A comparison of single- and multi-payer health insurance systems and options for reform

Hussey, Peter S.; Anderson, Gerard F.

doi:10.1016/s0168-8510(03)00050-2

Cited by 89 publications

(60 citation statements)

References 31 publications

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“…In none of the five could it be said that funding arrangements or resources are adequate or not debated. The arrangements confirm suggestions elsewhere that there are many options and variations on themes, but no single answer for how best to fund health services [29,30].…”

Section: Fundingsupporting

confidence: 62%

Advanced Asia's health systems in comparison

et al. 2006

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Section: Fundingsupporting

confidence: 62%

Advanced Asia's health systems in comparison

et al. 2006

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“…4 To date, efforts to redesign insurance have proceeded with little regard to patients' or families' ability to pay or the consequences of exposure to financial risk. To the extent that patient cost sharing or benefit gaps leave insured adults without adequate financial protection in the event of illness, erosion in the quality of insurance coverage will raise the number of Americans who are underinsured.…”

mentioning

confidence: 99%

Insured But Not Protected: How Many Adults Are Underinsured?

et al. 2005

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Health insurance is in the midst of a design shift toward greater financial risk for patients. Where medical cost exposure is high relative to income, the shift will increase the numbers of underinsured people. This study estimates that nearly sixteen million people ages 19-64 were underinsured in 2003. Underinsured adults were more likely to forgo needed care than those with more adequate coverage and had rates of financial stress similar to those of the uninsured. Including adults uninsured during the year, 35 percent (sixtyone million) were under-or uninsured. These findings highlight the need for policy attention to insurance design that considers the adequacy of coverage.T h e r e le n t le s s r i s e i n h e a lt h c a r e c o s ts and insurance premiums has spurred a move away from more-comprehensive insurance benefits for the population under age sixty-five. Trends instead point toward plans with higher deductibles, patient cost sharing, and, in some instances, a more restricted scope of benefits. Faced with the fourth consecutive year of double-digit premium inflation and the demise of managed care options, employers have sought to moderate their premium costs by offering new insurance products that shift more financial risk to workers.1 Insurance plans sold to small businesses, in particular, have moved to sharply higher deductibles; however, increases are also spreading across larger firms. 2Recent federal policies have also pushed toward higher patient cost sharing through enactment of new tax-protected health savings accounts (HSAs) available only to people with insurance policies having deductibles of at least $1,000 per person. Some proposals would further encourage such high-deductible plans. 3Although the United States already stands out among industrialized countries for the high share of medical costs its citizens pay out of pocket, trends point to still greater patient and family exposure to medical care costs in the future, reversing T h e U n d e r i n s u r e d H E

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“…In a single insurer system, health care system centralizes financing, which means that one organization collects and pools revenues and provides health care to all population. In contrast, in a multiple insurer system, several organizations are responsible for financing and administration with the specified group based on a certain criteria [23]. While the single insurer system (single pipe) includes all population within a single risk pool, multiple insurer system (multiple pipes) has many pools at different levels of potential health risks [14].…”

Section: Nhi As a Model Of New Typology On Health Care Systemmentioning

confidence: 99%