Voluntary health insurance in Europe. Country experience. Sagan A, S. Thomson ed. (original) (raw)
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Voluntary health insurance in Europe: country experience
No two markets for voluntary health insurance (VHI) are identical. All differ in some way because they are heavily shaped by the nature and performance of publicly financed health systems and by the contexts in which they have evolved. This volume contains short, structured profiles of markets for VHI in 34 countries in Europe. These are drawn from European Union member states plus Armenia, Iceland, Georgia, Norway, the Russian Federation, Switzerland and Ukraine. The book is aimed at policymakers and researchers interested in knowing more about how VHI works in practice in a wide range of contexts. Each profile, written by one or more local experts, identifies gaps in publicly financed health coverage, describes the role VHI plays, outlines the way in which the market for VHI operates, summarises public policy towards VHI, including major developments over time, and highlights national debates and challenges. The book is part of a study on VHI in Europe prepared jointly by the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe. A companion volume provides an analytical overview of VHI markets across the 34 countries.
Voluntary Health Insurance in the European Union: A Critical Assessment
International Journal of Health Services, 2002
The authors examine the role and nature of the market for voluntary health insurance in the European Union and review the impact of public policy, at both the national and E.U. levels, on the development of this market in recent years. The conceptual framework, based on a model of industrial analysis, allows a wide range of policy questions regarding market structure, conduct, and performance. By analyzing these three aspects of the market for voluntary health insurance, the authors are also able to raise questions about the equity and efficiency of voluntary health insurance as a means of funding health care in the European Union. The analysis suggests that the market for voluntary health insurance in the European Union suffers from significant information failures that seriously limit its potential for competition or efficiency and also reduce equity. Substantial deregulation of the E.U. market for voluntary health insurance has stripped regulatory bodies of their power to protect...
Voluntary Health Insurance in the European Union
Context -- The market for VHI in the European Union -- Access, equity and consumer protection -- Implications for the free movement of people and services within the European Union -- Trends and challenges -- Concluding remarks. Report prepared for the Directorate General for Employment and Social Affairs of the European Commission, 27 February 2002
The development of voluntary private health insurance in the Nordic countries
Nordic Journal of Health Economics, 2016
The Nordic countries represent an institutional setting with tax-based health care financing and universal access to health care services. Very few health care services are excluded from what are offered within the publically financed health care system. User fees are often non-existing or low and capped. Nevertheless, the markets for voluntary private health insurance (VPHI) have been rapidly expanding. In this paper we describe the development of the market for VPHI in the Nordic countries. We outline similarities and differences and provide discussion of the rationale for the existence of different types of VPHI. Data is collected on the population covered by VPHI, type and scope of coverage, suppliers of VPHI and their relations with health providers. It seems that the main roles of VPHI are to cover out-of-pocket payments for services that are only partly financed by the public health care system (complementary), and to provide preferential access to treatments that are also av...
Health Policy
The Nordic countries are healthcare systems with tax-based financing and ambitions for universal access to comprehensive services. This implies that distribution of healthcare resources should be based on individual needs, not on the ability to pay. Despite this ideological orientation, significant expansion in voluntary private health insurance (VPHI) contracts has occurred in recent decades. The development and role of VPHIs are different across the Nordic countries. Complementary VPHI plays a significant role in Denmark and in Finland. Supplementary VPHI is prominent in Norway and Sweden. The aim of this paper is to explore drivers behind the developments of the VPHI markets in the Nordic countries. We analyze the developments in terms of the following aspects: the performance of the statutory system (real or perceived), lack of coverage in certain areas of healthcare, governmental interventions or inability to reform the system, policy trends and the general socio-cultural environment, and policy responses to voting behavior or lobbying by certain interest groups. It seems that the early developments in VPHI markets have been an answer to the gaps in the national health systems created by institutional contexts, political decisions, and cultural interpretations on the functioning of the system. However, once the market is created it introduces new dynamics that have less to do with gaps and inflexibilities and more with cultural factors.
Compulsory Health Insurance: Comparative Analysis of Two European Countries
Emerging Markets Economics and Business: Proceedings of the 12th International Conference of Doctoral Students and Young Researchers, 2021
The compulsory health insurance institute is part of the healthcare financing scheme in several European countries. Despite this element, the form of regulation of this institute varies from country to country. The aim of the paper is to use a comparative analysis to point out the differences between compulsory health insurance in the market of the Slovak Republic and in the Czech Republic. The subject of the research is the regulation of compulsory health insurance. The countries of Slovakia and the Czech Republic serve as the object of the research. In these countries, despite their common history, the form of compulsory health insurance is different. The results point to several differences in the regulation of compulsory health insurance between countries. The conclusion of the article also makes recommendations for improving the financing of health care in Slovakia.
Statutory health insurance competition in Europe: A four-country comparison
Health Policy, 2013
This paper explores the goals and implementation of reforms introducing choice of and competition among insurers providing statutory health coverage in Belgium, Germany, the Netherlands and Switzerland. In theory, health insurance competition can enhance efficiency in health care administration and delivery only if people have free choice of insurer (consumer mobility), if insurers do not have incentives to select risks, and if insurers are able to influence health service quality and costs. In practice, reforms in the four countries have not always prioritised efficiency and implementation has varied. Differences in policy goals explain some but not all of the differences in implementation. Despite significant investment in risk adjustment, incentives for risk selection remain and consumer mobility is not evenly distributed across the population. Better risk adjustment might make it easier for older and less healthy people to change insurer. Policy makers could also do more to prevent insurers from linking the sale of statutory and voluntary health insurance, particularly where take-up of voluntary coverage is widespread. Collective negotiation between insurers and providers in Belgium, Germany and Switzerland curbs insurers' ability to influence health care quality and costs. Nevertheless, while insurers in the Netherlands have good access to efficiency-enhancing tools, data and capacity constraints and resistance from stakeholders limit the extent to which tools are used. The experience of these countries offers an important lesson to other countries: it is not straightforward to put in place the conditions under which health insurance competition can enhance efficiency. Policy makers should not, therefore, underestimate the challenges involved.
Low demand for substitutive voluntary health insurance in Germany
Croatian Medical Journal
To examine why the demand for substitutive voluntary health insurance in Germany is low. Method. A comparison of the benefits and costs of statutory and voluntary health insurance in Germany, based on a review of literature published in academic journals and books as well as gray literature. Results. Employees in Germany with gross earnings over 40,500 a year can choose to opt out of the statutory health insurance scheme (Gesetzliche Krankenversicherung, GKV) and purchase substitutive voluntary health insurance instead. Only a quarter of these employees and their dependants actually choose to opt out; the majority remain in the GKV. Substitutive voluntary health insurance does not generally afford greater benefits than the GKV in terms of services provided or choice of insurer and only affords marginal benefits in terms of choice of provider. It is also more expensive than the GKV for people with dependants, elderly people and people in poor health. Consequently, the choice to opt out and purchase substitutive voluntary health insurance is more likely to be taken by young, healthy or single people or couples with double incomes. Conclusion. Our analysis suggests that the demand for substitutive voluntary health insurance in Germany is low because the costs of opting out of the GKV are, in general, higher than the benefits afforded by purchasing substitutive voluntary health insurance. In the long term substitutive voluntary health insurance does not appear to provide good value for money when compared to the GKV, particularly for people with dependants, elderly people, and people in poor health.