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Brian Turner - One of the best experts on this subject based on the ideXlab platform.
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unwinding the state subsidisation of Private Health Insurance in ireland
Health Policy, 2015Co-Authors: Brian TurnerAbstract:Ireland's Private Health Insurance market provides primarily supplementary Health Insurance for hospital services, operating alongside a public hospital system to which residents have universal access entitlements, subject to some copayments for those without a medical card. The State subsidises the purchase of Private Health Insurance through measures including tax relief on premiums and not charging the full economic cost for Private beds in public hospitals. Furthermore, Privately insured patients occupying public beds in public hospitals did not, until 2014, incur charges for such accommodation, apart from modest statutory charges. In the Budget in October 2013, a number of measures were announced that began to unwind these subsidies. Although it was initially feared that these measures would add to premium inflation, leading in turn to further discontinuation of Health Insurance, the evidence suggests that premium inflation has eased and take-up has stabilised, although some of this may have been due to the introduction of lifetime community rating in May 2015. Nevertheless, it would appear that the restriction on the subsidisation of Private Health Insurance has not had a significant adverse effect on the market, while it has reduced an inequitable cross-subsidy.
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Premium inflation in the Irish Private Health Insurance market: drivers and consequences
Irish Journal of Medical Science, 2013Co-Authors: Brian TurnerAbstract:Background 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. Findings Factors behind this premium inflation include rising charges for beds in public hospitals, increasing volume of treatments and increasing quality of service and cover. Conclusion 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.
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premium inflation in the irish Private Health Insurance market drivers and consequences
Irish Journal of Medical Science, 2013Co-Authors: Brian TurnerAbstract:Background 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.
Elizabeth Savage - One of the best experts on this subject based on the ideXlab platform.
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preference heterogeneity and selection in Private Health Insurance the case of australia
Journal of Health Economics, 2013Co-Authors: Thomas C Buchmueller, Denzil G Fiebig, Glenn Jones, Elizabeth SavageAbstract:A basic prediction of theoretical models of Insurance is that if consumers have Private information about their risk of suffering a loss there will be a positive correlation between risk and the level of Insurance coverage. We test this prediction in the context of the market for Private Health Insurance in Australia. Despite a universal public system that provides comprehensive coverage for inpatient and outpatient care, roughly half of the adult population also carries Private Health Insurance, the main benefit of which is more timely access to elective hospital treatment. Like several studies on different types of Insurance in other countries, we find no support for the positive correlation hypothesis. Because strict underwriting regulations create strong information asymmetries, this result suggests the importance of multi-dimensional Private information. Additional analyses suggest that the advantageous selection observed in this market is driven by the effect of risk aversion, the ability to make complex financial decisions and income.
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run for cover now or later the impact of premiums threats and deadlines on supplementary Private Health Insurance in australia
2008Co-Authors: Randall P Ellis, Elizabeth SavageAbstract:Between 1997 and 2000 the Australian government introduced three policy reforms that aimed to increase Private Health Insurance coverage and reduce public hospital demand. The first provided income-based tax incentives; the second gave an across-the-board 30% premium subsidy; and the third introduced selective age-based premium increases for those enrolling after a deadline. Together the reforms increased enrolment by 50% and reduced the average age of enrollees. The deadline appeared to induce consumers to enroll now rather than delay. We estimate a model of individual Insurance decisions and examine the effects of the reforms on the age and income distribution of those with Private cover. We interpret the major driver of the increased enrollment as a response to a deadline and an advertising blitz, rather than a pure price response.
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run for cover now or later the impact of premiums threats and deadlines on Private Health Insurance in australia
International Journal of Health Care Finance & Economics, 2008Co-Authors: Randall P Ellis, Elizabeth SavageAbstract:Between 1997 and 2000 the Australian government introduced three policy reforms that aimed to increase Private Health Insurance coverage and reduce public hospital demand. The first provided income-based tax incentives; the second gave an across-the-board 30% premium subsidy; and the third introduced selective age-based premium increases for those enrolling after a deadline. Together the reforms increased enrolment by 50% and reduced the average age of enrollees. The deadline appeared to induce consumers to enroll now rather than delay. We estimate a model of individual Insurance decisions and examine the effects of the reforms on the age and income distribution of those with Private cover. We interpret the major driver of the increased enrollment as a response to a deadline and an advertising blitz, rather than a pure price response.
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Healthy wealthy and insured the role of self assessed Health in the demand for Private Health Insurance
Health Economics, 2008Co-Authors: Denise Doiron, Glenn Jones, Elizabeth SavageAbstract:Both adverse selection and moral hazard models predict a positive relationship between risk and Insurance; yet the most common finding in empirical studies of Insurance is that of a negative correlation. In this paper, we investigate the relationship between ex ante risk and Private Health Insurance using Australian data. The institutional features of the Australian system make the effects of asymmetric information more readily identifiable than in most other countries. We find a strong positive association between self-assessed Health and Private Health cover. By applying the Lokshin and Ravallion (J. Econ. Behav. Organ 2005; 56:141-172) technique we identify the factors responsible for this result and recover the conventional negative relationship predicted by adverse selection when using more objective indicators of Health. Our results also provide support for the hypothesis that self-assessed Health captures individual traits not necessarily related to risk of Health expenditures, in particular, attitudes towards risk. Specifically, we find that those persons who engage in risk-taking behaviours are simultaneously less likely to be in good Health and less likely to buy Insurance.
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Healthy wealthy and insured the role of self assessed Health in the demand for Private Health Insurance
Health Economics, 2008Co-Authors: Denise Doiron, Glenn Jones, Elizabeth SavageAbstract:Both adverse selection and moral hazard models predict a positive relationship between risk and Insurance; yet the most common finding in empirical studies of Insurance is that of a negative correlation. In this paper, we investigate the relationship between ex ante risk and Private Health Insurance using Australian data. The institutional features of the Australian system make the effects of asymmetric information more readily identifiable than in most other countries. We find a strong positive association between self-assessed Health and Private Health cover. By applying the Lokshin and Ravallion (J. Econ. Behav. Organ 2005; 56:141–172) technique we identify the factors responsible for this result and recover the conventional negative relationship predicted by adverse selection when using more objective indicators of Health. Our results also provide support for the hypothesis that self-assessed Health captures individual traits not necessarily related to risk of Health expenditures, in particular, attitudes towards risk. Specifically, we find that those persons who engage in risk-taking behaviours are simultaneously less likely to be in good Health and less likely to buy Insurance. Copyright © 2007 John Wiley & Sons, Ltd.
Manuel Willington - One of the best experts on this subject based on the ideXlab platform.
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collusion in the Private Health Insurance market empirical evidence for chile
Research Papers in Economics, 2008Co-Authors: Claudio A Agostini, Eduardo Saavedra, Manuel WillingtonAbstract:In September 2005, the Chilean Competition Authority filed a complaint against the 5 largest Private Health Insurance providers for violation of antitrust laws. The 5 providers were accused of colluding to reduce the coverage of the plans offered to customers between March 2002 and March 2003. The main fact is that during that period these 5 providers reduced the coverage offered from 100% for hospitalization and 80% for ambulatory care to 90% and 70% respectively. As usual the observation of parallel conduct is not enough to infer collusion and it is required to observe additional factors that allow us to reject the hypothesis of providers behaving competitively. In this paper, we show that some specific characteristics of the Health Insurance markets generate barriers to entry and switching costs that allow the possibility of a collusive agreement. Then, we adapt an imperfect competition model of product differentiation to derive some testable propositions that allow us to distinguish between competition and collusion outcomes in the Health Insurance market in Chile. Finally, we show econometric evidence consistent with a collusive agreement among the 5 largest providers and inconsistent with a competitive equilibrium. . In particular, by comparing the prosecuted and non-prosecuted open Isapres before and during the collusive period, we show that sales efforts of the accused Isapres were reduced during the transition period toward lower-quality plans, that the profitability of the two groups of Isapres increased, and that the rate of transfers within the group of accused Isapres fell during the transition period.
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collusion in the Private Health Insurance market empirical evidence for chile
Social Science Research Network, 2008Co-Authors: Claudio A Agostini, Eduardo Saavedra, Manuel WillingtonAbstract:In September 2005, the Chilean Competition Authority filed a lawsuit against the 5 largest Private Health Insurance providers for violation of antitrust laws, specifically accusing them of collusion in the coverage of the plans offered to consumers between March 2002 and March 2003. In fact, during that period these 5 providers reduced the coverage offered from 100% for hospitalization and 80% for ambulatory care to 90% and 70% respectively. As usual the observation of parallel conduct is not enough to infer collusion and it is required to observe additional factors allowing to reject the hypothesis of firms behaving competitively.In this paper, we analyze the institutional framework and the main characteristics of the Health system in Chile to show the existence of market segmentation, limited price competition, barriers to entry, and important switching costs. All of which allows to sustain a collusive agreement making it difficult for a new entrant to gain a significant market share quickly, even if it offers a better Health Insurance plan. Then, we adapt an imperfect competition model of product differentiation with risk averse consumers to derive some testable propositions that allow us to distinguish between competition and collusion outcomes in the Health Insurance market. Finally, we present robust econometric showing a statistically significant reduction in sales effort, marketing expenses and switching rates among cartel members, compared to non-cartel members, and also show an increase in the profitability of all providers in the market, but a statistically significant higher increase in the profitability of non-cartel members. The empirical evidence, therefore, is consistent with a collusive agreement among the 5 largest Health providers to reduce Insurance coverage and inconsistent with a competitive equilibrium.
Mark J Browne - One of the best experts on this subject based on the ideXlab platform.
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one sided commitment in dynamic Insurance contracts evidence from Private Health Insurance in germany
Journal of Risk and Uncertainty, 2013Co-Authors: Annette Hofmann, Mark J BrowneAbstract:This paper studies long-term Private Health Insurance (PHI) in Germany. It describes the main actuarial principles of premium calculation and relates these to existing theory. In the German PHI policyholders do not commit to renewing their Insurance contracts, but insurers commit to offering renewal at a premium rate that does not reflect revealed future information about the insured risk. We show that empirical results are consistent with theoretical predictions from one-sided commitment models: front-loading in premiums generates a lock-in of consumers, and more front-loading is generally associated with lower rates of lapse. Due to a lack of consumer commitment, dynamic information revelation about risk type implies that high-risk policyholders are more likely to retain their PHI contracts than are low-risk types.
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one sided commitment in dynamic Insurance contracts evidence from Private Health Insurance in germany
Social Science Research Network, 2012Co-Authors: Annette Hofmann, Mark J BrowneAbstract:This paper studies long-term Private Health Insurance (PHI) in Germany. It describes the main actuarial principles of premium calculation and relates these to existing theory. In the German PHI policyholders do not commit to renewing their Insurance contracts, but insurers commit to offering renewal at a premium rate that does not reflect revealed future information about the insured risk. We show that empirical results are consistent with theoretical predictions from one-sided commitment models: front-loading in premiums generates a lock-in of consumers, and more front-loading is generally associated with lower lapzation. Due to a lack of consumer commitment, dynamic information revelation about risk type implies that high-risk policyholders are more likely to retain their PHI contracts than are low-risk types.
Youngdae Kwon - One of the best experts on this subject based on the ideXlab platform.
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individual characteristics associated with the market size change of Private Health Insurance premium in korea
The Korean Journal of Health Service Management, 2012Co-Authors: Changhoon You, Sungwook Kang, Youngdae KwonAbstract:This study examined market size of Private Health Insurance premium and individual characteristics associated with the market size change in Korea, using wave 1 (2008) and wave 2 (2009) of Korea Health Panel. The market size was 24.4 trillion Korean won in 2008 and 26.9 trillion in 2009. The increase rate of Private Health Insurance premium among those who were the elderly, single, or the poor was higher than that among their counterpart respectively. Health status and utilization were insignificant in determining the increase rate of Private Health Insurance premium. These findings were more obvious among the uninsured in 2008 than among the insured in 2008. The increase of Private Health Insurance premium in Korea imply the increase of willingness-to-pay for Health risk through Private sector. The authors suggest policy intervention for accessability to Health care for the underprivileged and weak through enlargement of Korean social Health Insurance benefit.
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effects of supplementary Private Health Insurance on physician visits in korea
Journal of the Formosan Medical Association, 2009Co-Authors: Sungwook Kang, Changhoon You, Youngdae KwonAbstract:Background/Purpose The coverage of social Health Insurance has remained limited, despite it being compulsory in Korea. Accordingly, Koreans have come to rely upon supplementary Private Health Insurance (PHI) to cover their medical costs. We examined the effects of supplementary PHI on physician visits in Korea. Methods This study used individual data from 11,043 respondents who participated in the Korean Labor and Income Panel Survey in 2001. We conducted a single probit model to identify the relationship between PHI and physician visits, with adjustment for the following covariates: demographic characteristics, socioeconomic status, Health status, and Health-related behavior. Finally, we performed a bivariate probit model to examine the true effect of PHI on physician visits, with adjustment for the above covariates plus unobservable covariates that might affect not only physician visit, but also the purchase of PHI. Results We found that about 38% of all respondents had one or more Private Health plans. Forty-five percent of all respondents visited one or more physicians, and 49% of those who were Privately insured had physician visits compared with 42% of the uninsured. The single probit model showed that those with PHI were about 14 percentage points more likely to visit physicians than those who do not have PHI. However, this distinction disappears in the bivariate probit model. This result might have been a consequence of the nature of Private Health plans in Korea. Private Insurance companies pay a fixed amount directly to their enrollees in case of illness/injury, and the individuals are responsible subsequently for purchasing their own Healthcare services. Conclusion This study demonstrated the potential of Korean PHI to address the problem of moral hazard. These results serve as a reference for policy makers when considering how to finance Healthcare services, as well as to contain Healthcare expenditure.
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the benefits of supplementary Private Health Insurance for Healthcare utilization and survival among stomach cancer patients
Tohoku Journal of Experimental Medicine, 2009Co-Authors: Sungwook Kang, Changhoon You, Youngdae Kwon, Jae Hyung Noh, Sung KimAbstract:Social Health Insurance (SHI) has covered only 60% of Healthcare payments in Korea; therefore, Koreans rely upon supplementary Private Health Insurance (SPHI) to cover the rest of the payments. SPHI status is assumed to affect clinical treatment and outcome of patients with stomach cancer, which is the most prevalent cancer among Koreans. This study examined the relationships between SPHI and diagnosis, treatment, utilization, and survival among stomach cancer patients. Patients (n = 3,780) who underwent a radical gastrectomy from 2000 to 2003 were examined retrospectively. The mean age of all patients was 58 years, and 1,377 patients (36%) had one or more SPHI plan. Univariate analysis was used to examine differences between SPHI and non-SPHI patients in terms of demographic, socioeconomic, and clinical characteristics, followed by a multiple analysis with adjustment for the above parameters. SPHI patients were 5% more likely to visit a physician (p < 0.001) and were 0.8 times less likely to die (p = 0.03) than non-SPHI patients. In contrast, no difference was observed between the two groups in the stage of cancer at diagnosis, which may reflect the fact that the majority of Korean SPHI plans do not cover cancer screening services. Moreover, no significant difference was detected in the use of adjuvant therapy between groups, because it was covered by SHI. In conclusion, SPHI is a determinant of Healthcare utilization and survival among stomach cancer patients. It is necessary for Health policymakers to consider the benefits of SPHI in financing Healthcare services.