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"National health insurance"
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One Nation, Uninsured
Reveals the roots of America's failure to address the health care need of its citizens. In a comprehensive history of the failed efforts to enact universal insurance from the 1940s to the 1990s, the author shows how each attempt to enact national health insurance has met with fierce attacks by stakeholders
eBook
The transformation of American health insurance : on the path to medicare for all
Can American health insurance survive? In The Transformation of American Health Insurance, Troyen A. Brennan traces the historical evolution of public and private health insurance in the United States from the first Blue Cross plans in the late 1930s to reforms under the Biden administration. In analyzing this evolution, he finds long-term trends that form the basis for his central argument: that employer-sponsored insurance is becoming unsustainably expensive, and Medicare for All will emerge as the sole source of health insurance over the next two decades. After thirty years of leadership in health care and academia, Brennan argues that Medicare for All could act as a single-payer program or become a government-regulated program of competing health plans, like today's Medicare Advantage. The choice between these two options will depend on how private insurers adapt and behave in today's changing health policy environment. This critical evolution in the system of financing health care is important to employers, health insurance executives, government officials, and health care providers who are grappling with difficult strategic choices. It is equally important to all Americans as they face an inscrutable health insurance system and wonder what the future might hold for them regarding affordable coverage.
eBook
How public and private health insurance coverage mitigates catastrophic health expenditures in Republic of Korea
Background
The private health insurance (PHI) market in Republic of Korea has instituted indemnity insurance plans that provide partial reimbursements for some medical services or costs that are not covered by the National Health Insurance (NHI). To date, no study has estimated the extent to which PHI coverage lowers the economic burden of households’ access to health care. The current study aims to evaluate the design of Korea’s PHI system in terms of coverage using a catastrophic health expenditure (CHE) indicator and compare it with NHI.
Methods
This study determined the difference between the number of households that were subscribed to PHI and those that received reimbursements from PHI. Additionally, it compared the effects of reduced CHE by NHI benefits with PHI reimbursements. Furthermore, it compared PHI reimbursements based on income class. Finally, it analyzed the contribution of NHI and PHI to CHE reduction through a two-part model with hierarchical regression.
Results
The results indicated that of the 5644 households examined, 3769 subscribed to PHI, but only 246 households received reimbursements. Notably, NHI reduced CHE incidence by 15.17%, whereas PHI only reduced CHE by 1.22%. The NHI scheme indicated reduced inequality as it provided more benefits to the low-income class for their used medical services, whereas PHI paid more reimbursements to the high-income class. Accordingly, NHI coverage has protected households from CHE and improved equality to some extent; however, PHI coverage has had a relatively low effect on relieving CHE and has increased inequality.
Conclusions
The indemnity health insurance plans of PHI companies in Korea only cover partial medical costs or services, and so, most patients do not receive reimbursements. Thus, Korea’s PHI system needs to improve to provide benefits to patients more generously and alleviate their financial burden.
Journal Article
Pragmatic Vision
On March 23, 2010, President Barack Obama signed the Patient
Protection and Affordable Care Act into law, providing every
American with the opportunity to have guaranteed health care
coverage. The Affordable Care Act-frequently referred to as
Obamacare-is almost synonymous with Obama's presidential legacy and
reflects a series of key decisions that he made beginning before he
took office. As Meena Bose shows, it was Obama's particular brand
of pragmatic politics that ultimately shaped the passage of the
Affordable Care Act and made a lasting mark on health care reform
in the United States.
Pragmatic Vision examines eight of Obama's decisions
that resulted in the landmark enactment of health care reform,
starting with his commitment to health care reform in the 2008
presidential campaign and concluding with his decision to allow for
flexibility with its implementation, following technical hurdles
and Supreme Court rulings. Bose shows that Obama's steadfast
commitment to the issue was crucial to its passing, especially
after the Democrats lost their filibuster-proof majority in the
Senate. Obama's direct engagement built key political support for
the legislation and was aided by the senior White House staff and
Democratic leaders in Congress who skillfully navigated the bill to
passage just fourteen months after Obama took office.
The story of Obama's leadership in enacting the Affordable Care
Act is a tale of today's partisan divide and the polarization of
Congress. The legislation passed on a party-line vote and continued
to divide politicians long after its passage. Nevertheless, despite
repeated efforts by Republicans to repeal the law, it is more
popular today than ever and seems destined to remain in force until
the next stage of reform. Pragmatic Vision is an
authoritative guide to this singular achievement of the Obama
administration.
eBook
The Nigeria national health insurance authority act and its implications towards achieving universal health coverage
The National Health Insurance Scheme (NHIS) faced several inherent and systemic drawbacks towards achieving universal health coverage for all Nigerians, and this has led to the signing of the new National Health Insurance Authority Act (NHIA), 2022. This article highlights the benefits of NHIA, discusses the possible challenges and the way forward in its implementation. A narrative review of past literature searched in PubMed, MEDLINE, African Journal Online, and Goggle was conducted. A total of 76 publications were initially retrieved and following data triangulation, 55 were finally used. The authors also included their experiences. The NHIA addressed some of the shortcomings of the previous NHIS, however, it would still face several challenges in its implementation such as low government funding priority to health, shortage of healthcare workers and poor healthcare coverage, as well as problems with enforcement as it mandates all Nigerians to enroll. These and other impending constraints must be surmounted and all stakeholders must be involved to ensure the Act accomplishes its aim.
Journal Article