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1 – 10 of over 27000Rebecca 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 insurance…
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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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 study…
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.
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.
This chapter reviews the existing empirical evidence on how social insurance affects health. Social insurance encompasses programs primarily designed to insure against health…
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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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…
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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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 insurance…
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.
This qualitative study explores how individuals understand health insurance concepts and make health insurance purchase decisions. The study sought to develop a model of the…
Abstract
Purpose
This qualitative study explores how individuals understand health insurance concepts and make health insurance purchase decisions. The study sought to develop a model of the health insurance decision-making process.
Design/methodology/approach
This study used semi-structured interview questions and the micro-moment time-line interview technique with newly hired employees to discuss the steps that individuals follow when making health insurance decisions. The researcher used an open coding approach to analyze the steps listed by each participant, and emergent themes were used to code all interview transcripts in Atlas.ti.
Findings
This study identified information tactics used by individuals when evaluating health insurance documentation. The findings also shed light on the personal reflection individuals undertake when making their health insurance choices.
Practical implications
The information needs and preferred information sources identified in this study will be of interest to information professionals and human resources officers providing assistance with health insurance enrolment.
Originality/value
The findings demonstrating that participants characterized their health insurance choice as a shared decision is a novel contribution of this study.
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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…
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.
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Patrick Opoku Asuming and Deborah Aba Gaisie
The purpose of this study is to understand how risk attitudes drive demand for different types of insurance amongst Ghanaians.
Abstract
Purpose
The purpose of this study is to understand how risk attitudes drive demand for different types of insurance amongst Ghanaians.
Design/methodology/approach
This study uses data from a nationally representative survey of Ghanaian households (Ghana Living Standards Survey Round 7). Risk aversion is measured following the approach of Holt and Laury (2002) in the use of hypothetical questions about investment. Probit regressions are used to estimate the effect of risk aversion on insurance outcomes.
Findings
The paper finds evidence that supports the theory that risk attitudes influence insurance demand. Specifically, risk aversion is positively related to the uptake of insurance in general and in particular, public health insurance. Unlike previous literature, the authors do not find the sex of the respondent to affect the relationship between risk aversion and insurance demand except for private health insurance. Socio-economic factors such as wealth, age and education were found to strongly predict insurance demand.
Research limitations/implications
The findings confirm that risk attitude influence the demand for insurance in developing countries but socio-economic factors play a strong role in explaining low insurance penetration in such contexts.
Originality/value
Theoretically, attitudes towards risk have been strongly linked with insurance demand. Yet, empirical evidence on this relationship is limited in developing countries where insurance penetration is very low. This study is among the first to document the influence of risk attitude on the demand of a range of insurance products using a large nationally representative sample of individuals in a developing country.
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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 for Aceh…
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.
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