Beginning in 2014, an exchange will be established in each state to help consumers make valid comparisons between plans that are certified to have met benchmarks for quality and affordability. The exchanges will also administer the new health insurance subsidies and facilitate enrollment in private health insurance, Medicaid, and the Children’s Health Insurance Program (CHIP). Nobody will be re...

This report examines the major forms of administration of private health insurance plans. Plans are classified according to whether they are employer-only or joint worker-employer-operated and according to whether they are negotiated or not. A further focus of examination that often reflects industry patterns is whether the plans cover workers of a single employer or involve multi-employer arra...

AIMS To analyse inequalities by social class in children's access to and utilisation of health services in Catalonia (Spain), private health insurance coverage, and certain aspects of the quality of care received. DESIGN Cross sectional study using data from the 1994 Catalan Health Interview Survey. SETTING Child population of Catalonia. PARTICIPANTS A representative sample of non-institu...

We investigate whether people enrolled into voluntary health insurance (VHI) substitute public consumption with private (opt out) or just enlarge their private consumption, without reducing reliance upon public provisions (top up). We study the case of Italy, where a mixed insurance system is in place. To this purpose, we specify a joint model for public and private specialist visits counts, an...

This paper studies risk selection between public and private health insurance when some, but not all, individuals can opt out of otherwise mandatory public insurance. Using a theoretical model, I show that public insurance is adversely selected when insurers and insureds are symmetrically informed about health-related risks, and that there can be adverse or advantageous selection when insureds ...

The objective of this study was to estimate catastrophic healthcare expenditure in Brazil, using different definitions, and to identify vulnerability indicators. Data from the 2002-2003 Brazilian Household Budget Survey were used to derive total household consumption, health expenditure and household income. Socioeconomic position was defined by quintiles of the National Economic Indicator usin...

We empirically examine how the decision to purchase private health insurance and hospitalization are made based on labor income, socio-demographic factors, and private health insurance. The increase in household labor income and wealth has a positive effect on purchasing private health insurance. This suggests a supplementary effect for public health insurance under the strict control of a two-...

Steady growth in the number of uninsured and under-insured has sparked health reform proposals at the national and state levels. With many proposals emphasizing expanded access to private health insurance among the low-income population through the use of tax credits and an emphasis on stable and continuous primary care as a key to improving health care access, the interaction between health ce...

This paper analyses the political support for a social insurance that includes elements of redistribution when there exists an imperfect private insurance alternative. Individuals differ both in their income and risk. The social insurance is compulsory and charges an income-related contribution with pooling of risks. The private insurance is voluntary and charges a contribution based on individ...

Since 1996, an increasing proportion of federal government expenditure has been directed into Australia's healthcare system via private health insurance (PHI) subsidies, in preference to Medicare and the direct funding of public health services. A central rationale for this policy shift is to increase the use of private hospital services and thereby reduce pressure on public inpatient facilitie...