The Health Insurance Flexibility and Accountability (HIFA) demonstration initiative is a significant milestone in the evolution of the states’ ability to use section 1115 of the Social Security Act. Section 1115 gives the Secretary of the U.S. Department of Health and Human Services (HHS) the discretion to let states modify Medicaid and the State Children’s Health Insurance Program (SCHIP) by w...

There has been less controversy over the ownership of care provider agencies, but interest has grown over the last decade. State and Territory governments claim different views but all have transferred work to the private sector, ranging from outsourcing of particular functions (like cleaning) to complete privatisation – where a private company builds, owns and operates a facility serving mainl...

Previous research based on the Community Tracking Study (CTS) showed that while coverage expansions through the State Children's Health Insurance Program (SCHIP) greatly increased children's eligibility for public or private health insurance coverage, uninsurance rates remained unchanged because of low take-up by eligible children. However, more recent data show that this is changing. Children'...

The survey of private medical care expenditures and voluntary health insurance, made annually by the Social Security Administration, has special interest this year because of the increased attention being given to mounting medical care costs. In the following article, trends in the relationship of medical care expenditures to disposable personal income and prices are examined, as well as the tr...

One of the animating beliefs of British health service reformers in the first half of the twentieth century was that delivery would improve if greater co-ordination was imposed over disparate providers. The fundamental divisions were between the voluntary, public and private sectors. Voluntary provision predominantly meant acute care hospitals, but also included a range of other therapeutic and...

Private insurance plays a minor role in paying for pharmaceuticals in New Zealand, despite controversy about access through the public health system. The present study examines New Zealand consumers' perceptions of private insurance for pharmaceuticals. A self-administered questionnaire was completed by 433 consumers at thirty pharmacies. The questionnaire included 18 questions on demographics,...

In Malta, the health system is hybrid, with similarities to both UK system and the US system, where the National Health Service is supplemented by private practice. This is widely performed either as a primary job or as a supplement to a government salary. This article reviews unfavourable secular trends in Maltese fertility, births, marriages, separations, single parenthood and loans incurred ...

A ubiquitous form of government intervention in insurance markets is to provide compulsory, but partial, public insurance coverage and to allow voluntary purchases of supplementary private insurance. This paper investigates the effects of such programs on insurance coverage for the risks not covered by the public program, using the example of the US Medicare program. I find that Medicare does n...