Search results

Today, viral marketing is popular as a highly effective marketing strategy with a low cost for mass targeting. This is suitable for the Universal Health Coverage campaign which seeks to attract the whole nation’s population to voluntarily register with social health insurance. It uses the target market itself as a weapon and the marketing content as a bullet. This study aims to determine the exact viral marketing content for the Universal Health Coverage campaign in Indonesia.

Viral marketing content is formulated based on the feelings of the target market toward social health insurance. Qualitative content analysis was conducted to identify the media framing and the audience’s response. Two of the biggest online news websites were analysed to determine the media framing. The audience’s response was identified through a Facebook group discussion.

This study shows that negative media framing makes people question the benefit of participating in social health insurance. Considering the local wisdom of Indonesia, helping poor people through social health insurance would be the best viral marketing content.

Because of the limited number of sources focused on the audience’s responses that have been analysed, the variations in the audience response could not be captured completely. Researchers should also analyse other audience channels (social media and messenger application) besides Facebook.

The paper includes implications for the future marketing agenda of insurance providers in relation to engaging the community.

This study operationally introduced how to use the media channel selected and audience framing in designing an effective viral marketing content in health-care marketing.

Hospital and health system managers are facing several problems following the introduction of Ghana's national health insurance policy. This study aims to investigate the opinions of health managers about the problems emanating from the national health insurance policy for hospital managers in regard to reimbursement, claims management, service delivery and waiting time.

The study involved key informants from 12 National Health Insurance Scheme (NHIS) accredited district hospitals, which were purposively selected from five regions in Ghana. Data were collected using in‐depth personal interviews with managers of pharmacy, supply/procurement, accounts and insurance scheme units of the hospitals. Data analysis was guided by the major themes that emerged during the interviews. A framework approach to analysis was used, grouping and incorporating themes and sub‐themes that emerged from the interview data.

The major findings identified by interviewees with regards to problems confronting hospital management were: cash flow delays from the health insurance authority; lack of capacity to procure essential drug and non‐drug consumables; and the inability to take initiatives and carry on effective administrative work. Other problems identified by the interviewee included inadequate logistics and human resources, limited space within the hospitals to cope with the increasing number of service users and “moral hazard” on the part of policy holders.

The NHIS has brought many organizational and service management challenges to hospitals. To overcome these challenges, services under the health insurance authority need to be streamlined to remove cash flow bottlenecks. Also, accredited hospitals need to adopt and use new technology, especially computerization and automation of the health insurance service delivery system. This would enable the authority to cope with the huge management problems confronting hospitals and the national insurance scheme. Above all, appropriate fund management systems would have to be established in the hospitals to reduce moral hazards.

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.

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.

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.

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.

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 workers 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 policy-makers and politicians with a clearer understanding of the consequences of reform.

The Republic of the Philippines is seeking to expand access to the formal sector of medical care. Concentrates on the alternative ways in which that expansion can be financed. First, provides the background by presenting data on mortality and morbidity as indicators of health status, and of manpower and institutions as measures of care inputs. Second, examines private payment, concentrating on family resources, community co‐operatives, private insurance and employer provided services. Third, considers direct provision and national health insurance, which are the principal modes of public payment for care. Makes recommendations about the financing of health care and the mixed health economy that are of relevance in developed and less‐developed countries alike.

Purpose – The purpose of this article is to investigate one core research question: How can health information technology (HIT) be assessed in a national health care system context?

Design/methodology – We examine this question by taking a systematic approach within a national care system, in which the purpose of HIT is to contribute to a common national health care system's goal: to promote population health in an efficient way. Based on this approach we first develop a framework and our criteria of assessment, and then using Taiwan as a case study, demonstrate how one can apply this framework to assess a national system's HIT. The five criteria we developed are how well does the HIT (1) provide accessible and accurate public health and health care information to the population; (2) collect and provide population health and health care data for government and researchers to analyze population health and processes and outcomes of health care services; (3) provide accessible and timely information that helps to improve provision of cost-effective health care at an institutional level and promotes system-wide efficiency; (4) minimize transaction and administrative costs of the health care system; and (5) establish channels for population participation in governance while also protecting individual privacy.

Findings – The results indicate that Taiwan has high levels of achievement in two criteria while falling short in the other three. Major lessons we learned from this study are that HIT exists to serve a health care system, and the national health care system context dictates how one assesses its HIT.

Originality/value – There is a large body of literature published on the implementation of HIT and its impact on the quality and cost of health care delivery. The vast majority of the literature, however, is focused on a micro institutional level such as a hospital or a bit higher up, on an HMO or health insurance firm. Few have gone further to evaluate the implementation of HIT and its impact on a national health care system. The lack of such research motivated this study. The major contributions of this study are (i) to develop a framework that follows systems thinking principles and (ii) propose a process through which a nation can identify its objectives for HIT and systematically assess its national HIT system. Using Taiwan's national health care system as a case study, this paper demonstrated how it can be done.

Is health care a right or an entitlement? This question persists in the ongoing political, legal, and social turbulence surrounding efforts toward accessible and affordable health care in the United States.

The analysis is drawn from a review of the literature and interviewing a subject matter expert employed by a health maintenance organization in Michigan.

Since the early 1900s, federal legislation has been proposed to establish some type of health care structure that could sufficiently address the varying health care needs of Americans. These multiple attempts toward national health care reform invoke the inquiry of the federal government’s role and function to facilitate access to and management of health care. The passage of the Patient Protection and Affordable Care Act (PPACA) amplifies the conditions and consequences of implementing health care reform effectively.

For college students, the complexities of both the health care and higher education systems can be overwhelming, especially for those students who may already be struggling to pay for and/or finance their schooling and satisfy academic requirements to matriculate while simultaneously striving to maintain a reasonable level of health to complete their education. College students are but one of many vulnerable populations in the United States impacted by the complicated policies and procedures of accessing, delivering, funding, and paying for health care.

Objective – Measurement of the incidence of health financing contributions across socio-economic groups has proven valuable in informing health care financing reforms. However, there is little evidence as to how to carry out financing incidence analysis (FIA) in lower income settings. We outline some of the challenges faced when carrying out a FIA in Ghana, Tanzania and South Africa and illustrate how innovative techniques were used to overcome data weaknesses in these settings.

Methodology – FIA was carried out for tax, insurance and out-of-pocket (OOP) payments. The primary data sources were Living Standards Measurement Surveys (LSMS) and household surveys conducted in each of the countries; tax authorities and insurance funds also provided information. Consumption expenditure and a composite index of socio-economic status (SES) were used to assess financing equity. Where possible conventional methods of FIA were applied. Numerous challenges were documented and solution strategies devised.

Results – LSMS are likely to underestimate financial contributions to health care by individuals. For tax incidence analysis, reported income tax payments from secondary sources were severely under-reported. Income tax payers and shareholders could not be reliably identified. The use of income or consumption expenditure to estimate income tax contributions was found to be a more reliable method of estimating income tax incidence. Assumptions regarding corporate tax incidence had a huge effect on the progressivity of corporate tax and on overall tax progressivity. LSMS consumption categories did not always coincide with tax categories for goods subject to excise tax (e.g. wine and spirits were combined, despite differing tax rates). Tobacco companies, alcohol distributors and advertising agencies were used to provide more detailed information on consumption patterns for goods subject to excise tax by income category. There was little guidance on how to allocate fuel levies associated with ‘public transport’ use. Hence, calculations of fuel tax on public transport were based on individual expenditure on public transport, the average cost per kilometre and average rates of fuel consumption for each form of transport. For insurance contributions, employees will not report on employer contributions unless specifically requested to and are frequently unsure of their contributions. Therefore, we collected information on total health insurance contributions from individual schemes and regulatory authorities. OOP payments are likely to be under-reported due to long recall periods; linking OOP expenditure and illness incidence questions – omitting preventive care; and focusing on the last service used when people may have used multiple services during an illness episode. To derive more robust estimates of financing incidence, we collected additional primary data on OOP expenditures together with insurance enrolment rates and associated payments. To link primary data to the LSMS, a composite index of SES was used in Ghana and Tanzania and non-durable expenditure was used in South Africa.

Policy implications – We show how data constraints can be overcome for FIA in lower income countries and provide recommendations for future studies.

One of the leading indicators of the quality of human life is health and access to medical care. Increasing social concern over the problems of health has resulted in various nationwide proposals like medicare and medicaid. At present, many bills are pending before the United States Congress for the creation of a comprehensive national health insurance scheme. One result of this public awareness is the demand in many libraries for information on the various aspects of the health care industry in general and in particular, on health legislation, resources and facilities, prices and costs and insurance. The following survey aims to examine certain leading publications which provide statistical and other types of information in this area. Excluded from this survey are sources dealing specifically with clinical aspects of drugs and medicine. Moreover, additional and uptodate information on the specific topics discussed below can be obtained by consulting subject indexes like the Hospital Literature Index and the Insurance Periodicals Index.

Purpose – To assess the claim of moral hazard proponents that individuals insulated from paying for the health care they use tend to demand more, often unnecessary, services, or engage in unhealthier behaviors than they otherwise would, collectively driving up demand and increasing health care spending (HCS).

Methodology/Approach – To test the hypothesis that moral hazard increases rather than decreases HCS, I apply a multivariate analysis to examine data from 21 OECD countries over a 20-year period, using out-of-pocket spending (OPS) as a proxy for moral hazard and as the key variable predicting HCS, controlling for other potential drivers of spending.

Findings – OPS is independently associated with HCS, yet in the direction opposite to what moral hazard theory predicts – about $13 higher HCS per additional $10 OPS (p = 0.000).

Research limitations – As with other cross-national studies, limitations include (1) inability to assess differences in health care delivery and quality within and across countries; (2) differences in the measurement and availability of variables across countries; (3) lack of access to data of potential significance, and (4) hard to evaluate cross-national political and cultural differences with implications for health policy.

Policy implications – At least in the United States, unless a fully publicly financed system to cover medically necessary services is implemented, the policy goals of extending adequate health insurance to a national population and controlling HCS nationally will not be met.

Originality/Value of Paper – Most research on moral hazard in US health care has drawn from comparisons within rather than among national health systems. Therefore, the originality and value of this cross-national study lies in its ability to identify variables that could not be included in single nation studies and which have the ability to inform policy and political action.