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Book part
Publication date: 12 October 2011

Rebecca L. Utz, Richard Nelson and Peter Dien

This study evaluates whether sociodemographic characteristics, political affiliation, family-related circumstances, self-reported health status, and access to health

Abstract

This study evaluates whether sociodemographic characteristics, political affiliation, family-related circumstances, self-reported health status, and access to health insurance affect public opinion toward the current US health-care system. Opinions about the health-care system were measured in terms of consumer confidence and perceived need for health-care reform. Data come from the 2008 Cooperative Congressional Election Study (CCES), a nationwide survey of 1,000 respondents. All data were collected in November 2008, thus providing a useful alternative to volatile polling data because they were collected prior to and are thus immune to the polarized tone of the debates that have occurred over the past few years. Overall, we found that public confidence in medical technology and quality of care were consistently high, while confidence in the affordability of medical care was much lower among respondents. Younger adults, those with poor health, and those without health insurance had particularly low confidence in their ability to pay for health care. Although a strong majority of the population agreed that the US health-care system was in need of major reform, support for particular types of government-sponsored health insurance programs was primarily determined by political affiliation. In an era where a large proportion of the population has little access to health care (due to lack of insurance) and where the US government is facing tremendous opposition to the implementation of major reform efforts, it is useful to understand which subgroups of the population are most confident in the current health-care system and most likely to support reform efforts, as well as those who are most resistant to change given their precarious health needs, their inability to access health care (as a result of insurance or noninsurance), or their political affiliation.

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Access to Care and Factors that Impact Access, Patients as Partners in Care and Changing Roles of Health Providers
Type: Book
ISBN: 978-0-85724-716-2

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Book part
Publication date: 12 December 2007

Grace J. Yoo and Barbara W. Kim

As an ethnic group, Korean Americans have one of the highest uninsured rates in the U.S. (Brown et al., 2000). Through in-depth interviews (n=14) and surveys (n=268), this…

Abstract

As an ethnic group, Korean Americans have one of the highest uninsured rates in the U.S. (Brown et al., 2000). Through in-depth interviews (n=14) and surveys (n=268), this study found that one-third of the sample was uninsured. High premiums prevented the uninsured from purchasing health insurance. Although health insurance has been a strong predictor of health services utilization, this study also found that when examining the utilization of various health services by health insurance status, there were no major significant differences with the exception of Korean traditional health services. High deductibles prevented insured persons from utilizing health services.

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Inequalities and Disparities in Health Care and Health: Concerns of Patients, Providers and Insurers
Type: Book
ISBN: 978-0-7623-1474-4

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Book part
Publication date: 3 November 2005

D. Clayton Smith, James W. Grimm and Zachary W. Brewster

A random sample of insured adults (n=134) tests the effects of insurance on respondents’ emotional and physical health. Results showed that being married and being widowed…

Abstract

A random sample of insured adults (n=134) tests the effects of insurance on respondents’ emotional and physical health. Results showed that being married and being widowed improved physical health while having no religious identification heralded less emotional distress. Preferred Provider Organization services satisfaction was related to better physical health. Respondents in households that restructured themselves to acquire or maintain health coverage also reported more emotional distress than those in households without such problems. Implications of our results regarding improving insurance programs and the effects of marital status and the lack of religious affiliation upon adults’ health are discussed.

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Health Care Services, Racial and Ethnic Minorities and Underserved Populations: Patient and Provider Perspectives
Type: Book
ISBN: 978-0-76231-249-8

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Book part
Publication date: 30 May 2018

Nicolas R. Ziebarth

This chapter reviews the existing empirical evidence on how social insurance affects health. Social insurance encompasses programs primarily designed to insure against…

Abstract

This chapter reviews the existing empirical evidence on how social insurance affects health. Social insurance encompasses programs primarily designed to insure against health risks, such as health insurance, sick leave insurance, accident insurance, long-term care insurance, and disability insurance as well as other programs, such as unemployment insurance, pension insurance, and country-specific social insurance programs. These insurance systems exist in almost all developed countries around the world. This chapter discusses the state-of-the art evidence on each of these social insurance systems, briefly reviews the empirical methods for identifying causal effects, and examines possible limitations to these methods. The findings reveal robust and rich evidence on first-stage behavioral responses (“moral hazard”) to changes in insurance coverage. Surprisingly, evidence on how changes in coverage impact beneficiaries’ health is scant and inconclusive. This lack of identified causal health effects is directly related to limitations on how human health is typically measured, limitations on the empirical approaches, and a paucity of administrative panel data spanning long-time horizons. Future research must be conducted to fill these gaps. Of particular importance is evidence on how these social insurance systems interact and affect human health over the life cycle.

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Book part
Publication date: 6 December 2011

Nan L. Maxwell

Institutional rules and economies of scale can create incentives for firms to make inframarginal decisions when offering fringe benefits. We examine how such incentives…

Abstract

Institutional rules and economies of scale can create incentives for firms to make inframarginal decisions when offering fringe benefits. We examine how such incentives might affect a firm's offer of health insurance.

We develop and estimate an empirical model of the firm's offer of health insurance that includes incentives created by rules and economies of scale. We quantify the behavioral manifestations from rules and costs as recruiting difficulty in areas outside those in which compensation is set and the percentage of high-skilled jobs in the firm and use the California Health and Employment Surveys (CHES) to estimate the model.

We show a 10–13 percentage point increase in the probability of a firm offering workers health insurance in jobs outside of those in which compensation is being set, if the recruiting difficulty lies in mid- or high-skilled positions. This increase is about twice the size of the increase associated with recruiting difficulty in the position in which compensation is negotiated.

A failure to control for the influence of inframarginal decision making when estimating the wage-insurance tradeoff helps produce wrong-signed estimates.

By bringing institutional rules and economies of scale into the framework of a firm's offer of fringe benefits, we help move the focus of the fringe benefit-wage tradeoff away from the individual level.

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Advances in the Economic Analysis of Participatory and Labor-Managed Firms
Type: Book
ISBN: 978-0-85724-760-5

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Book part
Publication date: 20 June 2003

Paul Fronstin, Alphonse G Holtmann and Kerry Anne McGeary

The ultimate goal of this paper is to determine the differential effects of health insurance and health status on earnings. We believe that employment-based health

Abstract

The ultimate goal of this paper is to determine the differential effects of health insurance and health status on earnings. We believe that employment-based health insurance serves two purposes. First, health insurance provides protection against catastrophic financial losses associated with illness. Second, health insurance encourages consumption of health care services, which may ultimately improve a person’s health and productivity. To determine how health insurance and health status affect earnings, we estimate an empirical model that specifically examines the relationship between health insurance, health status, and earnings. We find the following. Earnings positively affect the likelihood of having health insurance. Having health insurance improved health status for women, but not for men. Higher earnings resulted in lower health status for women, but had no effect on the health status of men, and better health status and having health insurance increased earnings for both women and men. Our analysis implies that there are some returns to employment-based health insurance that go beyond the basic purpose of insurance.

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Worker Well-Being and Public Policy
Type: Book
ISBN: 978-1-84950-213-9

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Article
Publication date: 22 January 2021

Saeed Pahlevan Sharif, Navaz Naghavi, Fon Sim Ong, Hamid Sharif Nia and Hassam Waheed

The purpose of this paper is to examine the relationship between consumers' satisfaction with their health insurance and quality of life (QoL), the mediating role of…

Abstract

Purpose

The purpose of this paper is to examine the relationship between consumers' satisfaction with their health insurance and quality of life (QoL), the mediating role of perceived financial burden in this relationship, as well as the moderating effect of external locus of control (LoC) on the relationship between perceived financial burden and QoL among cancer patients.

Design/methodology/approach

A cross-sectional design was employed in order to collect quantitative data by means of a self-administrated questionnaire. Participants consisted of 387 conveniently selected consumers diagnosed with cancer in Iran. Furthermore, the questionnaire was translated into Persian using a forward–backward method. The model was tested using partial least squares structural equation modeling (PLS-SEM).

Findings

The results indicate that the more satisfied patients are with their health insurance, the higher QoL they experience, and this relationship is explained through reducing perceived financial burden in terms of direct and indirect costs of the disease. Although external LoC belief is negatively related to QoL, it buffers the negative association between financial burden and QoL.

Practical implications

Reducing the disparity between consumers' expectation and perception of the comprehensiveness of health insurance policies may relieve consumers' anxiety stemming from financial worries.

Originality/value

This paper fills a gap in the literature where consumers' perception about quality of insurance and its relationship with their QoL has received little attention so far.

Details

International Journal of Social Economics, vol. 48 no. 4
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 30 November 2020

Madan Mohan Dutta

Health insurance is one of the major contributors of growth of general insurance industry in India. It alone accounts for around 29% of total general insurance premium…

Abstract

Purpose

Health insurance is one of the major contributors of growth of general insurance industry in India. It alone accounts for around 29% of total general insurance premium income earned in India. The growth of this sector is important from the perspective of overall growth of general insurance Industry. At the same time, problems in this sector are also many which are affecting its performance.

Design/methodology/approach

The paper provides an understanding on performance of health insurance sector in India. This study attempts to find out how much claims and commission and management expenses it has to incur to earn certain amount of premium. Methodology used for the study is regression analysis to establish relationship between dependent variable (Profit/Loss) and independent variable (Health Insurance Premium earned).

Findings

Findings of the study indicate that there is significant relationship between earned premium and underwriting loss. There has been increase of premium earnings which instead of increasing profit for the sector in fact has increased underwriting loss over the years. The earnings of the sector is growing at compounded annual growth rate of 27% still it is unable to earn underwriting profit.

Originality/value

This study is self-driven based on secondary data obtained from insurance regulatory and development authority site.

Details

Vilakshan - XIMB Journal of Management, vol. 17 no. 1/2
Type: Research Article
ISSN: 0973-1954

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Article
Publication date: 4 April 2019

Sanusi Bintang, Mujibussalim Mujibussalim and Fikri Fikri

The purpose of this study is to explain the need for the implementation of decentralization of Indonesia social health insurance (INA-Medicare), with particular emphasis…

Abstract

Purpose

The purpose of this study is to explain the need for the implementation of decentralization of Indonesia social health insurance (INA-Medicare), with particular emphasis for Aceh Province. First, it discusses the inconsistency of Act on National Social Security System (ANSSS) to the 1945 Constitution, because certain rules in ANSSS are contrary to the 1945 Constitution. This weakens the practice of broader regional autonomy, lessens the importance of public service quality in health care and ignores specific cultural and religious values of the regional people. Then, it explains provisions on central and regional government authority in the 1945 Constitution, Act on Regional Autonomy and Act on Governing of Aceh. Later, it explores current law and practice of INA-Medicare under the national social security system and the centralized administering body. Finally, it provides reasons for decentralization of INA-Medicare, as the solution.

Design/methodology/approach

This study uses doctrinal legal research. It relies on both primary and secondary legal authorities. In additions, it also uses sociolegal research by relying on non-legal materials, including empirical data from books, journals and newspapers. Analysis of legal authorities is by legal reasoning process, whereas analysis of non-legal materials is by qualitative approach.

Findings

This study argues that the decentralization of INA-Medicare is more suitable for Aceh Province because of several reasons, including implementing broader regional autonomy, improving public service quality in health care and implementing the principle of sharia social health insurance.

Originality/value

The study is original because it focuses on a specific regional area of Aceh Province, Indonesia. It concentrates on specific legal issues and provides unique reasons for argumentation. Therefore, it provides important specific information for journal readers.

Details

International Journal of Law and Management, vol. 61 no. 2
Type: Research Article
ISSN: 1754-243X

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Article
Publication date: 11 May 2010

H. Holly Wang, Shaomin Huang, Linxiu Zhang, Scott Rozelle and Yuanyuan Yan

Since 1999, China has undergone reform of its healthcare system. City‐based social health insurance (SHI) is the primary form of current health insurance, supplemented by…

Abstract

Purpose

Since 1999, China has undergone reform of its healthcare system. City‐based social health insurance (SHI) is the primary form of current health insurance, supplemented by various commercial health insurance programs. The rural new cooperative medical system (NCMS) was introduced in 1993 and extended to cover the whole of rural China in 2003.

Design/methodology/approach

The paper developed a theoretical model for consumer demand of medical services and health insurance based on an expected utility framework with a two‐stage decision under uncertainty. The model is then applied to current health insurance systems in China for urban citizens and rural residents separately. Least square and logistic regressions are employed.

Findings

The major results are that although the factors driving the decisions on health insurance participation are basically the same for rural and urban citizens, the participation levels are quite different. The major difference is that urban SHI has higher coverage and urban citizens have higher income, resulting in a much larger urban medical expenditure.

Practical implications

The empirical analysis reveals that health insurance programs have played an important role in the healthcare expenditure for urban residents, while the NCMS has not made a significant impact towards increasing the ability of rural residents to seek more medical services, based on data at 2004.

Originality/value

This is the first paper employing a health production theory on China's new urban and rural healthcare programs.

Details

China Agricultural Economic Review, vol. 2 no. 2
Type: Research Article
ISSN: 1756-137X

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