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At least 649 records · Page 36Linked to original sources
PubMed2002

The effect of drug co-payment policy on the purchase of prescription drugs for children with infections in the community.

A cross-sectional study was conducted to investigate the influence of the co-payment policy in a community setting on the purchase of prescription medications for children with acute infections. Data for all purchased medications prescribed for children with an acute infectious disease were gathered from a pediatric health care center over a 6-week period. Parents of the sick children and controls were interviewed by telephone, using a short sociodemographic questionnaire, and were asked to state their reasons for not purchasing (either partially or completely) necessary medications, primarily antibiotics. Of the 779 children who received a prescription for antibiotics during the 6-week period, 162 (20.7%) failed to take the complete course of antibiotic treatment. One hundred and one parents of these children (62.3%) were interviewed, of whom 30 (29.7%) claimed that the main reason for not buying the full course of antibiotic medication was the cost. This group is characterized by low income, overcrowded housing conditions and a large quantity of prescription medications. The cost of prescribed medication under the co-payment policy is a serious barrier to the purchase of prescribed medication for children with acute infections in the primary care setting. The policy has a particularly deleterious effect in under-privileged populations and is in contradiction with the proclaimed principles of justice and equality underlying the obligatory Israeli National Israeli Health Insurance Law and similar laws in other western countries.

Acute Disease↗
PubMed1987

Health insurance and the demand for medical care: evidence from a randomized experiment.

We estimate how cost sharing, the portion of the bill the patient pays, affects the demand for medical services. The data come from a randomized experiment. A catastrophic insurance plan reduces expenditures 31 percent relative to zero out-of-pocket price. The price elasticity is approximately -0.2. We reject the hypothesis that less favorable coverage of outpatient services increases total expenditure (for example, by deterring preventive care or inducing hospitalization).

Analysis of Variance↗
PubMed1996

Health insurance: the tradeoff between risk pooling and moral hazard.

Choosing optimal health insurance coverage involves a trade-off between the gain from risk reduction and the deadweight loss from moral hazard. This paper examines this trade-off empirically by estimating both the demand for health insurance and the demand for health services. It relies on data from a randomized controlled trial of cost-sharing's effects on the use of health services and on the health status for a general, non-elderly population.

Actuarial Analysis↗
PubMed1996

Can MSAs help reduce healthcare costs?

Medical savings accounts (MSAs) have been proposed as one possible solution to the problem of escalating healthcare costs. Because MSAs allow consumers to shop for healthcare services and negotiate the cost, MSAs have the potential to restrain the rise in medical costs. This article compares MSAs to traditional insurance plans, highlighting the advantages and disadvantages of MSA.

Cost Sharing↗
PubMed1990

Illness-episode approach: costs and benefits of medigap insurance.

Over two-thirds of Medicare beneficiaries have private supplementary coverage, but few know enough about Medicare, their own supplements, or available alternatives to make intelligent comparisons and informed purchasing decisions. The illness-episode approach, a new way to provide insurance information to Medicare beneficiaries, calculates out-of-pocket costs likely to be faced by beneficiaries experiencing 13 illnesses, under Medicare alone and under different medigap policies. Applying the approach to six policies marketed in Los Angeles in 1986 revealed that plans varied widely in their ability to reduce financial vulnerability; many still leave the elderly with substantial out-of-pocket costs.

Community Participation↗
PubMed1991

Effects of cost sharing in health insurance on disability days.

We assess how cost sharing for medical services affects restricted activity days (RADs) and work loss disability days (WLDs), using data from a controlled experiment. We grouped the experimental insurance plans into four categories, one providing free care and the other three requiring varying amounts of cost sharing. RADs per person per year decreased by one to two days with greater cost sharing, with the strongest effects among those of average or poor health status, especially the non-poor. Unlike RADs, WLDs showed no systematic differences by plan.

Absenteeism↗
PubMed2001

A guide to understanding long-term care insurance.

Long-term care insurance is an increasingly popular benefit that has a number of advantages for both employers and employees. This coverage can protect employee assets and retirement savings and can be offered as a tax-free benefit if the plan is qualified. The premiums can be tax-deductible to employees, and the benefit is portable, since the policy is owned by the employee.

Guidelines as Topic↗
PubMed1985

Who are the underinsured?

Inadequate insurance, whether private or public, can impose ruinous private hardship and unexpected public burdens. "Who are the underinsured?" is both a definitional and an empirical question. Data from the National Medical Care Expenditure Survey, applied under various concepts of risk and expense, reveal that over a quarter of the nonelderly population is inadequately protected against the possibility of large medical bills. The private burdens of the underinsured are widely distributed across the population.

Actuarial Analysis↗
PubMed1976

Issues in national health insurance.

Health insurance, by reducing net price to the consumer and increasing the opportunities for revenue to the provider, has profound effects, among other things, on the volume, content and distribution of services, their prices, and the capacity of providers to produce them. The magnitude and nature of these effects depend, partly, on the design of insurance benefits and, partly, on the nature of the health care system, particularly its current and potential capacity and the methods it uses to pay providers. Those who believe that the unique aim of insurance is to protect against unpredictable expenses attempt to suppress these effects, mainly by imposing financial disincentives to utilization which, in turn, reduce protection for those who need it most. Those who wish to reform the system have a broader range of objectives which include protective efficacy, cost control, quantitative adequacy, qualitative adequacy, efficiency of production, efficiency of allocation, equity, and redistribution of capacity. An analysis of the effects of insurance in the light of these objectives reveals favorable as well as unfavorable consequences. The provision of comprehensive benefits generates the necessity for a fundamental change in the organization of health services, if the advantages are to be fully realized and the disadvantages minimized.

Deductibles and Coinsurance↗
PubMed1997

[Health insurance in the Russian Federation].

The need to reform health care in Russia became evident in the late 1980s when due to socioeconomic crisis, the government could not cover the expenses connected with this field and put the up-to-date expensive technologies into life. The introduction of the compulsory health insurance system (CHIS) is aimed at: 1) obtaining an additional financial source for health care by making the goal-oriented stable rates of deductions from the wage fund; 2) protecting the Russian Federation citizens' rights to have free medical aid of the guaranteed scope; 3) enhancing the quality of medial care delivered to the population by introducing a mechanism of movement of funds paid for a patient; 4) paying for medical care in relation to the volume and quality of the work done by simultaneously controlling the stipulated use of funds. Three-year experience of CHIS in Russia has indicated that there is a real mechanism of reformation and government regulation of health care under the conditions of transition to the market, with the interests of the general population and medical personnel in mind. Obvious legal, organizational, technological, and psychological problems and disadvantages have been found at all management levels, which are an obstacle in the way of the reforms and which whip up social tension and call for prompt decisions.

Adolescent↗
PubMed1999

Medical savings accounts: microsimulation results from a model with adverse selection.

This paper examines medical savings accounts combined with high-deductible catastrophic health plans (MSA/CHPs), exploring the possible consequences of making tax preferred MSA/CHPs available to the entire employment-related health insurance market. The paper uses microsimulation methods to examine the equilibrium effects of MSA/CHPs on health care and non-health care expenditures, tax revenues, insurance premiums, and exposure to risk. If MSA/CHPs are offered alongside comprehensive plans, biased MSA/CHP enrollment can lead to premium spirals that drive out comprehensive coverage. Our estimates also raise concerns about equity, insofar as those who stand to lose the most tend to be poorer and in families with infant children.

Demography↗