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Anaya VK, Feder JD. Addressing Health Inequity and Mental Health of Migrant Children at the Border: Dr Joshua D. Feder Interviewing Dr Karina Anaya at Refugee Health Alliance. Child Adolesc Psychiatr Clin N Am 2024; 33:xvii-xxiii. [PMID: 38395512 DOI: 10.1016/j.chc.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Affiliation(s)
| | - Joshua D Feder
- Editor in Chief, the Carlat Child Psychiatry Report Co-Chair, Disaster & Trauma Issues Committee, American Academy of Child & Adolescent Psychiatry.
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Kola L, Larsen A, Asafo S, Attah DA, Beaulieu A, Gavi JK, Hallgren K, Kadakia A, Obeng K, Ohene S, Snyder J, Ofori-Atta A, Ben-Zeev D. Developing the West African Digital Mental Health Alliance (WADMA). Nat Med 2023; 29:2680-2681. [PMID: 37758898 PMCID: PMC11037517 DOI: 10.1038/s41591-023-02548-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Affiliation(s)
- Lola Kola
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK.
- University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA.
- University of Ibadan, Ibadan, Nigeria.
| | - Anna Larsen
- University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - Seth Asafo
- Department of Psychiatry, University of Ghana Medical School, Accra, Ghana
| | - Dzifa Abra Attah
- Department of Psychiatry, University of Ghana Medical School, Accra, Ghana
| | - Alexa Beaulieu
- University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - Jonathan Kuma Gavi
- Department of Psychiatry, University of Ghana Medical School, Accra, Ghana
| | - Kevin Hallgren
- University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - Arya Kadakia
- University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | | | - Sammy Ohene
- Department of Psychiatry, University of Ghana Medical School, Accra, Ghana
| | - Jaime Snyder
- The Information School, University of Washington, Seattle, WA, USA
| | - Angela Ofori-Atta
- Department of Psychiatry, University of Ghana Medical School, Accra, Ghana
| | - Dror Ben-Zeev
- University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
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Chen X, Meng Q, Wang Y, Yao Y, Zhao Y. Insurance pools' merging in China needs careful design. Lancet 2023; 401:642. [PMID: 36841612 PMCID: PMC10176955 DOI: 10.1016/s0140-6736(23)00128-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 02/25/2023]
Affiliation(s)
- Xinxin Chen
- Institute of Social Science Surveys, Peking University, Bejing 100871, China
| | - Qinqin Meng
- Institute of Social Science Surveys, Peking University, Bejing 100871, China
| | - Yafeng Wang
- Institute of Social Science Surveys, Peking University, Bejing 100871, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Bejing 100871, China
| | - Yaohui Zhao
- National School of Development, Peking University, Bejing 100871, China.
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4
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Fang Y. Insurance pools' merging in China needs careful design. Lancet 2023; 401:641-642. [PMID: 36841610 DOI: 10.1016/s0140-6736(23)00139-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/27/2022] [Indexed: 02/25/2023]
Affiliation(s)
- Yian Fang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China.
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Mulcahy E. UK Health Alliance on Climate Change brings health professionals together to call for action. BMJ 2022; 379:o2649. [PMID: 36347530 DOI: 10.1136/bmj.o2649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elaine Mulcahy
- UK Health Alliance on Climate Change, c/o BMJ, London WC1H 9JR, UK
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Vanholder R, Agar J, Braks M, Gallego D, Gerritsen KGF, Harber M, Noruisiene E, Pancirova J, Piccoli GB, Stamatialis D, Wieringa F. OUP accepted manuscript. Nephrol Dial Transplant 2022; 38:1080-1088. [PMID: 35481547 DOI: 10.1093/ndt/gfac160] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
The world faces a dramatic man-made ecologic disaster and healthcare is a crucial part of this problem. Compared with other therapeutic areas, nephrology care, and especially dialysis, creates an excessive burden via water consumption, greenhouse gas emission and waste production. In this advocacy article from the European Kidney Health Alliance we describe the mutual impact of climate change on kidney health and kidney care on ecology. We propose an array of measures as potential solutions related to the prevention of kidney disease, kidney transplantation and green dialysis. For dialysis, several proactive suggestions are made, especially by lowering water consumption, implementing energy-neutral policies, waste triage and recycling of materials. These include original proposals such as dialysate regeneration, dialysate flow reduction, water distillation systems for dialysate production, heat pumps for unit climatization, heat exchangers for dialysate warming, biodegradable and bio-based polymers, alternative power sources, repurposing of plastic waste (e.g. incorporation in concrete), registration systems of ecologic burden and platforms to exchange ecologic best practices. We also discuss how the European Green Deal offers real potential for supporting and galvanizing these urgent environmental changes. Finally, we formulate recommendations to professionals, manufacturers, providers and policymakers on how this correction can be achieved.
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Affiliation(s)
- Raymond Vanholder
- European Kidney Health Alliance, Brussels, Belgium
- Nephrology Section, Department of Internal Medicine and Paediatrics, University Hospital Ghent, Gent, Belgium
| | - John Agar
- Renal Services, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Marion Braks
- European Kidney Health Alliance, Brussels, Belgium
| | - Daniel Gallego
- European Kidney Health Alliance, Brussels, Belgium
- European Kidney Patients Federation, Wien, Austria
| | - Karin G F Gerritsen
- Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Mark Harber
- University College London, Department of Renal Medicine, London, UK
| | - Edita Noruisiene
- European Kidney Health Alliance, Brussels, Belgium
- European Dialysis and Transplant Nurses Association-European Renal Care Association, Hergiswil, Switzerland
| | - Jitka Pancirova
- European Dialysis and Transplant Nurses Association-European Renal Care Association, Hergiswil, Switzerland
| | | | - Dimitrios Stamatialis
- Advanced Organ Bioengineering and Therapeutics-Technical Medical Centre, University of Twente, Enschede, The Netherlands
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Fokko Wieringa
- European Kidney Health Alliance, Brussels, Belgium
- Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, The Netherlands
- imec the Netherlands, Holst Centre, Eindhoven, The Netherlands
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Duret S, Hoang HM, Derens-Bertheau E, Delahaye A, Laguerre O, Guillier L. Combining Quantitative Risk Assessment of Human Health, Food Waste, and Energy Consumption: The Next Step in the Development of the Food Cold Chain? Risk Anal 2019; 39:906-925. [PMID: 30261117 DOI: 10.1111/risa.13199] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/21/2018] [Accepted: 08/24/2018] [Indexed: 06/08/2023]
Abstract
The preservation of perishable food via refrigeration in the supply chain is essential to extend shelf life and provide consumers with safe food. However, electricity consumed in refrigeration processes has an economical and an environmental impact. This study focuses on the cold chain of cooked ham, including transport, cold room in supermarket, display cabinet, transport by consumer, and domestic refrigerator, and aims to predict the risk for human health associated with Listeria monocytogenes, the amount of food wasted due to the growth of spoilage bacteria, and the electrical consumption to maintain product temperature through the cold chain. A set of eight intervention actions were tested to evaluate their impact on the three criteria. Results show that the modification of the thermostat of the domestic refrigerator has a high impact on food safety and food waste and a limited impact on the electrical consumption. Inversely, the modification of the airflow rate in the display cabinet has a high impact on electrical consumption and a limited impact on food safety and food waste. A cost-benefit analysis approach and two multicriteria decision analysis methods were used to rank the intervention actions. These three methodologies show that setting the thermostat of the domestic refrigerator to 4 °C presents the best compromise between the three criteria. The impact of decisionmaker preferences (criteria weight) and limitations of these three approaches are discussed. The approaches proposed by this study may be useful in decision making to evaluate global impact of intervention actions in issues involving conflicting outputs.
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Affiliation(s)
- Steven Duret
- Irstea, Refrigeration Processes Engineering Research Unit, Antony cedex, France
| | - Hong-Minh Hoang
- Irstea, Refrigeration Processes Engineering Research Unit, Antony cedex, France
| | | | - Anthony Delahaye
- Irstea, Refrigeration Processes Engineering Research Unit, Antony cedex, France
| | - Onrawee Laguerre
- Irstea, Refrigeration Processes Engineering Research Unit, Antony cedex, France
| | - Laurent Guillier
- Laboratory for Food Safety, Université Paris-Est, Maisons-Alfort, France
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Chandrashekar P, Jain SH. Improving High-Risk Patient Care through Chronic Disease Prevention and Management. J Law Med Ethics 2018; 46:773-775. [PMID: 30336093 DOI: 10.1177/1073110518804240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Pooja Chandrashekar
- Pooja Chandrashekar, A.B., is a Fullbright Fellow studying social policy in India. Sachin H. Jain, M.D., M.B.A., is an Adjunct Professor at the Stanford University School of Medicine and president of CareMore Health
| | - Sachin H Jain
- Pooja Chandrashekar, A.B., is a Fullbright Fellow studying social policy in India. Sachin H. Jain, M.D., M.B.A., is an Adjunct Professor at the Stanford University School of Medicine and president of CareMore Health
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Berry MD. Healthcare Reform: State Specific Responses. Issue Brief Health Policy Track Serv 2017; 2017:1-32. [PMID: 29360301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Abstract
Various approaches have been proposed to adjust for differences in enrollee risk in health plans. Because risk-selection strategies may have different effects on enrollment, we simulated three types of selection—dumping, skimming, and stinting. Concurrent diagnosis-based risk adjustment, and a hybrid using concurrent adjustment for about 8% of the cases and prospective adjustment for the rest, perform markedly better than prospective or demographic adjustments, both in terms of R2 and the extent to which plans experience unwarranted gains or losses. The simulation approach offers a valuable tool for analysts in assessing various risk-adjustment strategies under different selection situations.
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Affiliation(s)
- Harold S Luft
- Institute for Health Policy Studies, School of Medicine, University of California, San Francisco 94118, USA
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11
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Schrag WF. State risk pools examine their missions in light of health care reform. Nephrol News Issues 2015; 29:14. [PMID: 26677593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Başbuğ-Erkan BB, Yilmaz O. Successes and failures of compulsory risk mitigation: re-evaluating the Turkish Catastrophe Insurance Pool. Disasters 2015; 39:782-794. [PMID: 25752452 DOI: 10.1111/disa.12129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Turkish Catastrophe Insurance Pool (TCIP) is one of the best practices of public-private partnerships in an emerging market designed to reduce economic losses from disasters. This paper reviews the application of this compulsory mechanism along with data relating to the performance of the scheme following recent earthquakes in Turkey. We also consider the current perceptions of Turkish society towards the TCIP and how they can be enhanced. Our conclusions aim to assist stakeholders in government, homeowners, insurance companies, media, banks and civil society to appreciate the value of the system and key actions necessary to improve it.
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Affiliation(s)
- B Burcak Başbuğ-Erkan
- Director, Disaster Management Implementation and Research Centre, Middle East Technical University, Ankara, Turkey
| | - Ozlem Yilmaz
- Executive Board Member, Disaster Management Implementation and Research Centre, Middle East Technical University, Ankara, Turkey
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Strauss P. Captive insurance companies. J Med Pract Manage 2014; 30:208-210. [PMID: 25807627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The landscape of the business world is changing; and now, more than ever, business owners are recognizing that life is filled with risks: known risk, calculated risk, and unexpected risk. Every day, businesses thrive or fail based on understanding the risk of owning and operating their business, and business owners are recognizing that there are alternative risk financing mechanisms other than simply taking out a basket of standard coverage as recommended by your friendly neighborhood agent. A captive insurance company is an insurance company established to provide a broad range of risk management capabilities to affiliated companies. The captive is owned by the business owner and can provide insurance to the business for potential future losses, whether or not the losses are already covered by a commercial carrier or are "self-insured." The premiums paid by your business are tax deductible. Meanwhile, the premiums that your captive collects are tax-free up to $1.2 million annually.
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Eastern J. Should you accept insurance exchange coverage? Cutis 2014; 94:75-77. [PMID: 25184642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Patrick KC. Healthcare reform: state specific responses. Issue Brief Health Policy Track Serv 2012:1-43. [PMID: 22403851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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White J. Gap and parallel insurance in health care systems with mandatory contributions to a single funding pool for core medical and hospital benefits for all citizens in any given geographic area. J Health Polit Policy Law 2009; 34:543-583. [PMID: 19633222 DOI: 10.1215/03616878-2009-015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Single-pool systems as defined in this article may be accompanied by two forms of voluntary health insurance (VHI): gap coverage for benefits not included in the statutory arrangement and parallel coverage through which individuals pay extra for ostensibly superior versions of the statutory benefits. In all cases the markets for this coverage are much smaller than the market for private insurance in the United States. In each case, the market for VHI depends on perceived inadequacy in the statutory system. With gap coverage, the extent of the statutory benefit package is a more basic issue than the gap coverage itself. Parallel coverage raises more significant independent issues. It is particularly related to the dynamics and politics of waiting lists in the statutory system. Waiting lists appear to be a greater concern in single-pool systems than in social insurance systems due to the effects of having spending on a government's budget and some perverse incentives for physicians. Single-pool approaches are less politically plausible in the United States than adaptation of social insurance models because they leave less room for private insurance and thus will be less attractive to advocates of the private sector; yet leaving any room at all requires that the statutory system be less attractive than advocates of national health insurance could probably justify politically.
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McLeod H, Grobler P. The role of risk equalization in moving from voluntary private health insurance to mandatory coverage: the experience in South Africa. Adv Health Econ Health Serv Res 2009; 21:159-196. [PMID: 19791703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The South African health system has long been characterised by extreme inequalities in the allocation of financial and human resources. Voluntary private health insurance, delivered through medical schemes, accounts for some 60% of total expenditure but serves only the 14.8% of the population with higher incomes. A plan was articulated in 1994 to move to a National Health Insurance system with risk-adjusted payments to competing health funds, income cross-subsidies and mandatory membership for all those in employment, leading over time to universal coverage. This chapter describes the core institutional mechanism envisaged for a National Health Insurance system, the Risk Equalisation Fund (REF). A key issue that has emerged is the appropriate sequencing of the reforms and the impact on workers of possible trajectories is considered. METHODOLOGY The design and functioning of the REF is described and the impact on competing health insurance funds is illustrated. Using a reference family earning at different income levels, the impact on worker of various trajectories of reform is demonstrated. FINDINGS Risk equalization is a critical institutional component in moving towards a system of social or national health insurance in competitive markets, but the sequence of its implementation needs to be carefully considered. The adverse impact of risk equalization on low-income workers in the absence of income cross-subsidies and mandatory membership is considerable. IMPLICATIONS FOR POLICY The South African experience of risk equalization is of interest as it attempts to introduce more solidarity into a small but highly competitive private insurance market. The methodology for considering the impact of reforms provides policymakers and politicians with a clearer understanding of the consequences of reform.
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Affiliation(s)
- Heather McLeod
- Department of Public Health and Family Medicine, University of Cape Town, South Africa
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Carrin G, Mathauer I, Xu K, Evans DB. Universal coverage of health services: tailoring its implementation. Bull World Health Organ 2008; 86:857-63. [PMID: 19030691 PMCID: PMC2649543 DOI: 10.2471/blt.07.049387] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2008] [Revised: 08/22/2008] [Accepted: 08/25/2008] [Indexed: 11/27/2022] Open
Abstract
In 2005, the Member States of WHO adopted a resolution encouraging countries to develop health financing systems capable of achieving and/or maintaining universal coverage of health services - where all people have access to needed health services without the risk of severe financial consequences. In doing this, a major challenge for many countries will be to move away from out-of-pocket payments, which are often used as an important source of fund collection. Prepayment methods will need to be developed or expanded but, in addition to questions of revenue collection, specific attention will also have to be paid to pooling funds to spread risks and to enable their efficient and equitable use. Developing prepayment mechanisms may take time, depending on countries' economic, social and political contexts. Specific rules for health financing policy will need to be developed and implementing organizations will need to be tailored to the level that countries can support and sustain. In this paper we propose a comprehensive framework focusing on health financing rules and organizations that can be used to support countries in developing their health financing systems in the search for universal coverage.
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Affiliation(s)
- Guy Carrin
- Department of Health Systems Financing, Health Systems and Services, World Health Organization, Geneva, Switzerland.
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McIntyre D, Garshong B, Mtei G, Meheus F, Thiede M, Akazili J, Ally M, Aikins M, Mulligan JA, Goudge J. Beyond fragmentation and towards universal coverage: insights from Ghana, South Africa and the United Republic of Tanzania. Bull World Health Organ 2008; 86:871-6. [PMID: 19030693 PMCID: PMC2649570 DOI: 10.2471/blt.08.053413] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2008] [Revised: 07/29/2008] [Accepted: 07/31/2008] [Indexed: 11/27/2022] Open
Abstract
The World Health Assembly of 2005 called for all health systems to move towards universal coverage, defined as " access to adequate health care for all at an affordable price" . A crucial aspect in achieving universal coverage is the extent to which there are income and risk cross-subsidies in health systems. Yet this aspect appears to be ignored in many of the policy prescriptions directed at low- and middle-income countries, often resulting in high degrees of health system fragmentation. The aim of this paper is to explore the extent of fragmentation within the health systems of three African countries (Ghana, South Africa and the United Republic of Tanzania). Using a framework for analysing health-care financing in terms of its key functions, we describe how fragmentation has developed, how each country has attempted to address the arising equity challenges and what remains to be done to promote universal coverage. The analysis suggests that South Africa has made the least progress in addressing fragmentation, while Ghana appears to be pursuing a universal coverage policy in a more coherent way. To achieve universal coverage, health systems must reduce their reliance on out-of-pocket payments, maximize the size of risk pools, and resource allocation mechanisms must be put in place to either equalize risks between individual insurance schemes or equitably allocate general tax (and donor) funds. Ultimately, there needs to be greater integration of financing mechanisms to promote universal cover with strong income and risk cross-subsidies in the overall health system.
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Affiliation(s)
- Diane McIntyre
- Health Economics Unit, University of Cape Town, Observatory, South Africa.
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Gonser G. Health care agendas of the candidates. J Mass Dent Soc 2008; 57:9. [PMID: 18705207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Dodd C. Universal coverage, guaranteed. My plan: an employer mandate and a new insurance plan that pays for itself. Mod Healthc 2007; 37:24. [PMID: 18027412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Renaudin P, Prual A, Vangeenderhuysen C, Ould Abdelkader M, Ould Mohamed Vall M, Ould El Joud D. Ensuring financial access to emergency obstetric care: three years of experience with Obstetric Risk Insurance in Nouakchott, Mauritania. Int J Gynaecol Obstet 2007; 99:183-90. [PMID: 17900588 DOI: 10.1016/j.ijgo.2007.07.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2007] [Accepted: 07/12/2007] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The high cost of emergency obstetric care (EmOC) is a catastrophic health expenditure for households, causing delay in seeking and providing care in poor countries. METHODS In Nouakchott, the Ministry of Health instituted Obstetric Risk Insurance to allow obstetric risk sharing among all pregnant women on a voluntary basis. The fixed premium (US$21.60) entitles women to an obstetric package including EmOC and hospital care as well as post-natal care. The poorest are enrolled at no charge, addressing the problem of equity. RESULTS 95% of pregnant women in the catchment area (48.3% of the city's deliveries) enrolled. Utilization rates increased over the 3-year period of implementation causing quality of care to decline. Basic and comprehensive EmOC are now provided 24/7. The program has generated US$382,320 in revenues, more than twice as much as current user fees. All recurrent costs other than salaries are covered. CONCLUSION This innovative sustainable financing scheme guarantees access to obstetric care to all women at an affordable cost.
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Affiliation(s)
- P Renaudin
- Nouakchott Safe Motherhood Project, Direction Régionale des Affaires sanitaires et sociales, Nouakchott, Mauritania
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Felland L, Draper D, Liebhaber A. Massachusetts health reform: employers, lower-wage workers and universal coverage. Issue Brief Cent Stud Health Syst Change 2007:1-6. [PMID: 17679174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
As Massachusetts' landmark effort to reach nearly universal health coverage unfolds, the state is now focusing on employers to take steps to increase coverage. All employers--except firms with fewer than 11 workers--face new requirements under the 2006 law, including establishing Section 125, or cafeteria, plans to allow workers to purchase insurance with pre-tax dollars and paying a $295 annual fee if they do not make a "fair and reasonable" contribution to the cost of workers' coverage. Through interviews with Massachusetts health care leaders (see Data Source), the Center for Studying Health System Change (HSC) examined how the law is likely to affect employer decisions to offer health insurance to workers and employee decisions to purchase coverage. Market observers believe many small firms may be unaware of specific requirements and that some could prove onerous. Moreover, the largest impact on small employers may come from the individual mandate for all residents to have a minimum level of health insurance. This mandate may add costs for firms if more workers take up coverage offers, seek more generous coverage or pressure employers to offer coverage. Despite reform of the individual and small group markets, including development of new insurance products, concerns remain about the affordability of coverage and the ability to stem rising health care costs.
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Hacker J. Reform beyond access. A plan to extend Medicare model that would also limit costs, improve quality. Mod Healthc 2007; 37:20. [PMID: 17432256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Goldman CM. Why physician groups are self-insuring. J Med Pract Manage 2006; 22:5-7. [PMID: 16986632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Given the medical malpractice crisis in a number of states, many physicians are looking at alternatives to conventional insurance coverage. These options typically involve some form of risk sharing where the medical group assumes additional risks based on experience. This article identifies several options-retrospective payment plans, risk retention groups, captives, and rent-a-captives--and their associated risks and opportunities.
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Affiliation(s)
- C Mitchell Goldman
- Duane Morris LLP, 30 South 17th Street, Philadelphia, PA 19103-4196, USA.
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28
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Evans BJ, Flockhart DA. The unfinished business of U.S. drug safety regulation. Food Drug Law J 2006; 61:45-63. [PMID: 16838457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- Barbara J Evans
- Program in Pharmacogenomics, Ethics, and Public Policy, Indiana University Center for Bioethics, Indianapolis, IN, USA
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29
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Duffy M, Oemichen B. Co-op care: using cooperative principals to add value to health care. WMJ 2005; 104:40-1. [PMID: 16425918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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30
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Wertsch P. Wisconsin Medical Society Health System Reform Plan. WMJ 2005; 104:42-5. [PMID: 16425919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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31
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Galloro V. Thompson's 'no frills' plan. Former HHS chief proposes reinsurance system. Mod Healthc 2005; 35:16. [PMID: 16171230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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32
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Grey MR. Health care for the uninsured: here we go again. Conn Med 2005; 69:433-4. [PMID: 16350489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Michael R Grey
- High Street Health Center, Baystate Health Systems, Springfield, Massachusetts, USA
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33
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Strumpf EC. Issues related to state and employer innovations in insurance coverage. Issue Brief (Commonw Fund) 2005:1-8. [PMID: 16193605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
States and employers use a number of different programs and techniques to increase rates of insurance coverage. Successful strategies--whether based on Medicaid/SCHIP expansion, strengthening employer-based coverage, or regulating the individual market--require both flexibility to tailor approaches that best serve their residents and employees and basic protections to ensure that new programs do not leave vulnerable groups behind. In addition, continued financial, regulatory, and administrative support from the federal level is crucial for states and employers to explore innovative solutions to cover the uninsured.
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34
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Chollet D. Insuring the uninsured: finding the road to success. Front Health Serv Manage 2005; 21:17-27. [PMID: 16028499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This article outlines various strategies that have been proposed to expand health insurance. Many have been tried in limited ways, and the article describes the experience with those attempts. The discussion is organized from the perspective of the opposing points of view: approaches that would support private coverage and largely rely on demand incentives and approaches that presuppose a more direct government role. The article reaches no conclusion about which strategy might be a wiser course of action. However, it does take measure of the likely effects of each strategy where early experience or objective analysis is available.
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35
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Godard B, Raeburn S, Pembrey M, Bobrow M, Farndon P, Aymé S. Genetic information and testing in insurance and employment: technical, social and ethical issues. Eur J Hum Genet 2004; 11 Suppl 2:S123-42. [PMID: 14718940 DOI: 10.1038/sj.ejhg.5201117] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The present paper examines the professional and scientific views on the social, ethical and legal issues that impact on genetic information and testing in insurance and employment in Europe. For this purpose, many aspects have been considered, such as the concerns of medical geneticists, of the insurers and employers, of the public, as well as the regulatory frameworks and unresolved issues. The method used was primarily the review of the technical, social, economical and ethical aspects of advances in genetics and the concerns of parties who are involved, that is, the insurers, the employers and the public. The existing guidelines and legislation on this topic were also reported. Then, the method was to examine the issues debated by these parties in Europe, as well as by 47 experts from 14 European countries invited to an international workshop organized by the European Society of Human Genetics Public and Professional Policy Committee in Manchester, UK, 25-27 February 2000. The result of this was that the most important issues raised by genetic information and testing in insurance and employment in Europe include a need for clear definitions of terms used in genetics, declaring the grounds on which genetic information is or is not used, and promoting confidence between the public and the insurance industry. There is currently very little use of genetic information in relation to employment, but the situation should be kept under review.
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36
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Trujillo AJ, McCalla DC. Are Colombian sickness funds cream skimming enrollees? An analysis with suggestions for policy improvement. J Policy Anal Manage 2004; 23:873-888. [PMID: 15499708 DOI: 10.1002/pam.20052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
One of the primary objectives of Colombian social health insurance reform was to increase competition among for-profit insurers. Unfortunately, the flat capitated formula creates an opportunity for sickness funds to maximize reimbursement gains by cream skimming--selecting against unhealthy individuals. This paper explores sickness fund selection behavior to evaluate the efficiency losses associated with the introduction of managed competition in Colombia. Data from a 1997 Colombian household survey are analyzed with a bivariate probit model with partial observability using instrumental variables. The model yields some evidence of sickness fund selection based on health status. Public policy options to discourage risk selection by health status are discussed.
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37
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Worthylake TL. National health care improvements. MGMA Connex 2004; 4:17-8. [PMID: 15344609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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38
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Abstract
There is increasing advocacy for community-based health insurance (CBHI) schemes as part of a broader solution to health care financing problems in low-income countries, but to date there is very limited understanding of how CBHI schemes interact with other elements of a health care financing system. This paper aims to set out a preliminary conceptual framework for understanding such interactions, and highlights the kind of research questions raised by such a framework. A basic conceptual map of a CBHI scheme is developed, and extensions added to this map that incorporate (1). effects upon non-members of schemes, (2). government subsidies to providers, (3). government subsidies to schemes, and (4). issues raised by the existence of multiple risk-pooling schemes in a particular context. The utility of a broader approach to analyzing/assessing CBHI schemes is illustrated through examination of two policy issues, namely (1). coordination of CBHI risk pools and government risk pools, and (2). equity implications of CBHI schemes and the role of government subsidies in such schemes. It is concluded that there is a strong need for empirical work to explore how CBHI schemes and the broader health care financing system interact, and that even if individual schemes achieve their own objectives (in terms of equity, efficiency etc.), this does not necessarily imply that such objectives will be achieved at the system level.
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39
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Pannarunothai S, Patmasiriwat D, Srithamrongsawat S. Universal health coverage in Thailand: ideas for reform and policy struggling. Health Policy 2004; 68:17-30. [PMID: 15033549 DOI: 10.1016/s0168-8510(03)00024-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2002] [Accepted: 12/11/2002] [Indexed: 11/27/2022]
Abstract
Inequality in health between rich and poor in Thailand was well documented; millions of informal workers and their families lacked health insurance; and the poor paid more proportionately in income for health care. The universal coverage is conceived as one of the means to redress the situation. But the term 'universal coverage' may mean differently among different groups of stakeholders. This paper, based on empirical research of health policy reform, collected perceptions and ideas from stakeholders and discusses the ways and strategies that universal coverage might take shape in Thailand. Two sources of information were taken: one from the questionnaire survey (according to the Delphi technique, two rounds of survey were taken), another an in-depth interview. Obtained information for policy formulation included how best, as conceived by stakeholders, to implement the universal coverage, sources of finance, fiscal implication for Thai government, ways to prevent higher demand for unnecessary services, and involvement of local government. Recent policy move in Thailand (the so-called 30 baht for all diseases) emerged in 2001 generated hot debate nationwide. The programme is currently in its early phase and is likely to evolve overtime--i.e. whether or not this programme will be financed by certain types of taxes or from annual government expense still unclear; and budget allocation among different health providers still unsettled. Anyhow this programme may be interpreted as a policy shift away from the pro-market based toward a government-supported egalitarianism.
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Affiliation(s)
- Supasit Pannarunothai
- Faculty of Medicine, Centre for Health Equity Monitoring, Naresuan University, Phitsanulok 65000, Thailand
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40
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Borges W. Shelter from the storm. Tex Med 2004; 100:20-6. [PMID: 15303484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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41
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Carroll J. Health savings accounts ready to enter the market. Manag Care 2004; 13:13-6. [PMID: 15074148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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42
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Bouvier S. Hampshire HealthConnect. A local effort increases access to health care for the uninsured. J Ambul Care Manage 2004; 26:362-4. [PMID: 14567281 DOI: 10.1097/00004479-200310000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the absence of universal coverage, there is a need to develop solutions at a local and state level to the dramatic rise in the uninsured. This article summarizes a local countywide effort to address this issue in a rural area. Key ingredients for success include both hospital leadership (they have significant resources at their disposal), extensive community involvement (to maintain momentum for the program), and local physician leadership (physicians are, in essence, forgoing income in return for a formalization of who is eligible for the free care program).
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Affiliation(s)
- Sonia Bouvier
- Hamshire HealthConnect, Cooley Dickinson Hospital, Northampton, MA, USA
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43
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Abstract
This paper examines the role of provider payment policy as an instrument for addressing government and market failures and controlling costs in the health sector, particularly in developing countries. We empirically evaluate the impact of provider payment reform in Hainan province, China, on expenditures for different categories of services that had been subject to distorted prices under fee-for-service. Using a pre-post study design with a control group, we analyze two years of claims data to assess the impact of a January 1997 change to prospective payment for a sub-sample of the hospitals. This difference-in-difference empirical strategy allows us to isolate the supply-side payment reform effects from demand-side policy interventions. We find that prepayment is associated with a slower increase in spending on expensive drugs and high technology services, compared to fee-for-service. The fact that payment reform is associated with reduced growth in spending on the most expensive drugs is particularly encouraging, given that drugs account for a remarkably high percentage of both the level and growth of aggregate health expenditure in China. Payment reform can be an effective policy instrument for correcting market failures and adverse side effects of government health sector interventions (such as distorted prices to assure access to basic services), both of which can lead to excessive health care expenditure growth. Such health spending growth can have a particularly high opportunity cost for developing countries.
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Affiliation(s)
- Winnie Yip
- Health Care Financing, Harvard School of Public Health, University Place, Suite 410, South, 124 Mt. Auburn St., Cambridge, MA 02138, USA.
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44
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Richardson KP. California's controversial "play or pay" law: short-lived experiment or overdue solution? Manag Care Interface 2004; 17:40-3. [PMID: 15035599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Controversial legislation that guarantees health coverage for most private-sector workers was recently passed in California. Known as the Health Insurance Act of 2003, the legislation will most likely be subject to a variety of legal challenges. The author presents a comprehensive description of how the Act works and the constitutional challenges it may face.
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45
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Bhattacharjee S. Community health insurance. J Indian Med Assoc 2003; 101:760. [PMID: 15198406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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46
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Abstract
A major choice confronting many countries is between single-payer and multi-payer health insurance systems. This paper compares single-payer models in the areas of revenue collection, risk pooling, purchasing, and social solidarity. Single-payer and multi-payer systems each have advantages which may meet countries' priorities for their health insurance system. Single-payer systems are usually financed more progressively, and rely on existing taxation systems; they effectively distribute risks throughout one large risk pool; and they offer governments a high degree of control over the total expenditure on health. Multi-payer systems sacrifice this control for a greater ability to meet the diverse preferences of beneficiaries. Several major reforms of single-payer insurance systems--expansion of the role of private insurance and transformation to a multi-payer system--are then described and illustrated using specific country examples. These reforms have been implemented with some success in several countries but face several important challenges.
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Affiliation(s)
- P Hussey
- Health Policy and Management, John Hopkins University, 624 N Broadway, Baltimore, MD 21205, USA.
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47
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Carpenter D. Why small business is sick over health costs. Hosp Health Netw 2003; 77:38-42, 44, 46, 2. [PMID: 14669566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Overwhelmed by the cost of paying for health coverage, many small employers see their only options as cutting coverage, cutting staff or going out of business--any of which is bad news for communities and hospitals. There are creative alternatives to traditional insurance, and experts advise small businesses to explore those before taking drastic steps.
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48
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Chao S. Mass customization--the next generation of pharmacy management. Am J Manag Care 2003; Suppl Decison Maker News:5-7. [PMID: 14567452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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49
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Carroll J. Whatever happened to insurance? More small companies retain risk. Manag Care 2003; 12:30-2. [PMID: 12966849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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50
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Abstract
Reform proposals of health care systems in several countries have advocated variations of a risk adjustment/capitation system. These proposals face a serious objection: incentives to risk selection are prevalent in the system. By now, considerable literature has been devoted to finding ways of mitigating, if not eliminating, this problem, while at the same time preserving incentives to efficiency. We contribute to this debate presenting a transfer system that, under some circumstances, attains both provider efficiency and no risk selection. The transfer system extends typical linear payment systems. It can be interpreted as a fixed transfer in the beginning of the period plus an ex-post fund at the end of the period. The novelty rests in the way contributions to this fund are defined.
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Affiliation(s)
- Pedro Pita Barros
- Faculdade de Economia, Universidade Nova de Lisboa, Travessa Estêvão Pinto, P-1099-032 Lisboa, Portugal.
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