Global Marketplace for Private Health Insurance
532 Pages

Global Marketplace for Private Health Insurance


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Financial protection against the cost of illness and inclusion of vulnerable groups - will require better mobilization and use of private means. Private voluntary health insurance already plays an important role in mobilizing additional resources to the health sector and protecting against the catastrophic cost of illness in some countries. This review explores the context under which private voluntary health insurance could contribute to an improvement in the sustainability of the health sector and financial protection in other countries.



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Published 18 November 2009
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EAN13 9780821376775
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Global Marketplace
for Private Health Insurance
Strength in Numbers
Alexander S. Preker
Peter Zweifel
Onno P. SchellekensGlobal Marketplace for Private
Health InsuranceGlobal Marketplace for Private
Health Insurance
Strength in Numbers
Alexander S. Preker, Peter Zweifel,
and Onno P. Schellekens
Washington, D.C.© 2010 The International Bank for Reconstruction and Development / The World Bank
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ISBN: 978-0-8213-7507-5
e-ISBN: 978-0-8213-7677-5
DOI: 10.1596/978-0-8213-7507-5
Library of Congress Cataloging-in-Publication Data
Global marketplace for private health insurance : strength in numbers / Alexander S. Preker, Peter
Zweifel, and Onno P. Schellekens, eds.
p. cm.—(Health, nutrition and population series)
Includes bibliographical references and index.
ISBN-13: 978-0-8213-7507-5 (alk. paper); e-ISBN: 978-0-8213-7677-5
1. Insurance, Health—Economic aspects—Developing countries. I. Preker, Alexander S., 1951–
II. Zweifel, Peter. 1946– III. Schellekens, Onno P., 1964– IV. World Bank.
[DNLM: 1. Insurance, Health—economics. 2. Health Expenditures. 3. Models, Econometric. 4.
Private Sector. 5. World Health. W 100 G562 2008]
RA413.5.D44G56 2008368.38’2--dc22
Foreword xvii
Preface xix
Acknowledgments xxxi
Abbreviations and Acronyms xxxiii
1. Introduction: Strength in Numbers 1
Alexander S. Preker, Onno P. Schellekens, and Marianne Lindner
Introduction 1
Policy Design 4
A New Paradigm for Financing Health Care 12
Implementation Challenges 20
References 23
2. Six Regions, One Story 29
Denis Drechsler and Johannes P. Jütting
Introduction 29
Typology of Health Care Financing 33
Evidence of PHI in Low- and Middle-Income Countries 38
Outlook 85
Annex 2A WHO Data on Health Care Expenditure 88
between 1998 and 2002
Annex 2B Country Groups according to 2005 92
World Bank Classifi cation
Annex 2C PHI Spending, by Country Group 94
Annex 2D Non–Life and Life Insurance around the World 95
Notes 98
References 99
3. From Theory to Practice 107
Peter Zweifel
Introduction 107
Review of the Theoretical Predictions 108
Evidence from the Country Studies 121
Conclusions and Outlook 131
vvi Contents
Annex 3A Overview of Hypotheses and Results of Tests 133
Notes 139
4. Chile 143
Ricardo A. Bitrán and Rodrigo Muñoz
Introduction 143
Objectives and Methodology 146
Results 149
Conclusions 153
Annex 4A Statistical Tables 155
Notes 162
References 162
5. Egypt 163
Heba Nassar and Sameh El-Saharty
Introduction 163
Health Financing in Egypt 165
Status of Health Insurance in Egypt 166
Key Issues and Major Constraints related to 172
Health Care Financing in Egypt
Assessing the Potential for VHI 173
Conclusions and Recommendations 179
Annex 5A Statistical Tables 184
Notes 187
References 188
6. South Africa 189
Michael Thiede and Vimbayi Mutyambizi
Introduction 189
Situational Analysis of Health Financing in South Africa 190
The Private Sector 193
Financial Protection and Financial Vulnerability 199
Determinants of Utilization 202
Health Reform in South Africa 206
Challenges 207
References 207
7. Thailand 211
Siripen Supakankunti
Introduction 211
On Private Health Insurance 212
System, Mechanism, and Regulation 216 Contents vii
Business Environment 218
Problems and Constraints in Health Care Financing 219
Quantitative Analyses 221
Interpretation of the Results and Conclusions 230
Limitations and Suggestions 230
Notes 231
8. Turkey 233
Anna Cederberg Heard and Ajay Mahal
Introduction 233
Data and Methodology 238
Results 243
Conclusions and Policy Implications 250
Note 251
9. United States 253
M. Kate Bundorf and Mark V. Pauly
Introduction 253
Methods 254
Results 255
Conclusions 259
Notes 260
10. China 263
Teh-wei Hu and Xiao-hua Ying
Introduction 263
Background of China’s Health Care Financing System 266
Private Health Insurance in China Today 268
Key Issues of Health Care Financing in China 271
Determinants of Private Health Insurance Enrolment 272
Demand for Private Health Insurance: 278
Willingness to Pay and Ability to Pay
Potential Private Health Insurance Market 284
Policy Options and Conclusions 288
Notes 290
11. Brazil 293
Bernard F. Couttolenc and Alexandre C. Nicolella
Introduction 293
The Brazilian Context 293viii Contents
Key Issues Related to Health Care Financing 304
Policy Options 308
Conclusions 319
Annex 11A Financial Flows in the Brazilian Health Sector 321
Annex 11B Regression Results 322
Notes 323
References 324
12. India 327
Peter A. Berman, Rajeev Ahuja, and Vijaysekar Kalavakonda
Introduction 327
Overview 328
Financial Feasibility of PVHI 335
Some Policy Issues and Concerns 342
Conclusions 343
Notes 344
References 347
13. Nigeria 349
Obinna Onwujekwe and Edit V. Velényi
Introduction 349
Research Methodology 351
Results 355
Discussion 364
Note 365
14. Slovenia 369
Maks Tajnikar and Petra Došenovic ˇ Bonc ˇa
Introduction 369
The Slovenian Context 370
Health Insurance in Slovenia and the Advent of VHI 377
Issues Raised in the Development of VHI in Slovenia 380
Impact of VHI on the Effi ciency of Primary Care Providers 392
Conclusions: The Future and the Reforms Needed 395
in Slovenia’s Voluntary Health Insurance
Note 398
References 399
15. Republic of Korea 401
Kee Taig Jung
Introduction 401
The Korean Health Care System 402
NHI Financial Distress 405
Expansion of the Private Health Insurance Market 408
The Evaluation Study 411