Browsing by Subject "Health insurance"

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Economic problems of health insurance : reforms and competition
(2016) Lange, Renate; Schiller, Jörg
Although most modern societies agree that everyone should receive adequate access to medical treatment, health care systems worldwide vary greatly in terms of financing of health care costs, the provision of medical services, and regulatory aspects. Rising costs, economic downturns, and the demographic development have embraced the call for change particularly with regard to financing of health care costs and access to health insurance. Most health care systems have developed historically, but underwent fundamental changes as a consequence of policy decisions and reforms. Looking back on recent health reforms in the U.S. and Germany two divergent trends can be observed: Over the last two decades, German Statutory Health Insurance (SHI) primarily experienced benefit cuts and had to implement economic incentives and market-based instruments to a solidary-based social security model in order to overall contain costs. At the same time, recent health reforms in the U.S. have shown that a solely market-based health insurance system is hardly consistent with modern society’s ideas on fairness and distributive justice. Furthermore, the exclusion of large parts of the population from seeking health insurance as a result of high premiums is not only associated with high costs and negative effects (even for those holding insurance coverage), but overall seen as highly inefficient. This thesis aims to draw a comprehensive picture of economic problems of health insurance and, thereby, assesses economic goals and analyzes effects of recent health reforms in the two historically grown very different health insurance systems of Germany and the U.S. More specifically, three research questions will be addressed: First, looking at the demand for supplemental health insurance (SuppHI) in the aftermath of benefit reductions in German SHI, it investigates what factors drive the demand for SuppHI and what are possible sources of selection. Furthermore, this thesis offers new insights on what the two health insurance systems can learn and take over from each other. In this context, it discusses how new trends in health insurance in the U.S. (i.e. Health Savings Accounts (HSAs)) could be implemented in German SHI. The third focus of this thesis is on the mutual interdependence of public and private health insurance markets. Analyzing financial data of private health insurers in the U.S., it looks into the question of how premiums in Private Health Insurance (PHI) are affected by public health insurance programs (i.e. Medicaid).