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The purpose of this study is to understand how risk attitudes drive demand for different types of insurance amongst Ghanaians.

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.

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.

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.

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.

This paper aims to explore how historical context influences the content and selection of rhetorical legitimation strategies. Using case study method, this paper will focus on how insurance companies and labor tried to defend their legitimacy in the context of enactment of Medicare in the USA. What factors influenced the strategic (rhetorical) decisions made by insurance companies and labor unions in their institutional work?

The study is empirically grounded in archival research, involving an analysis of over 9,000 pages of congressional hearings on Medicare covering the period 1958–1965.

The authors show that rhetorical legitimation strategies depend significantly on the specific historical circumstances in which those strategies are used. The historical context lent credibility to certain arguments and organizations are forced to decide either to challenge widely held assumptions or take advantage of them. The authors show that organizations face strong incentives to pursue the latter option. Here, both the insurance companies and labor unions tried to show that their positions were consistent with classical liberal ideology, because of high respect of classical liberal principles among different stakeholders (policymakers, voters, etc.).

It is uncertain how much the results of the study could be generalized. More information about the organizations whose use of rhetorics the authors studied could have strengthened our conclusions.

The practical relevancy of the revised paper is that the authors should not expect hegemony challenging rhetorics from organizations, which try to influence legislators (and perhaps the larger public). Perhaps (based on the findings), this kind of rhetorics is not even very effective.

The paper helps to understand better how organizations try to advance their interests and gain acceptance among the stakeholders.

In this paper, the authors show how historical context in practice influence rhetorical arguments organizations select in public debates when their goal is to influence the decision-making of their audience. In particular, the authors show how dominant ideology (or ideologies) limit the options organizations face when they are choosing their strategies and arguments. In terms of the selection of rhetorical justification strategies, the most pressing question is not the “real” broad based support of certain ideologies. Insurance company and labor union representatives clearly believed that they must emphasize liberal values (or liberal ideology) if they wanted to gain legitimacy for their positions. In existing literature, it is often assumed that historical context influence the selection of rhetorical strategies but how this in fact happens is not usually specified. The paper shows how interpretations of historical contexts (including the ideological context) in practice influence the rhetorical strategies organizations choose.

This study aims to understand the progressive marketization of health data collection and use, through a study of its historical development in France, from the 1930s to the present day.

The authors collected a set of legal, institutional, political and media data. These came from the INA (National Audiovisual Institute), the French national newspaper websites and the websites legifrance.gouv.fr and vie-publique.fr. The authors then conducted a thematic content analysis.

The study results highlight the changes in the health-care system related to the increased use of data in France over three major periods. The first period – 1930s to 1980s – is marked by the creation of the French social security system to collect large sets of data to better manager people’s health care. The second period – 1980s to 2000s – is characterized by the adoption and assimilation of tools to manage patient data through several national and European regulations. The last period – 2000s to the present – saw the introduction of measures in favor of the digitalization of health care, and consequently of data, in parallel with the advancement of digital technologies in general. The institutional dynamics in healthcare have evolved with the nature of the actors and their practices, in connection with new perceptions about health data.

This research sheds light on the historical transformation of health data collection and use in France, revealing the involvement of diverse stakeholders, the discourses driving data development and the need for regulation. It exposes the dual nature of health data collection and use, initially sanctioned by the state and public entities but later exploited for private interests.

This chapter reviews the evidence on the role of physicians in shaping inequalities in access to and utilisation of healthcare. The authors examine three types of physician decisions that can influence inequalities in access and utilisation: location decisions, decisions to work in the public and/or private sector, and decisions or behaviours in the doctor–patient encounter. For each, the authors summarise the issues and empirical evidence on possible policies to help reduce inequalities in access. Future research to reduce inequalities should focus on changes to health systems that influence physician decisions, such as health insurance expansions, the public–private mix and financial incentives, as well as physician training and policies for a more diverse physician workforce.

The author studies the determinants of public trust in government doctors and hospitals (DH) – a crucial indicator of the quality of a country's healthcare system – in India by analyzing the India Human Development Survey (IHDS) 2011–2012.

The author uses descriptive statistics and a set of ordered probit regression models controlling for a set of individual-specific, household-level and other covariates and analyze across heterogeneous contexts (national/rural/urban/male heads/female heads/social groups).

Across contexts, people reporting a great deal of trust in private DH (PDH) are significantly more likely to report a great deal of trust in government DH. Those people with a great deal of trust in government schools to provide good education (vis-à-vis people with only some trust in government school) have significantly higher likelihood of reporting a great deal of trust in government DH. Visiting a private doctor last time (vis-à-vis a government doctor) makes reporting higher trust levels in government DH less likely.

India's healthcare system is afflicted with several resource allocation problems and low public trust issues are indicative of misgovernance. In presence of limited state capacity, ubiquitous corruption and underwhelming institutional trust, understanding the factors influencing public trust in healthcare providers is critical to designing appropriate trust-enhancing public health policies.

Given the sparse empirical literature on public trust in healthcare systems in the developing countries such as India, this study is a pertinent contribution as the study explains the determinants of public trust in DH using a comprehensive unit-recorded household survey dataset.

Characteristics that impact the levels of palliative care are introduced. Patients with the potential to be classified as palliative may be overlooked or simply so not seek medical attention. The population is much higher than those being treated on an annual basis. Data from the American Community Survey (ACS) and the Behavioral Risk Factor Surveillance System (BRFSS) are applied to the characteristics of palliative care and used to estimate the size of the palliative population in the United States (US).

High-quality labor supply is inevitable to maintain sustainable and steady economic growth. This study mainly explores the impact of the social pension system on the health of human capital, and further explores its impact mechanism.

On the basis of the data from China Family Panel Studies from 2012 to 2018, this article uses the fixed effect model and the mediation effect model to empirically study the influence of the social pension scheme on the health of human capital and further explore its influence mechanism.

This study shows that the social pension scheme can significantly improve the physical and mental health of laborers, especially for low-income and agricultural groups. The implementation of the social pension scheme contributes to increasing medical services and reducing the labor supply for the benefit of human health capital. Therefore, the government should continue to expand the coverage of the social pension scheme and comprehensively improve the importance of human health capital on economic growth.

Medical costs and labor supply play a mediating effect in the relationship between social pension and rural labors' health status, which indicates that medical costs and labor supply level are still important factors affecting the health status of rural labor. There are essential factors affecting the health status of the rural labor force, and their role should be given more consideration in the process of system design and improvement.

The existing studies have more frequently studied the effect of the implementation of social pension schemes from the perspective of economic performance, but this paper evaluates the policy effect of social pension schemes based on the perspective of health human capital, which enriches research on health performance in related fields.

This study aims to delve into the impact of the Pradhan Mantri Jan Arogya Yojana (PMJAY) on the well-being and quality of life of beneficiaries in Surat City of India. Employing correlation and regression analyses, the study uncovers significant correlations between Awareness, Healthcare Utilisation, and Financial Burden Reduction with well-being outcomes.

The investigation employs a structured questionnaire to gather data from 250 beneficiaries, exploring the relationships between Awareness, Healthcare Utilisation, Financial Burden Reduction, Well-Being and quality of Life. The data was collected using a structured questionnaire using a survey method.

The results highlighted the crucial role of Awareness in empowering beneficiaries to make informed healthcare decisions, positively influencing their well-being. Furthermore, the study underscores how active engagement with PMJAY's healthcare services enhances well-being. The mitigation of financial burdens emerges as a pivotal factor, signifying the program's efficacy in improving beneficiaries' quality of life.

The comprehensive model presented in this study reveals that PMJAY's multifaceted approach is pivotal in promoting enhanced well-being and quality of life among beneficiaries. These findings affect public health policies seeking to create holistic interventions that holistically address vulnerable populations' healthcare access, financial burdens, and overall well-being.

The objective of writing this case study is to allow management students to engage with the complexities of mergers and acquisitions (M&As) in the insurance sector in an emerging economy like India. Upon completion of this case study, the students will be able to critically evaluate the business environment of the insurance sector of a developing economy like India, analyse the impact of M&As on the insurance industry of India, appraise the post-merger consequences and strategies to deal with these consequences, assess the applicability of market power and growth theories in the context of M&As and develop a strategic action plan for handling post-merger challenges.

On 3 September 2021, the Insurance Regulatory and Development Authority of India (IRDAI) approved the “Scheme” related to the merger of the non-life insurance division of Bharti AXA General Insurance Company Limited (“Bharti AXA”) with ICICI Lombard General Insurance Company Limited (“ICICI Lombard”). Earlier, on 21 August 2020, the boards of the companies had approved entering into definitive agreements through a scheme of arrangement. The merger received approvals from different regulatory bodies as mandated (Gandhi et al., 2023). Bhargav Dasgupta, managing director and Chief Executive Officer of ICICI Lombard, stated, “This is a landmark step in the journey of ICICI Lombard, and we are confident that this transaction would be value accretive for our shareholders” (FE Bureau, 2020). However, the merger posed a dilemma for Dasgupta and the management regarding crop insurance owing to its impact on profitability. Crop insurance historically had high claim ratios nearing 135% for ICICI Lombard for financial year 2018. The company ceased to underwrite this product from 2019 onwards (TNN, 2019). However, ICICI Lombard had to fulfil the three-year commitment made by Bharti AXA to the state governments of Maharashtra and Karnataka towards crop insurance. It was a scheme initiated by the Government of India, covering farmers against losses due to cyclonic rains, rainfall deficits and other unforeseen calamities. Dasgupta faced a challenge in managing the interests of the farmers and the company’s shareholders while balancing profitability, which had already been impacted by the COVID-19 pandemic. This case study delves into post-merger complexities in the financial sector non-life insurance industry in emerging countries like India.

This case study is suitable for undergraduate and post-graduate management students and executives from the insurance industry.

Teaching notes are available for educators only.

CSS 11: Strategy.

This review aims to examine the literature on refugees’ and asylum seekers’ resilience, its historical evolution, key principles, assumptions and recommendations, while focusing on the Canadian context.

A narrative literature review has been applied to this manuscript. This approach allows the integration of a wide scope of literature and perspectives, from academic literature to grey literature (e.g. governmental reports and dissertations). Nevertheless, the limitations of this type of review were also discussed.

In spite of the gaining popularity of the resilience lens, which emphasizes an individual’s ability to overcome adversities and stressful events, more work is required for its effective integration into health practice, programs and policies, particularly as it relates to refugees’ and asylum seekers’ mental health care.

Careful consideration of refugees’ and asylum seekers’ mental health needs and Canadian mental health service delivery and policies is a critical first step in reaching such a goal.