Why private health insurance?

Thomson, Sarah; Sagan, Anna; Mossialos, Elías

doi:10.1017/9781139026468.001

Cited by 16 publications

(25 citation statements)

References 226 publications

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“…Nikolićhas extended the Commission's and the Court's application of the SGEI concept to the complementary private health insurance in Slovenia. He concluded, in line with Mossialos and Thompson's predictions, 84 that Slovenia had an even stronger case when applying the SGEI exception to its complementary private health insurance scheme than Ireland did in the BUPA case. According to his findings, government intervention in Slovenian complementary private health insurance along the lines of the Irish intervention analysed in the BUPA case could also be justified under the SGEI exception with an even greater degree of conviction.…”

Section: A Compatibility Of Health Insurance Schemes With Competitiomentioning

confidence: 62%

The Compatibility of Private Health Insurance Schemes with EU Law: Applying the Health Insurance Exception beyond Substitutive Private Health Insurance

Nikolić

2020

Camb. Yearb. Eur. Legal Stud.

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The lack of clarity as to the scope of the health insurance exception enshrined in Article 206 of the Solvency II Directive has created uncertainties surrounding the implications for government intervention in the private health insurance market. A contentious interpretation of the health insurance exception, offered by former EU Commissioner Bolkestein, and the approach subsequently taken by the Commission and the Court of Justice of the European Union in assessing the compatibility of Member State intervention in private health insurance have led to a divergence in the application of EU law, which further increases uncertainties around the legality of Member State intervention. This article proposes an alternative interpretation of the health insurance exception that draws on a contemporary understanding of private health insurance as a socio-economic institution aimed at achieving a highly competitive social market economy. This alternative interpretation extends the applicability of the health insurance exception from substitutive private health insurance to complementary private health insurance that covers statutory user charges and thus improves the compliance of national health insurance systems in several Member States with EU law and enhances the coherence of EU law.

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Section: A Compatibility Of Health Insurance Schemes With Competitiomentioning

confidence: 62%

The Compatibility of Private Health Insurance Schemes with EU Law: Applying the Health Insurance Exception beyond Substitutive Private Health Insurance

Nikolić

2020

Camb. Yearb. Eur. Legal Stud.

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“…In Malaysia, PHI is supplementary. Acquiring supplementary PHI guarantees expedited access to treatment, a greater selection of healthcare providers, and enhanced service or convenience, such as a private room [ 10 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…The functional type of PHI in Malaysia is supplementary in nature. It provides faster access to inpatient care in private hospitals, a wider range of health care providers, and improved amenities [ 10 ]. The annual limit, lifetime limit, ward categories, coverage of pre-hospitalisation diagnostic tests, post-hospitalisation treatment, surgical fees, emergency accidental outpatient treatment, cancer and dialysis outpatient treatment, and daily cash allowance are standard features on all medical cards.…”

Section: Introductionmentioning

confidence: 99%

Uptake and determinants of private health insurance enrollment in a country with heavily subsidised public healthcare: A cross-sectional survey in East Coast Malaysia

Khalim

Sukeri

2023

PLoS ONE

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Malaysia’s subsidised public healthcare system is heavily reliant on government funding. Increasing the uptake of private health insurance (PHI) would alleviate the financial burden on public healthcare facilities caused by high patient loads. The study aimed to determine the uptake of PHI and its associated factors among the East Coast Malaysian populations. A cross-sectional online survey was conducted between February and June 2021. Proportionate stratified sampling was applied to select 1138 participants, and logistic regression was performed to determine the factors associated with PHI uptake. The proportion of the study samples that purchased PHI was 54.3%. Enrolment of private health insurance was associated with working in the public sector (aOR: 6.06, 95% CI: 2.65, 13.88) and private sector (aOR: 6.27, 95% CI: 2.65, 14.85), being self-employed (aOR: 9.23, 95% CI: (3.59, 23.70), being in the middle 40% household income percentile (aOR: 2.74, 95% CI: 1.95, 3.85) and top 20% household income percentile (aOR: 4.42, 95% CI: 2.87, 6.80), and living in urban areas (aOR: 1.31, 95% CI: 1.01, 1.70). Even in the presence of subsidised public healthcare, the high proportion of PHI uptake reflects a demand for private health insurance. The study suggests that PHI should be promoted among those who are employed or self-employed, the middle- and high-income groups, and urban residents. The findings may be beneficial for the government and insurance companies to improve strategies to enhance PHI uptake among these population.

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“…The latter however requires government capacity to control for and mitigate against the adverse effects of private insurance, such as risk selection or the inability of poor individuals and those with worse health status to purchase insurance. For this reason, it is not a commonly used option in European countries [ 79 ].…”

Section: Discussionmentioning

confidence: 99%

Financing Healthcare in Central and Eastern European Countries: How Far Are We from Universal Health Coverage?

Tambor

Klich

Domagała

2021

IJERPH

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After the fall of communism, the healthcare systems of Central and Eastern European countries underwent enormous transformation, resulting in departure from publicly financed healthcare. This had significant adverse effects on equity in healthcare, which are still evident. In this paper, we analyzed the role of government and households in financing healthcare in eight countries (EU-8): Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, and Slovenia. A desk research method was applied to collect quantitative data on healthcare expenditures and qualitative data on gaps in universal health coverage. A linear regression analysis was used to analyze a trend in health expenditure over the years 2000–2018. Our results indicate that a high reliance on out-of-pocket payments persists in many EU-8 countries, and only a few countries have shown a significant downward trend over time. The gaps in universal coverage in the EU-8 countries are due to explicit rationing (a limited benefit package, patient cost sharing) and implicit mechanisms (wait times). There is need to increase the role of public financing in CEE countries through budget prioritization, reducing patient co-payments for medical products and medicines, and extending the benefit package for these goods, as well as improving the quality of care.

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Why private health insurance?

Cited by 16 publications

References 226 publications

The Compatibility of Private Health Insurance Schemes with EU Law: Applying the Health Insurance Exception beyond Substitutive Private Health Insurance

The Compatibility of Private Health Insurance Schemes with EU Law: Applying the Health Insurance Exception beyond Substitutive Private Health Insurance

Uptake and determinants of private health insurance enrollment in a country with heavily subsidised public healthcare: A cross-sectional survey in East Coast Malaysia

Financing Healthcare in Central and Eastern European Countries: How Far Are We from Universal Health Coverage?

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