romanian unemployment insurance indicators during 2004-2009 and finds that public expenditures had an opposite trend to that of GDP and budgetary revenues, decreasing during periods of economic growthand increasing during the current recession, which suggests an interaction with the economic cycle.

Health Insurance Basics

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the "Borda" Method: a Pilot Study.

Science.gov (United States)

Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

2015-01-01

Decision-making for medicines to be accepted in Iran's public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called "Borda" in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software "Math-lab"7, "SPSS" 17 and Excel 2007 were used in this study. "Borda" estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance decision making.

Federal Deposit Insurance Corporation (FDIC) Insured Banks

Data.gov (United States)

Department of Homeland Security — The Summary of Deposits (SOD) is the annual survey of branch office deposits for all FDIC-insured institutions including insured U.S. branches of foreign banks. Data...

Efficiency and competition in the Dutch non-life insurance industry: Effects of the 2006 health care reform

NARCIS (Netherlands)

Bikker, Jaap; Popescu, Adelina

This paper investigates the cost efficiency and competitive behaviour of the non-life – or property and casualty – insurance market in the Netherlands over the period 1995-2012. We focus on the 2006 health care reform, where public health care insurance has been included in the non-life insurance

Challenges of medicines management in the public and private sector under Ghana's National Health Insurance Scheme - A qualitative study.

Science.gov (United States)

Ashigbie, Paul G; Azameti, Devine; Wirtz, Veronika J

2016-01-01

Ghana established its National Health Insurance Scheme (NHIS) in 2003 with the goal of ensuring more equitable financing of health care to improve access to health services. This qualitative study examines the challenges and consequences of medicines management policies and practices under the NHIS as perceived by public and private service providers. This study was conducted in health facilities in the Eastern, Greater Accra and Volta regions of Ghana between July and August 2014. We interviewed 26 Key Informants (KIs) from a purposively selected sample of public and private sector providers (government and mission hospitals, private hospitals and private standalone pharmacies), pharmaceutical suppliers and NHIS district offices. Data was collected using semi-structured interview guides which covered facility accreditation, reimbursement practices, medicines selection, purchasing and pricing of medicines, and utilization of medicines. Codes for data analysis were developed based on the study questions and also in response to themes that emerged from the transcripts and notes. Most KIs agreed that the introduction of the NHIS has increased access to and utilization of medicines by removing cost barriers for patients; however, some pointed out the increased utilization could also be corollary to moral hazard. Common concerns across all facilities were the delays in receiving NHIS reimbursements, and low reimbursement rates for medicines which result in providers asking patients to pay supplementary fees. KIs reported important differences between private and public sectors including weak separation of prescribing and dispensing and limited use of drugs and therapeutic committees in the private sector, the disproportionate effects of unfavorable reimbursement prices for medicines, and inadequate participation of the private sector providers (especially pharmacies and licensed chemical sellers) in the NHIS. Health providers generally perceive the NHIS to have had a

Contributions to the old-age pension insurance and disability and survivor’s pension insurance for persons taking care of people with disabilities

Directory of Open Access Journals (Sweden)

Katarzyna Roszewska

2015-03-01

Full Text Available The care issue brings together a number of social issues. From the legal classification of care, through the problem how to support, the amount of benefits to the scope of protection of caregivers. One of the most noteworthy problems in care for the disabled persons is the duty of providing social insurance for caregivers. The publication focuses on the issue of payment of contributions. Carers’ insurance status is complex and unstable. The difficulty of evaluation is related to the lack of the final shape of long-term care system in deinstitutionalized conditions.

Health seeking behavior in Karnataka: Does micro-health insurance matter?

Directory of Open Access Journals (Sweden)

S Savitha

2013-01-01

Full Text Available Background: Health seeking behaviour in the event of illness is influenced by the availability of good health care facilities and health care financing mechanisms. Micro health insurance not only promotes formal health care utilization at private providers but also reduces the cost of care by providing the insurance coverage. Objectives: This paper explores the impact of Sampoorna Suraksha Programme, a micro health insurance scheme on the health seeking behaviour of households during illness in Karnataka, India. Materials and Methods: The study was conducted in three randomly selected districts in Karnataka, India in the first half of the year 2011. The hypothesis was tested using binary logistic regression analysis on the data collected from randomly selected 1146 households consisting of 4961 individuals. Results: Insured individuals were seeking care at private hospitals than public hospitals due to the reduction in financial barrier. Moreover, equity in health seeking behaviour among insured individuals was observed. Conclusion : Our finding does represent a desirable result for health policy makers and micro finance institutions to advocate for the inclusion of health insurance in their portfolio, at least from the HSB perspective.

75 FR 15603 - Common Crop Insurance Regulations; Florida Avocado Crop Insurance Provisions

Science.gov (United States)

2010-03-30

... to: (1) Theft; or (2) Inability to market the avocados for any reason other than actual physical... Crop Insurance Regulations; Florida Avocado Crop Insurance Provisions AGENCY: Federal Crop Insurance... Common Crop Insurance Regulations; Florida Avocado Crop Insurance Provisions to convert the Florida...

Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women.

Science.gov (United States)

Teede, Helena J; Joham, Anju E; Paul, Eldho; Moran, Lisa J; Loxton, Deborah; Jolley, Damien; Lombard, Catherine

2013-08-01

Polycystic ovary syndrome (PCOS) affects 6-18% of women. The natural history of weight gain in women with PCOS has not been well described. Here we aimed to examine longitudinal weight gain in women with and without PCOS and to assess the association between obesity and PCOS prevalence. The observational study was set in the general community. Participants were women randomly selected from the national health insurance scheme (Medicare) database. Mailed survey data were collected by the Australian Longitudinal Study on Women's Health. Data from respondents to survey 4, aged 28-33 years (2006, n = 9,145) were analyzed. The main outcome measures were PCOS prevalence and body mass index (BMI). Self-reported PCOS prevalence was 5.8% (95% CI: 5.3%-6.4%). Women reporting PCOS had higher weight, mean BMI [2.5 kg/m(2) (95% CI: 1.9-3.1)], and greater 10-year weight gain [2.6 kg (95% CI: 1.2-4.0)]. BMI was the strongest correlate of PCOS status with every BMI increment increasing the risk of reporting PCOS by 9.2% (95% CI: 6%-12%). This community based observational study with longitudinal reporting of weight shows that weight, BMI, and 10-year weight gain were higher in PCOS. We report the novel finding that obesity and greater weight gain are significantly associated with PCOS status. Considering the prevalence, major health and economic burden of PCOS, the increasing weight gain in young women, and established benefits of weight loss, these results have major public health implications. Copyright © 2012 The Obesity Society.

Life insurance density and penetration: panel data analysis across countries

OpenAIRE

Urbanavičiūtė, Greta

2016-01-01

Life Insurance Density and Penetration: Panel Data Analysis Across Countries This bachelor thesis examines two key indicators in the life insurance market: density and penetration. The main purpose is to analyse which factors have the biggest impact on these two indicators in 39 countries around the world. Panel data models, which represent the collected data best, were created. This paper examines the latest public data available in 39 countries, including the Baltic States, and new signific...

76 FR 71276 - Common Crop Insurance Regulations; Pecan Revenue Crop Insurance Provisions

Science.gov (United States)

2011-11-17

...-0008] RIN 0563-AC35 Common Crop Insurance Regulations; Pecan Revenue Crop Insurance Provisions AGENCY... Corporation (FCIC) proposes to amend the Common Crop Insurance Regulations, Pecan Revenue Crop Insurance... Regulations (7 CFR part 457) by revising Sec. 457.167 Pecan Revenue Crop Insurance Provisions, to be effective...

Alternative solutions for public and private catastrophe funding in Austria

Science.gov (United States)

Gruber, M.

2008-07-01

The impacts of natural hazards as well as their frequency of occurrence during the last decades have increased decisively. Therefore, the public as well as the private sector are expected to react to this development by providing sufficient funds, in particular for the improvement of protection measures and an enhanced funding of damage compensation for affected private individuals, corporate and public entities. From the public stance, the establishment of an appropriate regulatory environment seems to be indispensable. Structural and legal changes should, on the one hand, renew and improve the current distribution system of public catastrophe funds as well as the profitable investment of these financial resources, and on the other hand, facilitate the application of alternative mechanisms provided by the capital and insurance markets. In particular, capital markets have developed alternative risk transfer and financing mechanisms, such as captive insurance companies, risk pooling, contingent capital solutions, multi-trigger products and insurance securitisation for hard insurance market phases. These instruments have already been applied to catastrophic (re-)insurance in other countries (mainly the US and off-shore domiciles), and may contribute positively to the insurability of extreme weather events in Austria by enhancing financial capacities. Not only private individuals and corporate entities may use alternative mechanisms in order to retain, thus, to finance certain risks, but also public institutions. This contribution aims at analysing potential solutions for an improved risk management of natural hazards in the private and the public sector by considering alternative mechanisms of the capital and insurance markets. Also the establishment of public-private-partnerships, which may contribute to a more efficient cat funding system in Austria, is considered.

The effect of SCHIP expansions on health insurance decisions by employers.

Science.gov (United States)

Buchmueller, Thomas; Cooper, Philip; Simon, Kosali; Vistnes, Jessica

2005-01-01

This study uses repeated cross-sectional data from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC), a large nationally representative survey of establishments, to investigate the effect of the State Children's Health Insurance Program (SCHIP) on health insurance decisions by employers. The data span the years 1997 to 2001, the period when states were implementing SCHIP. We exploit cross-state variation in the timing of SCHIP implementation and the extent to which the program increased eligibility for public insurance. We find evidence suggesting that employers whose workers were likely to have been affected by these expansions reacted by raising employee contributions for family coverage options, and that take-up of any coverage, generally, and family coverage, specifically, dropped in these establishments. We find no evidence that employers stopped offering single or family coverage outright.

Catastrophes and Climate Change. Concerns and Possible Countermeasures of the Insurance Industry

Energy Technology Data Exchange (ETDEWEB)

Berz, G.A. [Geoscience Research, Munich Reinsurance Company, D-80791 Munich (Germany)

1999-07-01

In the last few decades, the international insurance industry has been confronted with a drastic increase in the scope and frequency of great natural disasters. The trend is primarily attributable to the continuing steady growth of the world population and the increasing concentration of people and economic values in urban areas. An additional factor is the global migration of populations and industries into areas such as coastal regions, which are particularly exposed to natural hazards. The natural hazards themselves, on the other hand, are showing a change for the worse as many atmospheric extremes are strongly influenced by global warming. In addition to the problems the insurance industry has with regard to pricing, capacity and loss reserves, the assessment of insured liabilities, preventive planning and the proper adjustment of catastrophe losses are gaining importance. The present problems will be dramatically aggravated if the greenhouse predictions come true. The changing probability distributions of many processes in the atmosphere will force up the frequency and severity of heat waves, droughts, bush fires, tropical and extratropical cyclones, tornados, hailstorms, floods and storm surges in many parts of the world with serious consequences for all types of property insurance, apart from the consequences of the stratospheric ozone destruction for health and life insurance. Rates will have to be raised and in certain areas insurance cover will only be available after considerable restrictions have been imposed, as for example significant deductibles and low liability or loss limits. In areas of high insurance density the loss potential of individual catastrophes can reach a level at which the national and international insurance industries will run into serious capacity problems. Recent disasters showed the disproportionately high participation of reinsurers in extreme disaster losses and the need for more risk transparency if the insurance industry is

Catastrophes and Climate Change. Concerns and Possible Countermeasures of the Insurance Industry

International Nuclear Information System (INIS)

Berz, G.A.

1999-01-01

In the last few decades, the international insurance industry has been confronted with a drastic increase in the scope and frequency of great natural disasters. The trend is primarily attributable to the continuing steady growth of the world population and the increasing concentration of people and economic values in urban areas. An additional factor is the global migration of populations and industries into areas such as coastal regions, which are particularly exposed to natural hazards. The natural hazards themselves, on the other hand, are showing a change for the worse as many atmospheric extremes are strongly influenced by global warming. In addition to the problems the insurance industry has with regard to pricing, capacity and loss reserves, the assessment of insured liabilities, preventive planning and the proper adjustment of catastrophe losses are gaining importance. The present problems will be dramatically aggravated if the greenhouse predictions come true. The changing probability distributions of many processes in the atmosphere will force up the frequency and severity of heat waves, droughts, bush fires, tropical and extratropical cyclones, tornados, hailstorms, floods and storm surges in many parts of the world with serious consequences for all types of property insurance, apart from the consequences of the stratospheric ozone destruction for health and life insurance. Rates will have to be raised and in certain areas insurance cover will only be available after considerable restrictions have been imposed, as for example significant deductibles and low liability or loss limits. In areas of high insurance density the loss potential of individual catastrophes can reach a level at which the national and international insurance industries will run into serious capacity problems. Recent disasters showed the disproportionately high participation of reinsurers in extreme disaster losses and the need for more risk transparency if the insurance industry is

Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

Science.gov (United States)

Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny

2015-10-29

Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured. We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured. Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

INSURANCE MARKET. GENERAL CONSIDERATIONS OF INSURANCES IN ROMANIA

Directory of Open Access Journals (Sweden)

MARINEL NEDELUŢ

2013-10-01

Full Text Available Insurance is a contract made by a company or society, or by the state, to provide a guarantee for loss, damage, illness, death etc in return for regular payments. In other words it is a means by which one pays a relatively small known cost for protection against an uncertain and much larger cost. Still, this contract (insurance policy makes it possible for the insured to cover only losses that are measurable in terms of money and caused strictly by hazardous events, independent from own doing. If no such events should happen, the benefits won’t exist in a tangible, material form, but will take the shape of security against ruin. Since the insurance industry has developed more during the last decade due to the powerful players that have entered the market, the services provided by the insurance companies, and not only their products have evolved a lot in order to meet the requirements of the consumers, and to make them familiar with this type of investments. Therefore all the means of advertising became essential in this process of implementation and familiarization with this area of activity: mass-media advertising, insurance brokerage companies, the internet are all parts of this process.

Powerful agent of change? The global insurance industry as a driver for greenhouse mitigation and adaptation

International Nuclear Information System (INIS)

Phelan, Liam; Taplin, Ros

2007-01-01

Full text: This paper explores the potential for the gloPal insurance industry to play a powerful and constructive role towards significant reductions in greenhouse gas emissions as well as in climate change adaptation. Climate change presents a formidable public policy challenge (IPCC 2001) and one to which sections of the insurance industry have been responsive (Mills 2005). The industry can be expected to play a further constructive role for three reasons: the industry has core capacities in risk management and loss prevention; the industry is the world's largest with annual income in the order of US$3.4 trillion derived from premiums and US$1 trillion derived from investments; and anthropogenic climate change is constricting limits to insurability, with implications for the ongoing functioning of the insurance sector (Mills and Lecomte 2006). Insurance understood as a social institution is both a crucial component of contemporary socio-economic systems and a powerful agent of socio-economic change (Pfeffer and Klock 1974, Denenberg et al. 1964). The ability to transfer risk historically has played a major facilitative role in economic and social development at the broadest scales of human socio-economic systems (Supple 1984; Clark 1999). Governments historically and currently explicitly harness the potential of insurance in support of specific public policy outcomes. The creation of the modern welfare state is a public policy objective on a grand scale achieved in part through application of insurance, in the form of universal health care and pensions (Lengwiler2003). The insurance industry itself also initiates significant socioeconomic change in three ways: direct engagement, for example by establishing the first fire brigades (Kline 1964a); loss prevention research, for example by conducting and financing research into building and vehicle safety (Mills and Lecomte 2006; Kline 1964b); and engaging in lobbying for implementation of safety standards (Kline

Life Insurance Contribution, Insurance Development and Economic Growth in China

Directory of Open Access Journals (Sweden)

Wang Ying

2017-07-01

Full Text Available Under L-type economy, remodelling the growth power in the medium and long term is essential. The insurance industry during the 13th Five-year Plan period has been given a heavy expectation on promoting economic quality and upgrading economic efficiency, so it will try to accelerate its innovation and development process which serves national needs, market demand and people's requirements. Referring to the previous researches of Solow and Zhang and measuring Capital Stock and Total Factor Productivity independently, the paper analyses the inherent correlation between insurance (including life insurance and non-life insurance and economic growth, reveals the contribution law of the insurance development in economic growth in the short and long term from both economic scale and quality respectively. It also shows enlightenments on policy decision for insurance industry, thus helps economic stability under the downturn periods.

INSURANCE INTERMEDIARIES

Directory of Open Access Journals (Sweden)

Andreea Stoican

2013-11-01

Full Text Available The actual Civil code regulates for the first time in the Romanian legislation the intermediation contract, until its entering into force existing multiple situations that lent themselves to this legal operation, but did not benefit of such particular legal rules. Yet, the case law has shown that the situations that arise in the activity of the legal or natural persons are much more complex, this leading, in time, to the reglementation of such particular rules. Such a case is that found in the matter of insurance contracts, the position of the insurance intermediaries being regulated especially by Law no. 32/2000, according to which they represent the natural or legal persons authorized in the conditions of the above mentioned legal document, that perform intermediation activities in the insurance field, in exchange of a remuneration, as well as the intermediaries from the EU member states that perform such an activity on the Romanian territory, in accordance with the freedom in performing services. Therefore, the present paper aims to analyze the conclusion of such insurance contracts and to underline the particular position of the insurance brokers, having the following structure: 1 Introduction; 2 The reglementation of the intermediation contract/brokerage agreement in the Romanian Law; 3 The importance of the intermediaries in the insurance contracts; 4 The conclusion of the insurance contracts; 5 Conclusions.

Implications of the 2017 Tax Cuts and Jobs Act for Public Health.

Science.gov (United States)

Glied, Sherry

2018-03-22

The recently passed Tax Cuts and Jobs Act will reduce total federal revenues by about 4% between 2018 and 2027. The law makes multiple changes to the taxation of individuals and corporations. It also repeals the Affordable Care Act's (ACA's) individual mandate penalties, which will erase some of the gains in insurance coverage achieved since implementation of the ACA's coverage expansions. The resulting increases in rates of uninsurance will likely lead to increased uncompensated care and deflect hospitals and health departments from addressing other prevention and public health needs. In addition, the law is expected to lead to substantial increases in the federal debt and, consequently, to calls for reductions in spending on entitlement programs, particularly Medicare, and on discretionary programs, including public health. Many other provisions of the law could also have second-order effects on public health. (Am J Public Health. Published online ahead of print March 22, 2018: e1-e3. doi:10.2105/AJPH.2018.304388).

MARKETING OF INSURANCE PRODUCTS BY THE NATIONAL INSURANCE COMPANY LIMITED, RAJAPALAYAM

OpenAIRE

Dr. H. Christy Cynthia; Dr. T. Jebasheela; V. Maheswari

2017-01-01

Insurance is a way of reducing uncertainty of occurrence of an event. Insurance is an investment. Its basic purpose is to derive plans to counteract the financial consequences of unfavorable events. Insurance is a social device for eliminating or reducing the cost to society to certain types of risks. Insurance is essentially a co-operative endeavor. It is the function of the insurance to protect the few against the heavy financial impact of anticipated misfortunes by spreading losses among m...

BUSINESS PROCESS MANAGEMENT IN INSURANCE CASE OF JADRANSKO INSURANCE COMPANY

OpenAIRE

Sanja Coric; Danijel Bara

2014-01-01

Selling insurance products in conditions of today’s modern technological solutions is faced with numerous challenges. Business processes in insurance as well as the results of these business processes are the real interface to policyholders. Modeling and analysis of business process in insurance ensure organizations to focus on the customer and increase the efficiency and quality of work. Managing critical business processes in every single organization, likewise in insurance is a key factor ...

Relationship between pre-weaning gain, age at puberty, and reproductive tract development in Angus heifers

Science.gov (United States)

Beef heifers should initiate reproductive cycles by 12 mo of age to insure multiple estrous cycles before the start of the breeding season to maximize fertility. Previous research indicated that pre-weaning gain positively influenced the onset of puberty and antral follicle numbers. Therefore, the...

Temporal trends in genital warts among individuals covered by the public prescription drug insurance plan in the province of Quebec, Canada, from 1998 to 2007.

Science.gov (United States)

Steben, Marc; Ouhoummane, Najwa; Rodier, Caroline; Brassard, Paul

2013-04-01

We assessed temporal trend in the incidence and prevalence of genital warts (GWs) in the province of Quebec, Canada, between 1998 and 2007 as a baseline for future assessment of the impact of Quebec human papillomavirus vaccination program. Data on GWs were obtained from the linkage of the physician service claims and the public insurance drug plan databases. Genital warts were identified through a prescription of podofilox, a medical procedure code specific to GWs or a diagnosis code for viral warts followed by a prescription of imiquimod or fluorouracil within 2 weeks. An episode was considered incident if it was preceded by a 12-month interval period free of GWs care. During the study period, a total of 27,138 episodes of GWs occurred among 24,267 individuals. The age-standardized incidence rate increased over time in men and women. The highest incidence was observed in women aged 20 to 24 years (391.9/100,000) and in men aged 25 to 29 years (383.3/100,000). Similar trends in prevalence were observed. The incidence and prevalence of GWs has increased among the population covered by the public insurance drug plan in Quebec.

Alternative solutions for public and private catastrophe funding in Austria

Directory of Open Access Journals (Sweden)

M. Gruber

2008-07-01

Full Text Available The impacts of natural hazards as well as their frequency of occurrence during the last decades have increased decisively. Therefore, the public as well as the private sector are expected to react to this development by providing sufficient funds, in particular for the improvement of protection measures and an enhanced funding of damage compensation for affected private individuals, corporate and public entities.

From the public stance, the establishment of an appropriate regulatory environment seems to be indispensable. Structural and legal changes should, on the one hand, renew and improve the current distribution system of public catastrophe funds as well as the profitable investment of these financial resources, and on the other hand, facilitate the application of alternative mechanisms provided by the capital and insurance markets.

In particular, capital markets have developed alternative risk transfer and financing mechanisms, such as captive insurance companies, risk pooling, contingent capital solutions, multi-trigger products and insurance securitisation for hard insurance market phases. These instruments have already been applied to catastrophic (re-insurance in other countries (mainly the US and off-shore domiciles, and may contribute positively to the insurability of extreme weather events in Austria by enhancing financial capacities. Not only private individuals and corporate entities may use alternative mechanisms in order to retain, thus, to finance certain risks, but also public institutions.

This contribution aims at analysing potential solutions for an improved risk management of natural hazards in the private and the public sector by considering alternative mechanisms of the capital and insurance markets. Also the establishment of public-private-partnerships, which may contribute to a more efficient cat funding system in Austria, is considered.

Are tax subsidies for private medical insurance self-financing? Evidence from a microsimulation model.

Science.gov (United States)

López Nicolás, Angel; Vera-Hernández, Marcos

2008-09-01

This paper develops an empirical strategy to estimate whether subsidies to private medical insurance are self-financing in countries where public and private insurance coexist and the latter covers the same treatments as the former. We construct a simulation routine based on a micro-econometric discrete choice model that allows us to evaluate the impact of premium changes on the utilization of outpatient and inpatient health care services. As an application, we estimate the budgetary effects of scrapping a subsidy from the purchase of individual private policies, using micro-data from Catalonia. Our results suggest that the subsidy is not self-financing. This result is driven by the fact that private medical insurance holders make concurrent use of public and private services, and by the price inelasticity of the demand for private policies.

What is the social gain from competency management? The employees' perception at a Brazilian public university

Directory of Open Access Journals (Sweden)

Guilherme Busch Rocha

Full Text Available Abstract In the present global scenario of strong competitive edge, the Human factor had its relevance enhanced, presenting itself as a key element to enhance organizations' flexibility and performance. Since the 1990s, one of the most widespread and studied Human Resources practices has consisted of the Management Model by Competency, that innovated by changing the "position" reference to the "people" element. Therefore, this paper tries to investigate what are the elements that influence the employees' perception of social gain within an establishment that had taken on the competency management model. This is a quantitative work with survey methodology. The sample consists of 422 employees of a Brazilian public university that had implanted the competency model in 2011. The questionnaire, available in an online environment, used the dimensions developed by Sarsur (2007. The relationships between the actions on corporate education, wage move, career move, managerial positions held, workplace and seniority (independent variables with the perception employees have of social gain (dependent variables were analyzed through non parametric statistical techniques. The results indicate that the employees' perception of social competency gains in the model displays an essentially utilitarian nature. Namely, just the benefited employees demonstrated higher rankings of perception regarding the new proposal.

Public Education and Radioactive Waste

International Nuclear Information System (INIS)

Sarten, S.

2009-01-01

Throughout the country the mention of anything nuclear or the word radiation ignites fear in the minds of many Americans. Political hype, news stories and the lack of basic understanding about nuclear power and radiation causes many people to reject what they do not understand. Often little, if any, thought may have been given to nearby nuclear weapons facilities where family members and neighbors were gainfully employed at these sites. As older nuclear facilities are closed being a result of the end of the Cold War, with indications that radioactive materials might be transported to other parts of the country, the public in expressing concern. It is important that the public have an understanding of how these materials are handled to insure public safety. It becomes important that both the companies handling these materials and the U.S. Department of Energy create an environment that will involve community participation in developing strategies that will promote and support an understanding of how radioactive wastes will be packaged, transported, and disposed. This is being performed in Oak Ridge, TN. through the efforts of the Oak Ridge Site Specific Advisory Board (ORSSAB). The ORSSAB is a DOE sponsored board of private citizens from all walks of life and professionalism's. The objective of this paper is to offer suggestions as to how public confidence, through education about nuclear, radioactive and associated and wastes are effectively handle the problems related to waste disposal, removal or on-site storage. It is essential that the public fully understand and become involved in the need for the reduction of the waste stream volumes and the technical problems being faced in reaching this goal. The effort of gaining public understanding and support of this important task cannot be limited to just those within close proximity to the facility presently housing these materials, but must extend to those outlying areas and along any potential route that might be

The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums.

Science.gov (United States)

Cogan, John F; Hubbard, R Glenn; Kessler, Daniel

2010-01-01

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008-that is, before versus after the plan-over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

Infusing Adult Education Principles Into a Health Insurance Literacy Program.

Science.gov (United States)

Brown, Virginia

2018-03-01

Health insurance literacy is an emerging concept in the health education and health promotion field. The passage of the Affordable Care Act highlighted the link between health insurance and health outcomes. However, the law does not specifically address how the public should be educated on choosing an appropriate health insurance plan. Research shows adults, regardless of previous health insurance status, are likely confused and uncertain about their selection. The University of Maryland Extension developed and created health insurance Smart Choice Health Insurance™ to reduce confusion and increase confidence and capability to make this decision. Andragogy, an adult learning theory, was used to guide the development of the program and help ensure best practices are used to achieve desired outcomes. Using the six principles of andragogy, the team incorporated reality-based case studies, allowed adults time to practice, and emphasized choice making and many other elements to create an atmosphere conducive to adult learning. Results from Smart Choice indicate the program is successful in reducing confusion and increasing confidence. Furthermore, feedback from participants and trained educators indicates that adults were engaged in the program and found the materials useful. Based on program success, creation of new health insurance literacy programs grounded in adult education principles is under way.

Insurance of nuclear risk

International Nuclear Information System (INIS)

Lacroix, M.

1976-01-01

Insurance for large nuclear installations covers mainly four types of risk: third party liability which in accordance with the nuclear conventions, is borne by a nuclear operator following an incident occurring in his installation or during transport of nuclear substances; material damage to the installation itself, which precisely is not covered by third party liability insurance; machinery breakdown, i.e. accidental damage or interruption of operation. Only the first category must be insured. In view of the magnitude of the risk, nuclear insurance resorts to co-insurance and reinsurance techniques which results in a special organisation of the nuclear insurance market, based on national nuclear insurance pools and on the Standing Committee on Atomic Risk of the European Insurance Committee. Conferences of the chairmen of nuclear insurance pools are convened regularly at a worldwide level. (NEA) [fr

Cost-effectiveness of Training Programmes in Insurance Sector of India

Directory of Open Access Journals (Sweden)

Surbhi JAIN

2015-09-01

Full Text Available In the present era of globalization, trough competition and advancement of information technology, the paradigm for success has shifted towards intellectual assets. New ways of commerce and management structures are required to effectively exploit intellectual assets foremost to an improved approach on the development of human capital. Training requires substantial allocation of monetary, human and time resources. A systematic evaluation of training programs is the call of the time. The insurance sector has been playing a vital role in the process of economic advancement since independence in India. The objective of the present study is to identify the cost-effectiveness of training programs in the insurance sector in India. A sample of four companies has been randomly selected. This study is descriptive in nature. Secondary data has been analysed. Effectiveness-cost ratios were calculated and inferences have been drawn accordingly. Finding suggests that training programs in public insurance sector is more cost-effective as compared to private insurance sector in India.

THE MODEL OF INTERACTION BETWEEN INSURANCE INTERMEDIARIES AND INSURANCE COMPANIES IN THE ASSURANCE OF SUSTAINABLE DEVELOPMENT OF THE INSURANCE MARKET

Directory of Open Access Journals (Sweden)

Nataliia Kudriavska

2017-11-01

Full Text Available The purpose of this paper is the investigation of the model of interaction between insurance intermediaries and insurance companies in the assurance of sustainable development of the insurance market. The methodology is based on the new studies and books. It is underlined the importance of potency and effectiveness of this model, its influence on the insurance market stability. It is analysed the European experience and specific of Ukrainian insurance market. The main ways for improving its model and ways of its practical realization are characterized. Results. The problems that exist in the broker market in general are connected with an ineffective state policy. In particular, we can say about the absence of many laws, acts, resolutions, which explain what a broker have to do in case of different problems with insurance companies, another brokers and clients. At the same time, the problem of distrust to national brokers exists. It provokes a decline of the demand for their services and so on. However, it is possible to solve these problems. Practical implications. For this, it is necessary to do some acts. The first one is to implement resolutions that regulate relationships between insurance brokers and insurance companies, clearly regulate the model of its interaction. This model affects the stability of the insurance market in general. The second is to find methods of solving problems of the increase in insurance culture of the population (for example, by the way of advertisement. The third one is to solve problems connected with the appearance of foreign brokers in the insurance market of Ukraine. Actually, the Ukrainian market of insurance brokers is not developed enough. That is why it needs big changes and reforms. Value/originality. Among alternatives of the strategic development of insurance, the method of quick liberalization and gradual development is distinguished. According to the liberal way, it is possible to transfer to the

Insurance + Access ≠ Health Care: Typology of Barriers to Health Care Access for Low-Income Families

Science.gov (United States)

DeVoe, Jennifer E.; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A.

2007-01-01

PURPOSE Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. METHODS A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, “Is there anything else you would like to tell us?” Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. RESULTS Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. CONCLUSIONS Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere. PMID:18025488

77 FR 25349 - Mutual Insurance Holding Company Treated as Insurance Company

Science.gov (United States)

2012-04-30

..., the first mutual fire insurer was established. The first American mutual insurance company, the Philadelphia Contributionship for the Insurance of Houses from Loss by Fire, was founded in 1752.\\3\\ \\3\\ The...

China's Insurance Regulatory Reform, Corporate Governance Behavior and Insurers' Governance Effectiveness.

Science.gov (United States)

Li, Huicong; Zhang, Hongliang; Tsai, Sang-Bing; Qiu, Aichao

2017-10-17

External regulation is an important mechanism to improve corporate behavior in emerging markets. China's insurance governance regulation, which began to supervise and guide insurance corporate governance behavior in 2006, has experienced a complex process of reform. This study tested our hypotheses with a sample of 85 firms during 2010-2011, which was obtained by providing a questionnaire to all of China's shareholding insurance companies. The empirical study results generally show that China's insurance governance effectiveness has significantly improved through strict regulation. Insurance corporate governance can improve business acumen and risk-control ability, but no significant evidence was found to prove its influence on profitability, as a result of focusing less attention on governance than on management. State ownership is associated with higher corporate governance effectiveness than non-state ownership. Listed companies tend to outperform non-listed firms, and life insurance corporate governance is more effective than that of property insurers. This study not only contributes to the comprehensive understanding of corporate governance effectiveness but also to the literature by highlighting the effect of corporate governance regulation in China's insurance industry and other emerging economies of the financial sector.

Insurance Salespeople's Attitudes towards Collusion: The Case of Taiwan’s Car Insurance Industry

OpenAIRE

Lu-Ming Tseng; Wen-Pin Su

2014-01-01

Insurance researchers believe that the increase in insurance fraud may be associated with the unethical decisions made by some insurance salespeople. However, to date, research that has empirically investigated the link between insurance salespeople and collusion is scant. Using the car insurance industry in Taiwan as an example, this paper explores the impact of the opportunity to obtain the fraudulent claim and that of the size of actual loss on car insurance salespeople's attitudes towards...

INFORMATION FROM THE CERN HEALTH INSURANCE SCHEME

CERN Document Server

Tel : 7-3635

2002-01-01

Please note that, from 1 July 2002, the tariff agreement between CERN and the Hôpital de la Tour will no longer be in force. As a result the members of the CERN Health Insurance Scheme will no longer obtain a 5% discount for quick payment of bills. More information on the termination of the agreement and the implications for our Health Insurance Scheme will be provided in the next issue of the CHIS Bull', due for publication in the first half of July. It will be sent to your home address, so, if you have moved recently, please check that your divisional secretariat has your current address. Tel.: 73635 The Organization's Health Insurance Scheme (CHIS) has launched its own Web pages, located on the Website of the Social & Statutory Conditions Group of HR Division (HR-SOC). The address is short and easy-to-remember www.cern.ch/chis The pages currently available concentrate on providing basic information. Over the coming months it is planned to fill out the details and introduce new topics. Please give us ...

78 FR 56583 - Deposit Insurance Regulations; Definition of Insured Deposit

Science.gov (United States)

2013-09-13

... as a potential global deposit insurer, preserve confidence in the FDIC deposit insurance system, and... the United States.\\2\\ The FDIC generally pays out deposit insurance on the next business day after a... since 2001 and total approximately $1 trillion today. In many cases, these branches do not engage in...

Pricing behaviour of nonprofit insurers in a weakly competitive social health insurance market.

Science.gov (United States)

Douven, Rudy C H M; Schut, Frederik T

2011-03-01

In this paper we examine the pricing behaviour of nonprofit health insurers in the Dutch social health insurance market. Since for-profit insurers were not allowed in this market, potential spillover effects from the presence of for-profit insurers on the behaviour of nonprofit insurers were absent. Using a panel data set for all health insurers operating in the Dutch social health insurance market over the period 1996-2004, we estimate a premium model to determine which factors explain the price setting behaviour of nonprofit health insurers. We find that financial stability rather than profit maximisation offers the best explanation for health plan pricing behaviour. In the presence of weak price competition, health insurers did not set premiums to maximize profits. Nevertheless, our findings suggest that regulations on financial reserves are needed to restrict premiums. Copyright © 2011 Elsevier B.V. All rights reserved.

Voluntary health insurance in the European Union: a critical assessment.

Science.gov (United States)

Mossialos, Elias; Thomson, Sarah M S

2002-01-01

The authors examine the role and nature of the market for voluntary health insurance in the European Union and review the impact of public policy, at both the national and E.U. levels, on the development of this market in recent years. The conceptual framework, based on a model of industrial analysis, allows a wide range of policy questions regarding market structure, conduct, and performance. By analyzing these three aspects of the market for voluntary health insurance, the authors are also able to raise questions about the equity and efficiency of voluntary health insurance as a means of funding health care in the European Union. The analysis suggests that the market for voluntary health insurance in the European Union suffers from significant information failures that seriously limit its potential for competition or efficiency and also reduce equity. Substantial deregulation of the E.U. market for voluntary health insurance has stripped regulatory bodies of their power to protect consumers and poses interesting challenges for national regulators, particularly if the market is to expand in the future. In a deregulated environment, it is questionable whether this method of funding health care will encourage a more efficient and equitable allocation of resources.

A comparative study of the application of alternative risk transfer methods of insurance in South Africa and Zimbabwe

Directory of Open Access Journals (Sweden)

Athenia Bongani Sibindi

2015-08-01

Full Text Available Alternative risk transfer techniques represent the crown jewels in the risk management arena. This non-traditional method of insurance has gained prominence over the last few decades. Against this backdrop, the present study seeks to unravel the development of the alternative risk financing insurance segment within a developing country setting. The study specifically sets out to compare and contrast the ART insurance market segments of South Africa and Zimbabwe. The study is documents that the Zimbabwean market is at a nascent stage of development, whilst the South African market is fully developed. Notwithstanding the prospects for the development of this sector looks bright

Probabilistic insurance

OpenAIRE

Wakker, P.P.; Thaler, R.H.; Tversky, A.

1997-01-01

textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these preferences are intuitively appealing they are difficult to reconcile with expected utility theory. Under highly plausible assumptions about the utility function, willingness to pay for probabilistic i...

Incentivising flood risk adaptation through risk based insurance premiums : Trade-offs between affordability and risk reduction

NARCIS (Netherlands)

Hudson, Paul F.; Botzen, W.J.W.; Feyen, L.; Aerts, Jeroen C.J.H.

2016-01-01

The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

Incentivising flood risk adaptation through ris based insurance premiums: trade-offs between affordability and risk reduction

NARCIS (Netherlands)

Hudson, P.G.M.B.; Botzen, W.J.W.; Feyen, L.; Aerts, J.C.J.H.

2016-01-01

The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

Enterprise risk management and firm value within China’s insurance industry

Directory of Open Access Journals (Sweden)

Qiuying Li

2014-02-01

Research purpose: The purpose of the study is to empirically examine the relationship between ERM and firm value. The study is undertaken within the context of the Chinese insurance industry. Motivation for the study: Recent attempts to link ERM with firm value have been undertaken primarily in the USA and Europe and have produced ambiguous and inconclusive findings. Research design, approach and method: Data was obtained from the China Insurance Regulatory Commission, a government body responsible for regulating insurance products and services in China. The data sample consisted of 135 insurance companies operating in China (in 2010. Regression modelling is employed to analyse the data. Main findings: The results show the relationship between ERM and firm value at first appears statistically significant within a Pearson correlation matrix but then falls below statistical significance on closer scrutiny through regression analysis. Accordingly, it is recommended that insurers in China should not look to aggressive investment in ERM as a strategy for producing quick gains in firm value. Practical/managerial implications: Risk managers should plan ERM development from a risk management maturity perspective, which equates the highest level of ERM development with ERM’s capacity to improve firm resilience to the unknown and serve as a mechanism for strategic decision-making. Contribution/value-add: The study employed return on equity as a proxy for firm value, utilising ordinary least squares regression modelling to test propositions of the relationships between variables.

[Participant structure and economic benefit of prevention bonus programmes in company health insurance funds].

Science.gov (United States)

Friedrichs, M; Friedel, H; Bödeker, W

2009-10-01

This study investigates differences in sex, age, and educational level between participants and non-participants of prevention bonus programmes. The differences in the utilisation of drugs, hospital care, and sickness absence before the start of the programmes between these groups are also shown. Finally the economic benefit of the health insurance funds attributed to these programmes is estimated. Data from some 5.2 million insured subjects of 74 company health insurance funds in Germany were linked to information on enrollment into a prevention bonus programme anonymously. In a descriptive analysis the differences in the sociodemographic patterns between both groups are shown as well as the differences in costs to the health insurances in the three sectors mentioned above. The benefit to the health insurance funds is estimated by means of an analysis of covariance. Prevention bonus programmes yields an annual benefit of at least 129 euro per participant. Men aged 40 and older and women aged 30 and older are more likely to opt into such a programme. The same is true for persons with a higher educational level. There are only few differences in health-care utilisation between the participants and non-participants of the programmes before enrollment. Only 1.4% of all insured persons participated in the programmes. There is at least a short-term gain to both involved parties: the insured and the health insurance funds. The programmes are not dominated by deadweight effects. Long-term effects and effectiveness of prevention bonus programmes still have to be investigated. Copyright Georg Thieme Verlag KG Stuttgart . New York.

Achievement of public health recommendations for physical activity and prevention of gains in adiposity in adults

DEFF Research Database (Denmark)

Grøntved, A.

2013-01-01

Physical activity (PA) is considered a cornerstone in weight control and public health guidelines recommend regular participation to prevent gains in adiposity. It may therefore come as a surprise that the cumulative evidence from observational studies to support this is not strong. A weakness...... of many published observational studies on this topic has been a reliance on a single baseline assessment of PA. Using only the baseline information on PA in a prospective study cause misclassification because of participants often change activity level during follow-up. In turn this causes regression...

Women's Health Insurance Coverage

Science.gov (United States)

... Women's Health Policy Women’s Health Insurance Coverage Women’s Health Insurance Coverage Published: Oct 31, 2017 Facebook Twitter LinkedIn ... that many women continue to face. Sources of Health Insurance Coverage Employer-Sponsored Insurance: Approximately 57.9 million ...

Inequalities in health: the role of health insurance in Nigeria

Directory of Open Access Journals (Sweden)

Amanda Chukwudozie

2016-08-01

Full Text Available Health financing is a core necessity for sustainable healthcare delivery. Access inequalities due to financial restrictions in low-middle income countries, and in Africa especially, significantly affect disease rates and health statistics in these regions. This paper focuses on the role of a national health insurance cover as a funding medium in Nigeria, highlighting the theoretical premise of health insurance, its driving forces, key benefits and key limitations particular to the country under scrutiny. Emphasis is laid on its overall effect on the pressing public health issue of health inequality.

Designing an Health Insurance Scheme for Government Employees in Bangladesh: A Concept Paper

OpenAIRE

Hamid, Syed Abdul

2014-01-01

Introducing compulsory health insurance for government employees bears immense importance for stepping towards universal healthcare coverage in Bangladesh. Lack of scientific study on designing such scheme, in the Bangladesh context, motivates this paper. The study aims at designing a comprehensive insurance package simultaneously covering health, life and accident related disability risks of the public employees, where the health component would extend to all dependent family members. ...

Availability of Insurance Linkage Programs in U.S. Emergency Departments

Directory of Open Access Journals (Sweden)

Mia Kanak

2014-07-01

Full Text Available Introduction: As millions of uninsured citizens who use emergency department (ED services are now eligible for health insurance under the Affordable Care Act, the ED is ideally situated to facilitate linkage to insurance. Forty percent of U.S. EDs report having an insurance linkage program. This is the first national study to examine the characteristics of EDs that offer or do not offer these programs. Methods: This was a secondary analysis of data from the National Survey for Preventive Health Services in U.S. EDs conducted in 2008-09. We compared EDs with and without insurance programs across demographic and operational factors using univariate analysis. We then tested our hypotheses using multivariable logistic regression. We also further examined program capacity and priority among the sub-group of EDs with no insurance linkage program. Results: After adjustment, ED-insurance linkage programs were more likely to be located in the West (RR= 2.06, 95% CI = 1.33 – 2.72. The proportion of uninsured patients in an ED, teaching hospital status, and public ownership status were not associated with insurance linkage availability. EDs with linkage programs also offer more preventive services (RR = 1.87, 95% CI = 1.37–2.35 and have greater social worker availability (RR = 1.71, 95% CI = 1.12–2.33 than those who do not. Four of five EDs with a patient mix of ≥25% uninsured and no insurance linkage program reported that they could not offer a program with existing staff and funding. Conclusion: Availability of insurance linkage programs in the ED is not associated with the proportion of uninsured patients served by an ED. Policy or hospital-based interventions to increase insurance linkage should first target the 27% of EDs with high rates of uninsured patients that lack adequate program capacity. Further research on barriers to implementation and cost effectiveness may help to facilitate increased adoption of insurance linkage programs. [West J

Workable Social Health Insurance Systems in Sub-Saharan Africa ...

African Journals Online (AJOL)

the private sector in Africa is embracing joint health insurance schemes for their ... the unemployed, the under-employed and the unemployable (who ...... Agyepong, A.I. and Adjei, S., 2008, 'Public Social Policy Development and Implementation: .... Johannesburg, South Africa', WBI Learning Resource Series: World Bank.

Optimal static allocation decisions in the presence of portfolio insurance

OpenAIRE

Goltz, Felix; Martellini, Lionel; Şimşek, Koray Deniz; Simsek, Koray Deniz

2008-01-01

The focus of this paper is to determine what fraction a myopic risk-averse investor should allocate to investment strategies with convex exposure to stock market returns in a general economy with stochastically time-varying interest rates and equity risk premium. Our conclusion is that typical investors should optimally allocate a sizable fraction of their portfolio to such portfolio insurance strategies, and the associated utility gains are significant. While the fact that static investors w...

CURRENT CHANGES ON INSURANCE MARKET

Directory of Open Access Journals (Sweden)

Madalina Giorgiana MANGRA

2016-12-01

Full Text Available The offer of insurance products is about the requirements and needs of the consumer who must always have information regarding: the type of insurance risk covered and the excluded risks, the sum insured, the payment of premiums and their duration. The accurate information of customer requires, from the commencement of contract and throughout its duration, that he or she is aware of the obligations throughout the contractual period. Most of the Romanians are turning their attention to one of the insurance companies found in the top 10 in 2016, supervised by F.S.A. (Financial Supervision Authority, preferring to have a policy of mandatory household and goods insurance, auto liability or life insurance, but are also interested in travel health insurance when going abroad, private health insurance or private pension insurance. Romanians' reluctance regarding the conclusion of an insurance comes from their distrust in insurance companies (see the situations of companies like Astra Insurance, Carpatica Insurance etc., their personal financial situation and the fear that they will not receive protection if the risk is covered but the insured sum is insufficient

7 CFR 457.159 - Stonefruit crop insurance provisions.

Science.gov (United States)

2010-01-01

... selling through an on-farm or roadside stand, farmer's market, and permitting the general public to enter...); (f) That are grown in an orchard that, if inspected, is considered acceptable by us; and (g) That... or to determine the condition of the orchard. (2) The calendar date for the end of the insurance...

Perception of quality of health delivery and health insurance subscription in Ghana.

Science.gov (United States)

Amo-Adjei, Joshua; Anku, Prince Justin; Amo, Hannah Fosuah; Effah, Mavis Osei

2016-07-29

National health insurance schemes (NHIS) in developing countries and perhaps in developed countries as well is a considered a pro-poor intervention by helping to bridge the financial burden of access to quality health care. Perceptions of quality of health service could have immense impacts on enrolment. This paper shows how perception of service quality under Ghana's insurance programme contributes to health insurance subscription. The study used the 2014 Ghana Demographic and Health Survey (GDHS) dataset. Both descriptive proportions and binary logistic regression techniques were applied to generate results that informed the discussion. Our results show that a high proportion of females (33 %) and males (35 %) felt that the quality of health provided to holders of the NHIS card was worse. As a result, approximately 30 % of females and 22%who perceived health care as worse by holding an insurance card did not own an insurance policy. While perceptions of differences in quality among females were significantly different (AOR = 0.453 [95 % CI = 0.375, 0.555], among males, the differences in perceptions of quality of health services under the NHIS were independent in the multivariable analysis. Beyond perceptions of quality, being resident in the Upper West region was an important predictor of health insurance ownership for both males and females. For such a social and pro-poor intervention, investing in quality of services to subscribers, especially women who experience enormous health risks in the reproductive period can offer important gains to sustaining the scheme as well as offering affordable health services.

Toward an Anthropology of Insurance and Health Reform: An Introduction to the Special Issue.

Science.gov (United States)

Dao, Amy; Mulligan, Jessica

2016-03-01

This article introduces a special issue of Medical Anthropology Quarterly on health insurance and health reform. We begin by reviewing anthropological contributions to the study of financial models for health care and then discuss the unique contributions offered by the articles of this collection. The contributors demonstrate how insurance accentuates--but does not resolve tensions between granting universal access to care and rationing limited resources, between social solidarity and individual responsibility, and between private markets and public goods. Insurance does not have a single meaning, logic, or effect but needs to be viewed in practice, in context, and from multiple vantage points. As the field of insurance studies in the social sciences grows and as health reforms across the globe continue to use insurance to restructure the organization of health care, it is incumbent on medical anthropologists to undertake a renewed and concerted study of health insurance and health systems. © 2016 by the American Anthropological Association.

Insurance and nuclear power

International Nuclear Information System (INIS)

Whipple, C.

1985-01-01

The Price-Anderson Act is discussed, which establishes procedures for insuring nuclear facilities (including nuclear power plants). The act was enacted with the dual purpose of protecting the public and encouraging the development of a private nuclear energy industry. Criticisms that can generally be grouped into four categories regarding the Act are presented, the most controversial aspect being that should an accident occur, the aggregate liability of the reactor operator, the NRC, or any others who might be at fault is limited to $560 million. Lawsuits for amounts in excess of $560 million are prohibited. The 1975 renewal of the Price-Anderson Act does provide that damages in excess of the $560 million prompt Congress to review the particular incident and take action to protect the public from the consequences of a disaster of such magnitude

Mapping public policy on genetics.

Science.gov (United States)

Weisfeld, N E

2002-06-01

The mapping of the human genome and related advances in genetics are stimulating the development of public policies on genetics. Certain notions that currently prevail in public policy development overall--including the importance of protecting privacy of information, an interest in cost-effectiveness, and the power of the anecdote--will help determine the future of public policy on genetics. Information areas affected include discrimination by insurers and employers, confidentiality, genetic databanks, genetic testing in law enforcement, and court-ordered genetic testing in civil cases. Service issues address clinical standards, insurance benefits, allocation of resources, and screening of populations at risk. Supply issues encompass funding of research and clinical positions. Likely government actions include, among others: (1) Requiring individual consent for the disclosure of personal information, except when such consent would impose inordinate costs; (2) licensing genetic databases; (3) allowing courts to use personal information in cases where a refusal to use such information would offend the public; (4) mandating health insurers to pay for cost-effective genetic services; (5) funding pharmaceutical research to develop tailored products to prevent or treat diseases; and (6) funding training programs.

78 FR 33690 - Common Crop Insurance Regulations; Pecan Crop Insurance Provisions; Correction

Science.gov (United States)

2013-06-05

...-0008] RIN 0563-AC35 Common Crop Insurance Regulations; Pecan Crop Insurance Provisions; Correction... FR 13454-13460). The regulation pertains to the insurance of Pecans. DATES: Effective Date: June 5...: [[Page 33691

Health Insurance

Science.gov (United States)

Health insurance helps protect you from high medical care costs. It is a contract between you and your ... Many people in the United States get a health insurance policy through their employers. In most cases, the ...

Introducing voluntary private health insurance in a mixed medical economy: are Hong Kong citizens willing to subscribe?

Science.gov (United States)

He, Alex Jingwei

2017-08-25

Struggling to correct the public-private imbalance in its health care system, the Hong Kong SAR Government seeks to introduce a government-regulated voluntary health insurance scheme, or VHIS, a distinctive financing instrument that combines the characteristics of private insurance with strong government regulation. This study examines citizens' responses to the new scheme and their willingness to subscribe. First-hand data were collected from a telephone survey that randomly sampled 1793 Hong Kong adults from September 2014 to February 2015. Univariate and multivariate methods were employed in data analysis. More than one third of the respondents explicitly stated intention of subscribing to the VHIS, a fairly high figure considering the scheme's voluntary nature. Multivariate analysis revealed moderate evidence of adverse selection, defined as individuals' opportunistic behaviors when making insurance purchasing decision based on their own assessment of risks or likelihood of making a claim. The excellent performance of Hong Kong's public medical system has had two parallel impacts. On the one hand, high-risk residents, particularly the uninsured, do not face a pressing need to switch out of the overloaded public system despite its inadequacies; this, in turn, may reduce the impact of adverse selection that may lead to detrimental effects to the insurance market. On the other hand, high satisfaction reinforces the interests of those who have both the need for better services and the ability to pay for supplementary insurance. Furthermore, the high-risk population demonstrates a moderate interest in the insurance despite the availability of government subsidies. This may offset the intended effect of the reform to some extent.

Health insurance basic actuarial models

CERN Document Server

Pitacco, Ermanno

2014-01-01

Health Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and ‘protection products’, more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i.e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short int...

Insuring Care: Paperwork, Insurance Rules, and Clinical Labor at a U.S. Transgender Clinic.

Science.gov (United States)

van Eijk, Marieke

2017-12-01

What is a clinician to do when people needing medical care do not have access to consistent or sufficient health insurance coverage and cannot pay for care privately? Analyzing ethnographically how clinicians at a university-based transgender clinic in the United States responded to this challenge, I examine the U.S. health insurance system, insurance paperwork, and administrative procedures that shape transgender care delivery. To buffer the impact of the system's failure to provide sufficient health insurance coverage for transgender care, clinicians blended administrative routines with psychological therapy, counseled people's minds and finances, and leveraged the prestige of their clinic in attempts to create space for gender nonconforming embodiments in gender conservative insurance policies. My analysis demonstrates that in a market-based health insurance system with multiple payers and gender binary insurance rules, health care may be unaffordable, or remain financially challenging, even for transgender people with health insurance. Moreover, insurance carriers' "reliance" on clinicians' insurance-related labor is problematic as it exacerbates existing insurance barriers to the accessibility and affordability of transgender care and obscures the workings of a financial payment model that prioritizes economic expediency over gender nonconforming health.

How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?

Science.gov (United States)

Trish, Erin E; Herring, Bradley J

2015-07-01

The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans' transactions with employers and the other concentration measure representing insurers' bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration. Copyright © 2015 Elsevier B.V. All rights reserved.

Impact of Primary Language and Insurance on Pediatric Hearing Health Care in a Multidisciplinary Clinic.

Science.gov (United States)

Su, Brooke M; Park, Jason S; Chan, Dylan K

2017-10-01

Objective This study aims to describe the effects of primary language and insurance status on care utilization among deaf or hard-of-hearing children under active otolaryngologic and audiologic care. Study Design Cross-sectional analysis. Setting Multidisciplinary hearing loss clinic at a tertiary center. Subjects and Methods Demographics, hearing loss data, and validated survey responses were collected from 206 patients aged 0 to 19 years. Two-sided t tests and χ 2 tests were used to obtain descriptive statistics and hypothesis testing. Results Of the sample, 52.4% spoke primarily English at home. Non-English-speaking children and families were less likely to receive psychiatric counseling (12.2% vs 35.2% in the English group, P children were less likely to know the type or degree of their child's hearing loss (56.9% vs 75.4%, P = .022), and these children were older on presentation to the clinic (8.5 vs 6.5 years of age, P = .01) compared to privately insured children. Publicly insured children were less likely to receive cochlear implants ( P = .046) and reported increased difficulty obtaining hearing aids ( P = .047). While all patients reported impairment in hearing-related quality of life, publicly insured children aged 2 to 7 years were more likely to perform below minimum thresholds on measures of auditory/oral functioning. Conclusion Even when under active care, deaf or hard-of-hearing children from families who do not speak English at home or with public insurance face more difficulty obtaining educational services, cochlear implants, and hearing aids. These findings represent significant disparities in access to necessary interventions.

76 FR 20298 - Insurer Reporting Requirements; List of Insurers; Required To File Reports

Science.gov (United States)

2011-04-12

... vehicle insurers that are required to file reports on their motor vehicle theft loss experiences. An... the agency. Each insurer's report includes information about thefts and recoveries of motor vehicles... more vehicles not covered by theft insurance policies issued by insurers of motor vehicles, other than...

75 FR 34966 - Insurer Reporting Requirements; List of Insurers Required To File Reports

Science.gov (United States)

2010-06-21

... vehicle insurers that are required to file reports on their motor vehicle theft loss experiences. An... the agency. Each insurer's report includes information about thefts and recoveries of motor vehicles... vehicles not covered by theft insurance policies issued by insurers of motor vehicles, other than any...

76 FR 64174 - Public Input on the Report to Congress on How To Modernize and Improve the System of Insurance...

Science.gov (United States)

2011-10-17

... submit views on: 1. Systemic risk regulation with respect to insurance; 2. Capital standards and the... risk; 3. Consumer protection for insurance products and practices, including gaps in State regulation... general creditor claims; iii. In the case of life insurance companies, on the loss of the special status...

Validation of a probabilistic model for hurricane insurance loss projections in Florida

International Nuclear Information System (INIS)

Pinelli, J.-P.; Gurley, K.R.; Subramanian, C.S.; Hamid, S.S.; Pita, G.L.

2008-01-01

The Florida Public Hurricane Loss Model is one of the first public models accessible for scrutiny to the scientific community, incorporating state of the art techniques in hurricane and vulnerability modeling. The model was developed for Florida, and is applicable to other hurricane-prone regions where construction practice is similar. The 2004 hurricane season produced substantial losses in Florida, and provided the means to validate and calibrate this model against actual claim data. This paper presents the predicted losses for several insurance portfolios corresponding to hurricanes Andrew, Charley, and Frances. The predictions are validated against the actual claim data. Physical damage predictions for external building components are also compared to observed damage. The analyses show that the predictive capabilities of the model were substantially improved after the calibration against the 2004 data. The methodology also shows that the predictive capabilities of the model could be enhanced if insurance companies report more detailed information about the structures they insure and the types of damage they suffer. This model can be a powerful tool for the study of risk reduction strategies

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Science.gov (United States)

2010-07-01

... the cost of collision damage waiver (CDW) or theft insurance? 301-10.451 Section 301-10.451 Public... I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance? (a) General rule—no. You will not be reimbursed for CDW or theft insurance for travel within CONUS for the following...

Paternity leave in Sweden: costs, savings and health gains.

Science.gov (United States)

Månsdotter, Anna; Lindholm, Lars; Winkvist, Anna

2007-06-01

The initial objective is to examine the relationship between paternity leave in 1978-1979 and male mortality during 1981-2001, and the second objective is to calculate the cost-effectiveness of the 1974 parental insurance reform in Sweden. Based on a population of all Swedish couples who had their first child together in 1978 (45,801 males), the risk of death for men who took paternity leave, compared with men who did not, was estimated by odds ratios. The cost-effectiveness analysis considered costs for information, administration and production losses, minus savings due to decreased sickness leave and inpatient care, compared to health gains in life-years and quality-adjusted life-years (QALYs). It is demonstrated that fathers who took paternity leave have a statistically significant decreased death risk of 16%. Costs minus savings (discounted values) stretch from a net cost of EUR 19 million to a net saving of EUR 11 million, and the base case cost-effectiveness is EUR 8000 per QALY. The study indicates that that the right to paternity leave is a desirable reform based on commonly stated public health, economic, and feminist goals. The critical issue in future research should be to examine impact from health-related selection.

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study

Directory of Open Access Journals (Sweden)

Gyr Niklaus

2011-03-01

Full Text Available Abstract Background A high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job. However, little is known about the satisfaction of staff of insurance companies with medical appraisals that they have commissioned. Our questionnaire survey prospectively included all medical appraisals arriving at Swiss insurances from FEB to APR 2008. We assessed the satisfaction of the commissioner with medical appraisals performed by medical assessors. In addition, we evaluated the contribution of several factors to overall satisfaction. The unit of sample was the medical appraisal. Findings We analysed 3165 medical appraisals, 2444 (77% of them from the public disability insurance, 678 (22% from private accident, liability and loss of income insurances and 43 (1% from other insurances. Overall satisfaction of staff of insurance companies in Switzerland was high, but satisfaction of the disability insurance with appraisals was generally lower compared to satisfaction of private insurances. The staff of the disability insurance judged time for preparation as too long in 30%. For staff of private insurance companies 20% of appraisals were not "worth its price". Well-grounded and comprehensible conclusions were the single most important factor for high overall satisfaction (OR 10.1; 95%-CI: 1.1-89.3. Conclusions From the viewpoint of staff of insurance companies, a relevant part of medical appraisals arrives too late. Medical assessors have to take the specific needs of insurances into account, to perform more appraisals with sound conclusions in due time.

Korean medicine coverage in the National Health Insurance in Korea: present situation and critical issues

Directory of Open Access Journals (Sweden)

Byungmook Lim

2013-09-01

Full Text Available National Health Insurance (NHI in Korea has covered Korean medicine (KM services including acupuncture, moxibustion, cupping, and herbal preparations since 1987, which represents the first time that an entire traditional medicine system was insured by an NHI scheme anywhere in the world. This nationwide insurance coverage led to a rapid increase in the use of KM, and the KM community became one of the main interest groups in the Korean healthcare system. However, due to the public's safety concern of and the stagnancy in demand for KM services, KM has been facing new challenges. This paper presents a brief history and the current structure of KM health insurance, and describes the critical issues related to KM insurance for in-depth understanding of the present situation.

Farmers Insures Success

Science.gov (United States)

Freifeld, Lorri

2012-01-01

Farmers Insurance claims the No. 2 spot on the Training Top 125 with a forward-thinking training strategy linked to its primary mission: FarmersFuture 2020. It's not surprising an insurance company would have an insurance policy for the future. But Farmers takes that strategy one step further, setting its sights on 2020 with a far-reaching plan to…

76 FR 41138 - Insurer Reporting Requirements; List of Insurers Required To File Reports

Science.gov (United States)

2011-07-13

... passenger motor vehicle insurers that are required to file reports on their motor vehicle theft loss... information about thefts and recoveries of motor vehicles, the rating rules used by the insurer to establish... companies with a fleet of 20 or more vehicles not covered by theft insurance policies issued by insurers of...

Nuclear energy communications in France: gaining public confidence

International Nuclear Information System (INIS)

Chaussade, J.-P.

1990-01-01

Nuclear power plants today are an accepted part of the French landscape; a total of 54 units have been constructed on some 20 different sites. They have been relatively well accepted by the general public and, in particular, by those people living in the vicinity of plants. This favourable situation, however, did not come about automatically - it required a great deal of effort in terms of public information, starting during the 1970s. This effort must be maintained, especially since public confidence in nuclear energy was severely shaken by the Chernobyl accident. Our success in pursuing France's planned construction programme depends on our ability to build on this confidence. Indeed, since 1987, we have had to rethink our communications strategy. However, Electricite de France (EDF) is not alone in this; public authorities, the SCSIN (an Industry Department equivalent to the NRC), CEA (French atomic energy commission), in its capacity as a research organisation, together with plant constructor Framatome and nuclear fuel company Cogema, all have a role to play in this communications drive. The key to our communications campaign lies in listening to public opinion. Opinion polls and qualitative surveys allow us to judge public awareness and pinpoint expectations and concerns. This article summarises the main surveys we have carried out. (3 figures) (Author)

Sum Insured Determination for Cereal, Citrus and Vineyards in the Spanish Agricultural Insurance System

Science.gov (United States)

Lozano, C.; Tarquis, A. M.; Gómez-Barona, J. A.

2012-04-01

In general, insurance is a form of risk management used to hedge against a contingent loss. The conventional definition is the equitable transfer of a risk of loss from one entity to another in exchange for a premium or a guaranteed and quantifiable small loss to prevent a large and possibly devastating loss being agricultural insurance a special line of property insurance. Agriculture insurance, as actually are designed in the Spanish scenario, were established in 1978. At the macroeconomic insurance studies scale, it is necessary to know a basic element for the insurance actuarial components: sum insured. When a new risk assessment has to be evaluated in the insurance framework, it is essential to determinate venture capital in the total Spanish agriculture. In this study, three different crops (cereal, citrus and vineyards) cases are showed to determinate sum insured as they are representative of the cases found in the Spanish agriculture. Crop sum insured is calculated by the product of crop surface, unit surface production and crop price insured. In the cereal case, winter as spring cereal sowing, represents the highest Spanish crop surface, above to 6 millions of hectares (ha). Meanwhile, the four citrus species (oranges, mandarins, lemons and grapefruits) occupied an extension just over 275.000 ha. On the other hand, vineyard target to wine process shows almost one million of ha in Spain. A new method has been applied to estimate crop sum insured in these three cases. Under the maximum economic impact assumption, the maximum market price has been used to insurance each species. Depending on crop and reliability of the data base available, the insured area or insured production has been used in this estimation. When for a certain crop varieties or type of varieties show different insurance prices a geometric average was used as average insurance price for that particular crop. One extreme difficult case was vineyards, where differentiate prices based on

Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion.

Science.gov (United States)

Boyle, Melissa A; Lahey, Joanna N

2016-01-01

Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands' labor supply decreases, wives' labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act. Copyright © 2015 Elsevier B.V. All rights reserved.

75 FR 9247 - Single Family Mortgage Insurance Premium, Single Family

Science.gov (United States)

2010-03-01

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-13] Single Family Mortgage Insurance Premium, Single Family AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notice... is soliciting public comments on the subject proposal. Lenders use the Single Family Premium...

Multigroup Path Analysis of the Influence of Healthcare Quality, by Different Health Insurance Types.

Science.gov (United States)

Hong, Yong-Rock; Holcomb, Derek; Ballard, Michael; Schwartz, Laurel

Winds of change have been blowing in the U.S. healthcare system since passage of the Affordable Care Act. Examining differences between individuals covered by different types of insurance is essential if healthcare executives are to develop new strategies in response to the emerging health insurance market. In this study, we used multigroup path analysis models to examine the moderating effects of health insurance on direct and indirect associations with general health status, satisfaction with received care, financial burden, and perceived value of the healthcare system. Data were obtained from the 2012 Medical Expenditure Panel Survey and analyzed according to the types of insurance: private, public, and military. With the satisfactory fit of the model (χ = 2,532.644, df = 96, p spending.

Shifting to Value-Based Principles in Sickness Insurance: Challenges in Changing Roles and Culture.

Science.gov (United States)

Ståhl, Christian; Andersson, Frieda

2018-02-12

Purpose Management principles in insurance agencies influence how benefits are administered, and how return to work processes for clients are managed and supported. This study analyses a change in managerial principles within the Swedish Sickness Insurance Agency, and how this has influenced the role of insurance officials in relation to discretion and accountability, and their relationship to clients. Methods The study is based on a qualitative approach comprising 57 interviews with officials and managers in four insurance offices. Results The reforms have led to a change in how public and professional accountability is defined, where the focus is shifted from routines and performance measurements toward professional discretion and the quality of encounters. However, the results show how these changes are interpreted differently across different layers of the organization, where New Public Management principles prevail in how line managers give feedback on and reward the work of officials. Conclusions The study illustrates how the introduction of new principles to promote officials' discretion does not easily bypass longstanding management strategies, in this case managing accountability through top-down performance measures. The study points out the importance for public organizations to reconcile new organizational principles with the current organizational culture and how this is manifested through managerial styles, which may be resistant to change. Promoting client-oriented and value-driven approaches in client work hence needs to acknowledge the importance of organizational culture, and to secure that changes are reflected in organizational procedures and routines.

Insurance + access not equal to health care: typology of barriers to health care access for low-income families.

Science.gov (United States)

Devoe, Jennifer E; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A

2007-01-01

Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, "Is there anything else you would like to tell us?" Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere.

32 CFR 220.11 - Special rules for automobile liability insurance and no-fault automobile insurance.

Science.gov (United States)

2010-07-01

... and no-fault automobile insurance. 220.11 Section 220.11 National Defense Department of Defense... insurance and no-fault automobile insurance. (a) Active duty members covered. In addition to Uniformed.... 1095 and this part. (c) Exclusion of automobile liability insurance and no-fault automobile insurance...

Alternative health insurance schemes

DEFF Research Database (Denmark)

Keiding, Hans; Hansen, Bodil O.

2002-01-01

In this paper, we present a simple model of health insurance with asymmetric information, where we compare two alternative ways of organizing the insurance market. Either as a competitive insurance market, where some risks remain uninsured, or as a compulsory scheme, where however, the level...... competitive insurance; this situation turns out to be at least as good as either of the alternatives...

78 FR 52780 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

Science.gov (United States)

2013-08-26

...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of FY... Assistance/Subsidy Arrangement (Arrangement), 85 (as of June 2013) private sector property insurers sell... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...

77 FR 36566 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

Science.gov (United States)

2012-06-19

...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of FY... Assistance/Subsidy Arrangement (Arrangement), 82 (as of April, 2012) private sector property insurers sell... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...

Insurer views on reimbursement of preventive services in the dental setting: results from a qualitative study.

Science.gov (United States)

Feinstein-Winitzer, Rebecca T; Pollack, Harold A; Parish, Carrigan L; Pereyra, Margaret R; Abel, Stephen N; Metsch, Lisa R

2014-05-01

We explored insurers' perceptions regarding barriers to reimbursement for oral rapid HIV testing and other preventive screenings during dental care. We conducted semistructured interviews between April and October 2010 with a targeted sample of 13 dental insurance company executives and consultants, whose firms' cumulative market share exceeded 50% of US employer-based dental insurance markets. Participants represented viewpoints from a significant share of the dental insurance industry. Some preventive screenings, such as for oral cancer, received widespread insurer support and reimbursement. Others, such as population-based HIV screening, appeared to face many barriers to insurance reimbursement. The principal barriers were minimal employer demand, limited evidence of effectiveness and return on investment specific to dental settings, implementation and organizational constraints, lack of provider training, and perceived lack of patient acceptance. The dental setting is a promising venue for preventive screenings, and addressing barriers to insurance reimbursement for such services is a key challenge for public health policy.

Insurance: Accounting, Regulation, Actuarial Science

OpenAIRE

Alain Tosetti; Thomas Behar; Michel Fromenteau; Stéphane Ménart

2001-01-01

We shall be examining the following topics: (i) basic frameworks for accounting and for statutory insurance rules; and (ii) actuarial principles of insurance; for both life and nonlife (i.e. casualty and property) insurance.Section 1 introduces insurance terminology, regarding what an operation must include in order to be an insurance operation (the legal, statistical, financial or economic aspects), and introduces the accounting and regulation frameworks and the two actuarial models of insur...

Risk Management in Insurance Companies

OpenAIRE

Yang, Xufeng

2006-01-01

Insurance is the uncertain business in uncertain society. Today, insures face more complex and difficult risks. Efficient risk management mechanisms are essential for the insurers. The paper is set out initially to explore UK insurance companies risk management and risk disclosure by examining companies annual report after all the listed insurance companies are required to disclose risk information in their annual report, which seeks to reflect the recent development in UK insurance companies...

Health insurance reform: labor versus health perspectives.

Science.gov (United States)

Ammar, Walid; Awar, May

2012-01-01

The Ministry of Labor (MOL) has submitted to the Council of Ministers a social security reform plan. The Ministry of Public Health (MOPH) considers that health financing should be dealt with as part of a more comprehensive health reform plan that falls under its prerogatives. While a virulent political discussion is taking place, major stakeholders' inputs are very limited and civil society is totally put away from the whole policy making process. The role of the media is restricted to reproducing political disputes, without meaningful substantive debate. This paper discusses health insurance reform from labor market as well as public health perspectives, and aims at launching a serious public debate on this crucial issue that touches the life of every citizen.

Household perceptions towards a redistributive policy across health insurance funds in Tanzania

DEFF Research Database (Denmark)

Chomi, Eunice; Mujinja, Phares; Hansen, Kristian Schultz

2015-01-01

Background The Tanzanian health insurance system comprises multiple health insurance funds targeting different population groups but which operate in parallel, with no mechanisms for redistribution across the funds. Establishing such redistributive mechanisms requires public support, which...... data collected from a survey of 695 households relating to perceptions of household heads towards cross-subsidisation of the poor to enable them to access health services. Kruskal-Wallis test is used to compare perceptions by membership status. Generalized ordinal logistic regression models are used...

Marketing in life insurance

Directory of Open Access Journals (Sweden)

Njegomir Vladimir

2006-01-01

Full Text Available Insurance industry has traditionally been oriented on sale of its products i.e. at the stage which from the aspect of marketing theory can be characterized as sales phase, phase which proceeds the marketing orientation. However, faced with numerous challenges of modern business environment such as globalization, deregulation and sophisticated information technology insurance companies must change their way of doing business. Competition is becoming fierce as insurance companies are faced with competition not only from insurance industry but also from other competitors, such as banks, that are in position to offer product substitutes for life insurance products. In this new environment information about customers and their education are becoming critical factors. Insurance companies must know their customers what influences their demand for life insurance, what is the amount of their income, what is inflation rate, their expenditures on other goods i.e. opportunity costs, etc. Those are factors that force insurance companies to concentrate more on present and potential buyers and their needs and force them to give their best to satisfy those needs in a way that will produce delighted customers.

Health insurance in India: what do we know and why is ethnographic research needed.

Science.gov (United States)

Ahlin, Tanja; Nichter, Mark; Pillai, Gopukrishnan

2016-01-01

The percentage of India's national budget allocated to the health sector remains one of the lowest in the world, and healthcare expenditures are largely out-of-pocket (OOP). Currently, efforts are being made to expand health insurance coverage as one means of addressing health disparity and reducing catastrophic health costs. In this review, we document reasons for rising interest in health insurance and summarize the country's history of insurance projects to date. We note that most of these projects focus on in-patient hospital costs, not the larger burden of out-patient costs. We briefly highlight some of the more popular forms that government, private, and community-based insurance schemes have taken and the results of quantitative research conducted to assess their reach and cost-effectiveness. We argue that ethnographic case studies could add much to existing health service and policy research, and provide a better understanding of the life cycle and impact of insurance programs on both insurance holders and healthcare providers. Drawing on preliminary fieldwork in South India and recognizing the need for a broad-based implementation science perspective (studying up, down and sideways), we identify six key topics demanding more in-depth research, among others: (1) public awareness and understanding of insurance; (2) misunderstanding of insurance and how this influences health care utilization; (3) differences in behavior patterns in cash and cashless insurance systems; (4) impact of insurance on quality of care and doctor-patient relations; (5) (mis)trust in health insurance schemes; and (6) health insurance coverage of chronic illnesses, rehabilitation and OOP expenses.

Disability Insurance Benefits and Labor Supply

OpenAIRE

Jonathan Gruber

2000-01-01

Disability Insurance (DI) is a public program that provides income support to persons unable to continue work due to disability. The difficulty of defining disability, however, has raised the possibility that this program may be subsidizing the early retirement of workers who are not truly disabled. A critical input for assessing the optimal size of the DI program is therefore the elasticity of labor force participation with respect to benefits generosity. Unfortunately, this parameter has be...

Chinese insurance agents in ?bad barrels?: a multilevel analysis of the relationship between ethical leadership, ethical climate and business ethical sensitivity

OpenAIRE

Zhang, Na; Zhang, Jian

2016-01-01

Background The moral hazards and poor public image of the insurance industry, arising from insurance agents? unethical behavior, affect both the normal operation of an insurance company and decrease applicants? confidence in the company. Contrarily, these scandals may demonstrate that the organizations were ?bad barrels? in which insurance agents? unethical decisions were supported or encouraged by the organization?s leadership or climate. Objective The present study brings two organization-l...

Supplementary insurance as a switching cost for basic health insurance: Empirical results from the Netherlands.

Science.gov (United States)

Willemse-Duijmelinck, Daniëlle M I D; van de Ven, Wynand P M M; Mosca, Ilaria

2017-10-01

Nearly everyone with a supplementary insurance (SI) in the Netherlands takes out the voluntary SI and the mandatory basic insurance (BI) from the same health insurer. Previous studies show that many high-risks perceive SI as a switching cost for BI. Because consumers' current insurer provides them with a guaranteed renewability, SI is a switching cost if insurers apply selective underwriting to new applicants. Several changes in the Dutch health insurance market increased insurers' incentives to counteract adverse selection for SI. Tools to do so are not only selective underwriting, but also risk rating and product differentiation. If all insurers use the latter tools without selective underwriting, SI is not a switching cost for BI. We investigated to what extent insurers used these tools in the periods 2006-2009 and 2014-2015. Only a few insurers applied selective underwriting: in 2015, 86% of insurers used open enrolment for all their SI products, and the other 14% did use open enrolment for their most common SI products. As measured by our indicators, the proportion of insurers applying risk rating or product differentiation did not increase in the periods considered. Due to the fear of reputation loss insurers may have used 'less visible' tools to counteract adverse selection that are indirect forms of risk rating and product differentiation and do not result in switching costs. So, although many high-risks perceive SI as a switching cost, most insurers apply open enrolment for SI. By providing information to high-risks about their switching opportunities, the government could increase consumer choice and thereby insurers' incentives to invest in high-quality care for high-risks. Copyright © 2017 Elsevier B.V. All rights reserved.

Reference Pricing with Endogenous or Exogenous Payment Limits: Impacts on Insurer and Consumer Spending.

Science.gov (United States)

Brown, Timothy T; Robinson, James C

2016-06-01

Reference pricing (RP) theories predict different outcomes when reference prices are fixed (exogenous) versus being a function of market prices (MPs) (endogenous). Exogenous RP results in MPs at both high-price and low-price firms converging towards the reference price from above and below, respectively. Endogenous RP results in MPs at both high-price and low-price firms decreasing, with low-price firms acting strategically to decrease the reference price in order to gain market share. We extend these models to a hospital context focusing on insurer and consumer payments. Under exogenous RP, insurer and consumer payments to low-price hospitals increase, and insurer payments to high-price hospitals decrease, but predictions regarding consumer payments are ambiguous for high-price hospitals. Under endogenous RP, insurer payments to high-price and low-price hospitals decrease, and consumer payments to low-price hospitals decrease, but predictions regarding consumer payments are ambiguous for high-price hospitals. We test these predictions with difference-in-differences specifications using 2008-2013 data on patients undergoing joint replacement. For 2 years following RP implementation, insurer payments to high-price and low-price hospitals moved downward, consistent with endogenous RP. However, when the reference price was not reset to account for changes in MPs, insurer payments to low-price hospitals reverted to pre-implementation levels, consistent with exogenous RP. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Serbian insurance market: Select issues

Directory of Open Access Journals (Sweden)

Obadović Mirjana M.

2010-01-01

Full Text Available Every day insurance companies face a number of risks arising from the insurance industry itself, as well as risks arising from insurance company operations. In this constant fight against risks insurance companies use different models and methods that help them better understand, have a more comprehensive view of, and develop greater tolerance towards risks, in order to reduce their exposure to these risks. The model presented in this paper has been developed for implementation in insurance risk management directly related to insurance company risk, i.e. it is a model that can reliably determine the manner and intensity with which deviations in the initial insurance risk assessment affect insurance company operations, in the form of changes in operational risks and consequently in insurance companies’ business strategies. Additionally we present the implementation of the model in the Serbian market for the period 2005-2010.

Maternal factors influencing late entry into prenatal care: a stratified analysis by race or ethnicity and insurance status.

Science.gov (United States)

Baer, Rebecca J; Altman, Molly R; Oltman, Scott P; Ryckman, Kelli K; Chambers, Christina D; Rand, Larry; Jelliffe-Pawlowski, Laura L

2018-04-09

Examine factors influencing late (> sixth month of gestation) entry into prenatal care by race/ethnicity and insurance payer. The study population was drawn from singleton live births in California from 2007-2012 in the birth cohort file maintained by the California Office of Statewide Health Planning and Development, which includes linked birth certificate and mother and infant hospital discharge records. The sample was restricted to infants delivered between 20 and 44 weeks gestation. Logistic regression was used to calculate relative risks (RR) and 95% confidence intervals (CI) for factors influencing late entry into prenatal care. Maternal age, education, smoking, drug or alcohol abuse/dependence, mental illness, participation in the Women, Infants and Children's program and rural residence were evaluated for women entering prenatal care > sixth month of gestation compared with women entering prenatal care entry for each race or ethnicity and insurance payer. The sample included 2 963 888 women. The percent of women with late entry into prenatal care was consistently higher among women with public versus private insurance. Less than 1% of white non-Hispanic and Asian women with private insurance entered prenatal care late versus more than 4% of white non-Hispanic and black women with public insurance. After stratifying by race or ethnicity and insurance status, women less than 18 years of age were more likely to enter prenatal care late, with young Asian women with private insurance at the highest risk (15.6%; adjusted RR 7.4, 95% CI 5.3-10.5). Among all women with private insurance, > 12-year education or age > 34 years at term reduced the likelihood of late prenatal care entry (adjusted RRs 0.5-0.7). Drugs and alcohol abuse/dependence and residing in a rural county were associated with increased risk of late prenatal care across all subgroups (adjusted RRs 1.3-3.8). Participation in the Women, Infants and Children's program was associated with decreased

The Dynamics of Market Insurance, Insurable Assets, and Wealth Accumulation

OpenAIRE

Koeniger, Winfried

2002-01-01

We analyze dynamic interactions between market insurance, the stock of insurable assets and liquid wealth accumulation in a model with non-durable and durable consumption. The stock of the durable is exposed to risk against which households can insure. Since the model does not have a closed form solution we first provide an analytical approximation for the case in which households own abundant liquid wealth. It turns out that precautionary motives still matter because of fluctuations of the p...

Insurance dictionary

International Nuclear Information System (INIS)

Mueller-Lutz, H.L.

1984-01-01

Special technical terms used in the world of insurance can hardly be found in general dictionaries. This is a gap which the 'Insurance dictionary' now presented is designed to fill. In view of its supplementary function, the number of terms covered is limited to 1200. To make this dictionary especially convenient for ready reference, only the most commonly used translations are given for each key word in any of the four languages. This dictionary is subdivided into four parts, each containing the translation of the selected terms in the three other languages. To further facilitate the use of the booklet, paper of different colours was used for the printing of the German, English, French and Greek sections. The present volume was developed from a Swedish insurance dictionary (Fickordbok Foersaekring), published in 1967, which - with Swedish as the key language- offers English, French and German translations of the basic insurance terms. (orig./HP) [de

20 CFR 404.276 - Publication of notice of increase.

Science.gov (United States)

2010-04-01

... DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.276 Publication of notice of increase. When we determine that an automatic cost-of-living increase is due, we...

Dental insurance! Are we ready?

Directory of Open Access Journals (Sweden)

Ravi SS Toor

2011-01-01

Full Text Available Dental insurance is insurance designed to pay the costs associated with dental care. The Foreign Direct Investment (FDI bill which was put forward in the winter session of the Lok Sabha (2008 focused on increasing the foreign investment share from the existing 26% to 49% in the insurance companies of India. This will allow the multibillion dollar international insurance companies to enter the Indian market and subsequently cover all aspects of insurance in India. Dental insurance will be an integral a part of this system. Dental insurance is a new concept in Southeast Asia as very few countries in Southeast Asia cover this aspect of insurance. It is important that the dentists in India should be acquainted with the different types of plans these companies are going to offer and about a new relationship which is going to emerge in the coming years between dentist, patient and the insurance company.

Entitlement to Sickness Benefits in Sweden: The Social Insurance Officers Experiences

Directory of Open Access Journals (Sweden)

Ulrika Müssener

2008-01-01

Full Text Available Background: Social insurance offices (SIOs handle a wide range of complex assessments of the entitlement to sickness benefits for an increasing number of clients on sick leave and consequently, the demands on the SIOs have increased considerably.Aim: To gain deeper knowledge of the problems experienced by the SIOs in their work associated with entitlement to sickness benefits.Method: A descriptive and explorative qualitative approach was used to analyse data from two focus-group interviews, including six participants in each group.Results: The participants discussed different dilemmas in regard to; physicians’ responsibility for issuing sickness certificates, interactions with the insured individuals, disclosure of decisions, communications with medical consultants, documentation of sickness benefit claims, threats in the workplace, as well as their own competence. The SIOs regarded incomplete information on sickness certificates as a main problem, because they frequently had to contact the client and the physicians who issued the certificates in order to obtain further details, leading to delays in the decision-making whether to grant sickness benefits.Conclusions: More knowledge regarding SIOs work is required to improve the methods used in the sickness insurance system and to ensure adequate training of new staff members.

Biased selection within the social health insurance market in Colombia.

Science.gov (United States)

Castano, Ramon; Zambrano, Andres

2006-12-01

Reducing the impact of insurance market failures with regulations such as community-rated premiums, standardized benefit packages and open enrolment, yield limited effect because they create room for selection bias. The Colombian social health insurance system started a market approach in 1993 expecting to improve performance of preexisting monopolistic insurance funds by exposing them to competition by new entrants. This paper tests the hypothesis that market failures would lead to biased selection favoring new entrants. Two household surveys are analyzed using Self-Reported Health Status and the presence of chronic conditions as prospective indicators of individual risk. Biased selection is found to take place, leading to adverse selection among incumbents, and favorable selection among new entrants. This pattern is absent in 1997 but is evident in 2003. Given that the two incumbents analyzed are public organizations, the fiscal implications of the findings in terms of government bailouts, are analyzed.

The insurance of nuclear installations

International Nuclear Information System (INIS)

Francis, H.W.

1977-01-01

A brief account is given of the development of nuclear insurance. The subject is dealt with under the following headings: the need for nuclear insurance, nuclear insurance pools, international co-operation, nuclear installations which may be insured, international conventions relating to the liability of operators of nuclear installations, classes of nuclear insurance, nuclear reactor hazards and their assessment, future developments. (U.K.)

Regulated Medicare Advantage And Marketplace Individual Health Insurance Markets Rely On Insurer Competition.

Science.gov (United States)

Frank, Richard G; McGuire, Thomas G

2017-09-01

Two important individual health insurance markets-Medicare Advantage and the Marketplaces-are tightly regulated but rely on competition among insurers to supply and price health insurance products. Many local health insurance markets have little competition, which increases prices to consumers. Furthermore, both markets are highly subsidized in ways that can exacerbate the impact of market power-that is, the ability to set price above cost-on health insurance prices. Policy makers need to foster robust competition in both sectors and avoid designing subsidies that make the market-power problem worse. Project HOPE—The People-to-People Health Foundation, Inc.

Group Life Insurance

CERN Multimedia

2013-01-01

The CERN Administration would like to remind you that staff members and fellows have the possibility to take out a life insurance contract on favourable terms through a Group Life Insurance.   This insurance is provided by the company Helvetia and is available to you on a voluntary basis. The premium, which varies depending on the age and gender of the person insured, is calculated on the basis of the amount of the death benefit chosen by the staff member/fellow and can be purchased in slices of 10,000 CHF.    The contract normally ends at the retirement age (65/67 years) or when the staff member/fellow leaves the Organization. The premium is deducted monthly from the payroll.   Upon retirement, the staff member can opt to maintain his membership under certain conditions.   More information about Group Life Insurance can be found at: Regulations (in French) Table of premiums The Pension Fund Benefit Service &...

Economic rationality, the affordability of private long-term care insurance, and the role for public policy.

Science.gov (United States)

Crown, W H; Capitman, J; Leutz, W N

1992-08-01

This study uses data from the 1984 panel of the Survey of Income and Program Participation (SIPP) of the U.S. Bureau of the Census to develop new estimates of the potential market for private long-term care insurance. It found that this market is potentially significant--especially among individuals in the 65-69 age group who are willing to spend up to 50% of their discretionary income on such insurance--but considerably lower than previous estimates, such as those of Cohen and colleagues (1987).

Risks and nuclear insurance

International Nuclear Information System (INIS)

Debaets, M.; Springett, G.D.; Luotonen, K.; Virole, J.

1988-01-01

When analysing the nuclear insurance market, three elements must be taken into account: the nuclear operator's liability is regulated by national laws and/or international Conventions, such operators pay large premiums to insure their nuclear installations against property damage and finally, the nuclear insurance market is made up of pools and is mainly a monopoly. This report describes the different types of insurance coverage, the system governing nuclear third party liability under the Paris Convention and the Brussels Supplementary Convention and several national laws in that field. The last part of the report deals with liability and insurance aspects of international transport of nuclear materials [fr

46 CFR 308.403 - Insured amounts.

Science.gov (United States)