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"INSURANCE · POLICY"
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One nation uninsured : why the U.S. has no national health insurance
One Nation, Uninsured offers a vividly written history of America's failed efforts to address the health care needs of its citizens. Covering the entire twentieth century, Jill Quadagno shows how each attempt to enact national health insurance was met with fierce attacks by powerful stakeholders, who mobilized their considerable resources to keep the financing of health care out of the government's hands.
eBook
Factors influencing medical insurance participation and satisfaction among non-standard workers in China
Objectives
Universal health coverage is the goal of China’s healthcare system reform. However, with the growth of the gig economy, problems such as the failure of non-standard workers to participate in basic medical insurance continue to arise. Consequently, we investigated the factors that influence non-standard workers’ medical insurance participation and satisfaction, with the goal of improving their participation.
Methods
This study collected data on insurance participation among non-standard workers through 635 questionnaire surveys. Based on Andersen’s model and logistic regression analysis, this study examined the factors influencing their insurance enrollment and analyzed the satisfaction level with medical insurance policies among those who participated.
Results
The majority of non-standard workers were young healthy men, whose utilization of health services was low. The coverage rate of basic medical insurance for non-standard workers was 38.4%, which is relatively low. Those who were young with a high monthly income, participated in commercial or other medical insurance, and self-rated their health status as good were inclined to opt out of basic medical insurance. Non-standard workers’ satisfaction with the basic medical insurance policy was 2.5 points on average. Those who were male, highly educated, floating population members, lacked an understanding of the basic medical insurance policy, and self-rated their health status as poor were more likely to have low satisfaction with the basic medical insurance policy.
Conclusion
The insurance participation rate of non-standard workers needs to be improved. To do so, it is necessary to intensify the publicity concerning medical insurance policies; raise the awareness of non-standard workers, especially young healthy non-standard workers, about insurance; and improve the insurance policies of non-standard workers according to their industry particularities.
Journal Article
The role of health insurance literacy in the process and outcomes of choosing a health insurance policy in the Netherlands
In several countries, citizens are expected to be critical consumers when choosing a health insurance policy. However, there are indications that citizens do not always have the sufficient skills, so called health insurance literacy (HIL), to do this. We investigated whether the level of HIL among Dutch citizens is related to the way in which they experience the process of choosing a policy, and furthermore whether it is related to their health insurance choices. We obtained information by sending questionnaires to members of the Nivel Dutch Health Care Consumer Panel in 2020. Of the 1,500 approached, 806 panel members participated (response rate 54%). Our results indicate that, compared to those with a high HIL, respondents with a low HIL more often find choosing a health insurance policy difficult, not interesting, and boring, and less often consider it important and worthwhile. Furthermore, they make less use of the opportunity to switch from one health insurer to another. However, they do still opt for a supplementary insurance policy and a voluntary deductible to the same extent as citizens with a high HIL. We conclude that the HIL level among Dutch citizens is related to the way in which they experience the process of choosing a health insurance policy and to the extent to which they switch from one insurer to another. But it is not related to their health insurance choices. Follow-up research should focus on how citizens with a low HIL can be better supported when choosing a health insurance policy.
Journal Article
Q-ROF Fuzzy TOPSIS and VIKOR Methods for the Selection of Sustainable Private Health Insurance Policies
As a result of the inability of people to meet their demands in the face of increasing demands, people tend to have private health insurance in addition to the general health insurance offered as a public service. Due to the increasing trend of taking out private sustainable health insurance, the number of private sustainable health insurance plans in the health insurance market has increased significantly. Therefore, people may be confronted by a wide range of private health insurance plan options. However, there is limited information about how people analyze private health insurance policies to protect their health in terms of benefit payouts as a result of illness or accident. Thus, the objective of this study is to provide a model to aid people in evaluating various plans and selecting the most appropriate one to provide the best healthcare environment. In this study, a hybrid fuzzy Multiple Criteria Decision Making (MCDM) method is suggested for the selection of health insurance plans. Because of the variety of insurance firms and the uncertainties associated with the various coverages they provide, q-level fuzzy set-based decision-making techniques have been chosen. In this study, the problem of choosing private health insurance was handled by considering a case study of evaluations of five alternative insurance companies made by expert decision makers in line with the determined criteria. After assessments by expert decision makers, policy choices were compared using the Q-Rung Orthopair Fuzzy (Q-ROF) sets Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Q-ROF VIšeKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) methods. This is one of the first attempts to solve private health policy selection under imprecise information by applying Q-ROF TOPSIS and Q-ROF VIKOR methods. At the end of the case study, the experimental results are evaluated by sensitivity analysis to determine the robustness and reliability of the obtained results.
Journal Article
Catastrophic care : how American health care killed my father--and how we can fix it
\"A visionary and completely original investigation that will change the way we think about health care: how and why it is failing, why expanding insurance coverage will only make things worse, and how it can be transformed into a transparent, affordable, successful system. In 2007, David Goldhill's father died from a series of infections acquired in a well-regarded New York hospital. The bill was for several hundred thousand dollars--and Medicare paid it. These circumstances left Goldhill angry and determined to understand how it was possible that world-class technology and well-trained personnel could result in such simple, inexcusable carelessness--and how a business that failed so miserably could be rewarded with full payment. Catastrophic Care is the eye-opening result. Goldhill explicates a health-care system that now costs nearly $2.5 trillion annually, bars many from treatment, provides inconsistent quality of care, offers negligible customer service, and in which an estimated 200,000 Americans die each year from errors. Above all, he exposes the fundamental fallacy of our entire system--that Medicare and insurance coverage make care cheaper and improve our health--and suggests a comprehensive new approach that could produce better results at more acceptable costs immediately by giving us, the patients, a real role in the process. \"-- Provided by publisher.
Book
How do citizens with low health insurance literacy choose a health insurance policy in the Netherlands? An interview study
Various countries have implemented a choice-based health insurance system. For such systems to function as intended, it is crucial that all citizens have the opportunity to make well-informed decisions with regard to their health insurance policy. There is, however, ample research evidence to suggest that many citizens may lack the required skills to do so, thus increasing the likelihood of suboptimal insurance choices and incurring unexpected costs. The current study explored what barriers citizens in the Netherlands, with low health insurance literacy (HIL), face when selecting a health insurance policy, and what their specific needs and preferences are regarding information and support. Semi-structured interviews (online or telephone) were performed between January 2023 and April 2023 among sixteen with a low level of HIL. The data were analyzed using thematic analysis methods. Our results show that not all citizens with low HIL are sufficiently motivated to actively look for alternative health insurance options every year. This is partly due to the feeling that it is a task imposed upon them by the government, and because choosing a health insurance policy is perceived as too complicated and not sufficiently worthwhile. There is a need among citizens with low HIL for clear and practical information about health insurance policies, especially from the government and health insurers. In addition to this need, we recommend enhancing awareness regarding the consequences of neglecting to explore such health insurance options. Moreover, more personal attention for the process of selecting a health insurance policy should be offered to vulnerable groups such as those who possess insufficient digital skills.
Journal Article