Rising inequality and the implications for the future of private insurance in Canada

Stabile, Mark; Isabelle, Maripier

doi:10.1017/s1744133117000457

Cited by 8 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although double insurance was initiated to respond to difficulties in access to the public system, once the private insurance market became established, it took on a life of its own, and as cultural patterns changed, the demand for private insurance remained strong. Another argument to explain the increasing trend towards VPHI relies on the progressive inequality in income distribution, particularly among the top earners [5]. As the level of economic inequality increases, it becomes more and more difficult for publicly provided insurance to satisfy the median citizen, as the targeted population is more and more heterogeneous.…”

Section: Introductionmentioning

confidence: 99%

Income and wealth as determinants of voluntary private health insurance: empirical evidence in Spain, 2008–2014

Pinilla

López-Valcarcel

2020

BMC Public Health

View full text Add to dashboard Cite

Background: Few studies have quantitatively estimated the income elasticity of demand of voluntary private health insurance (VPHI) in countries with a universal National Health Service. Most studies to date have uses cross-sectional data. Methods: In this paper we used a longitudinal database from the Bank of Spain to analyse the financial behaviour of approximately six thousand families per wave. We used three waves (2008, 2011 and 2014). We estimated income and wealth semi-elasticities of VPHI in Spain considering personal and family characteristics (age, sex, level of health, education, composition of the household), i.e. changes in the probability of buying VPHI as result of 1% change in income or wealth. We estimated cross-sectional models for each wave and longitudinal models for families remaining for at least two waves, taking account of possible selection bias due to attrition. Results: Cross-sectional models suggest that the income effect on the probability of buying a VPHI increased from 2008 to 2014. The positive impact was observed for, wealth. In 2008 a 1% increase in income is associated with an increase in the probability of having VPHI of 0.064 [95%-CI: 0.023; 0.104]-on the probability scale (0.1)whereas in 2014, this effect is of 0.116 [95%-CI, 0.094; 0.139]. In 2011 and 2014 the wealth effect is not significant at 5%. The estimation of the longitudinal model leads to different results where both, income and wealth are associated with non-significant results. Conclusion: Our three main conclusions are: 1) Cross-sectional estimates of semi-elasticities of VPHI might be biased upwards; 2) Wealth is alongside income are economic determinants, of the decision to buy VPHI in high-income countries; 3) The effects of income and wealth on the probability of buying VHPI are neither linear nor log-linear. There are no significant differences among 60% of the most disadvantaged families, while the families of the two upper wealth quintiles show clearly differentiated behaviour with a higher probability of insurance.

show abstract

Section: Introductionmentioning

confidence: 99%

Income and wealth as determinants of voluntary private health insurance: empirical evidence in Spain, 2008–2014

Pinilla

López-Valcarcel

2020

BMC Public Health

View full text Add to dashboard Cite

show abstract

“…3 It is also notable that the characteristics we found to be associated with private drug insurance are similar to those of people who did not report cost-related nonadherence to prescription drugs and foregoing of other household spending to afford prescription medications. 13 In the current study, people aged 18-24 years had slightly lower rates of insurance coverage than other age groups. This may have been due to the fact that people at this age become ineligible to be covered under their parent's employersponsored insurance coverage.…”

Section: Discussionmentioning

confidence: 47%

Income-related disparities in private prescription drug coverage in Canada

Bolatova

Law

2019

cmajo

View full text Add to dashboard Cite

Background: Canada does not have universal public coverage for prescription drugs, which leaves an important role for private insurance plans. However, we do not have recent data on the characteristics of Canadians who report holding such coverage, particularly differences based on household income. We performed a study to examine the relation between household income and private drug insurance coverage in Canada. Methods: We used data from the 2015-2016 cycle of the Canadian Community Health Survey to investigate the relation between household income and holding private drug insurance. We constructed modified multivariate Poisson regression models with robust error variances, including several potential confounders. Results: Overall, 59.4% of respondents reported having private drug insurance. We found a strong dose-response relation between household income level and private drug insurance coverage: 19.8% of those with a household income less than $20 000 reported private coverage, compared to 76.2% of those with a household income of $80 000 or more. Interpretation: Higher-income households are much more likely to hold private drug insurance coverage in Canada. This likely contributes to differential access to medicines and health outcomes by different income groups.

show abstract

“…Political will and economic conditions are critical to the enforceability of rights (Garland, 2015: 627). Given the political–economic trends discussed above, and as growing inequality leads to pubic healthcare services failing to satisfy more and more Canadians (Stabile and Isabelle, 2018), the push to enforce the post-social right will continue to strengthen. The right provides the critical basis for a marked shift towards a mode of health law as governance according to neo-liberal principles.…”

Section: Two-tier Healthcare Two-tier Citizenshipmentioning

confidence: 99%

Towards a Post-Social Right to Life, Liberty and Security of the Person Through Markets? Conceptions of Citizenship and the Implications for Health Law as Governance

Guebert

2019

Social & Legal Studies

View full text Add to dashboard Cite

In the context of increased expectations of healthcare services and fiscal pressures, rights claims constitute a force pushing for privatization and thus threaten Canada’s single-tier public system. This article introduces the concept of a ‘post-social right’ to understand the current legal effort to enforce a right to healthcare derivative of section 7 of the Canadian Charter of Rights and Freedoms. Commonly considered as a ‘negative’ right, I suggest that the right also has positive capacity. Rather than simply protecting against unjust state intervention, section 7 claims valorize a particular mode of sustaining life, liberty and security of the person according to neo-liberal principles. A right to markets in healthcare aligns health law with the logic of prudentialism as a technology of governance. As the enforceability of the right expands and strengthens, health law as governance operates to normalize market solutions to health matters. It follows that a form of two-tier citizenship arises, dividing ‘activated’ citizens from the ‘inactive’.

show abstract

Rising inequality and the implications for the future of private insurance in Canada

Cited by 8 publications

References 19 publications

Income and wealth as determinants of voluntary private health insurance: empirical evidence in Spain, 2008–2014

Income and wealth as determinants of voluntary private health insurance: empirical evidence in Spain, 2008–2014

Income-related disparities in private prescription drug coverage in Canada

Towards a Post-Social Right to Life, Liberty and Security of the Person Through Markets? Conceptions of Citizenship and the Implications for Health Law as Governance

Contact Info

Product

Resources

About