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Private voluntary health insurance in development : friend or foe?
Private voluntary health insurance already plays an important role in the health sector of many low and middle income countries.The book reviews the context under which private insurance could contribute to an improvement in the financial sustainability of the health sector, financial protection against the costs of illness, household income.
eBook
Institutional differences and geographical disparity: the impact of medical insurance on the equity of health services utilization by the floating elderly population - evidence from China
Background
The Chinese government has now achieved universal coverage of medical insurance through two systems: the Basic Medical Insurance System for Urban Employees (BMISUE) and the Basic Medical Insurance System for Urban and Rural Residents (BMISURR). This paper aims to identify the impact of China’s current medical insurance system on equity in the use of health services by the floating elderly population from two aspects: institutional differences and geographical disparity.
Methods
The data used in the study are from the China Migrants Dynamic Survey (CMDS) conducted by the National Health and Wellness Council of China. This study uses the Logit model to estimate the impact of the medical insurance system on the utilization of health services and the Propensity Score Matching (PSM) method to further test the robustness of the results.
Results
The study found that the type of medical insurance does not affect health services utilization by the floating elderly population in China. However, for those participating in the same medical insurance, participation in different regions will significantly affect the use of health service resources. For the BMISURR, when the place of the insurance is the same as the place of residence, the proportion of the floating elderly population that will see a doctor when they are sick will increase by 4.80%. For the BMISUE, when the place of the insurance is the same as the place of residence, the proportion of the floating elderly population that will see a doctor when they are sick will increase by 10.30%.
Conclusions
The difference between the place of insurance and the place of residence results in the unbalanced utilization of health services by the floating elderly population participating in the same medical insurance system.
Journal Article
Implementation process and challenges for the community-based integrated care system in Japan
Since 10 years ago, Japan has been creating a long-term vision to face its peak in the number of older people that will be reached in 2025 when baby boomers will turn 75 years of age. In 2003, the government set up a study group called \"Caring for older people in 2015\" which led to a first reform of the Long-Term Care Insurance System in 2006. This study group was the first to suggest the creation of a community-based integrated care system.
Three measures were taken in 2006: 'Building an active ageing society: implementation of preventive care services', 'Improve sustainability: revision of the remuneration of facilities providing care' and 'Integration: establishment of a new service system'. These reforms are at the core of the community-based integrated care system.
The socialization of long-term care that came along with the ageing of the population, and the second shift in Japan towards an increased reliance on the community can provide useful information for other ageing societies. As a super ageing society, the attempts from Japan to develop a rather unique system based on the widely spread concept of integrated care should also become an increasing focus of attention.
Journal Article
New Approach to the Public Authorities’ Activities Development in the Crop Insurance System: Lithuanian Case
This article substantiates the structure of the crop insurance system and describes the participants of the insurance system and their activities. The positive impact of crop insurance development on all participants of the system has also been clarified. The aim of the article is to present a methodology for assessing substantiated directs of activity for public authorities in order to make more active crop insurance system performance. The application of the proposed methodology can help to activate crop insurance processes and to expand farmers’ activities and achieve better commercial results of insurance companies. It has been proven that it is beneficial for the public authorities to reinsure farmers’ crops and to refuse to pay direct payments to farmers for the losses incurred. The criteria selected for the assessment of the development directions are relevant to all participants of the insurance system. The research was carried out in a region of Lithuania in which the composition of agricultural business entities corresponds to the situation in the whole agricultural sector of the country. The identification of the insurance system participants and their functions, as well as the use of an expert assessment method with the application of quantitative data processing, showed directions for the activation of crop insurance activities.
Journal Article
Private voluntary health insurance regulation
Health care expenditures can be financed through a mix of public resources and private spending. Private spending is a much larger share of total health spending in low- and middle-income countries than in higher income countries. Moreover, a significant percentage of private spending in those countries is out-of-pocket direct payments for health care services by individuals. Out of pocket expenditures account for more than 60 percent of the total health care spending in low-income countries and 40 percent of total health care spending in middle-income countries. A growing number of low- and middle-income governments are considering private health insurance as a way of both reducing the risk that individuals will have a catastrophic financial burden and achieving other public health care goals. Among these goals are reducing the financial burden on overstretched public health financing, achieving more equitable access to health care, and improving quality and efficiency in the delivery of health care services. An important component of a successful private health insurance market, however, is its legal framework. As discussed in detail later in this book, countries regulate insurance companies to counter systemic market failures that lead to an inefficient and inequitable market. In particular, insurance laws are designed to prevent insurers from becoming insolvent and from engaging in unfair practices and discriminatory behavior. When private health insurance serves as a significant source of financing in a nation's health care system, usually insurance laws also include a range of consumer protection laws that enhance both access to the services covered by private health insurers and the adequacy of the benefits provided by the insurer. This chapter provides a general overview of private health insurance. It begins with a discussion of the definition of private health insurance and the potential roles of private health insurance as part of a nation's health care financing system. In addition, the chapter reviews the variety of entities that sell private health insurance
Book
Global marketplace for private health insurance : strength in numbers
The development challenges of addressing health problems in low- and middle-income countries are daunting but not insurmountable. There are now known and affordable interventions to deal with many aspects of the HIV/AIDS crisis as well as the continued challenge posed by malaria and other major infectious diseases. Three major development objectives of health insurance in low- and middle income countries are highlighted in this volume: securing sustainable financing for health care providers that serve the health needs of vulnerable populations; providing financial protection against the impoverishing cost of illness; and reducing social exclusion from organized health financing and delivery systems. Private health insurance schemes can address the needs of the poor and other vulnerable populations with appropriate combinations of subsidies, risk pooling, household savings, and user charges. The authors of this book argue in favor of a multipillar approach to health care financing in low- and middle-income countries that combines these instruments in addressing the underlying development objectives described above, while putting a strong emphasis on private voluntary health insurance. In this way, private means can make a significant contribution to public ends.
eBook
BMIT: A Blockchain-Based Medical Insurance Transaction System
The Blockchain-Based Medical Insurance Transaction System (BMIT) developed in this study addresses key issues in traditional medical insurance—information silos, data tampering, and privacy breaches—through innovative blockchain architectural design and technical infrastructure reconstruction. Built on a consortium blockchain architecture with FISCO BCOS (Financial Blockchain Shenzhen Consortium Blockchain Open Source Platform) as the underlying platform, the system leverages FISCO BCOS’s distributed ledger, granular access control, and efficient consensus algorithms to enable multi-stakeholder on-chain collaboration. Four node roles and data protocols are defined: hospitals (on-chain data providers) generate 3D coordinate hashes of medical data via an algorithmically enhanced Bloom Filter for on-chain certification; patients control data access via blockchain private keys and unique parameters; insurance companies verify eligibility/claims using on-chain Bloom filters; the blockchain network stores encrypted key data (public keys, Bloom filter coordinates, and timestamps) to ensure immutability and traceability. A 3D-enhanced Bloom filter—tailored for on-chain use with user-specific hash functions and key control—stores only 3D coordinates (not raw data), cutting storage costs for 100 records to 1.27 KB and reducing the error rate to near zero (1.77% lower than traditional schemes for 10,000 entries). Three core smart contracts (identity registration, medical information certification, and automated verification) enable the automation of on-chain processes. Performance tests conducted on a 4-node consortium chain indicate a transaction throughput of 736 TPS (Transactions Per Second) and a per-operation latency of 181.7 ms, which meets the requirements of large-scale commercial applications. BMIT’s three-layer design (“underlying blockchain + enhanced Bloom filter + smart contracts”) delivers a balanced, efficient blockchain medical insurance prototype, offering a reusable technical framework for industry digital transformation.
Journal Article