Europe and Central Asia - Health insurance and competition

Health financing systems in some Europe and Central Asia (ECA) countries are undergoing some major reforms. In parallel with the transition from central planning to develop market-based economies, countries in Central Europe have moved within a relatively short period of time from having health systems that were government managed and funded by taxes to single health insurance systems that are payroll-funded. The next chapter (chapter two) describes the insurance context in Austria, the Netherlands, Slovakia, and Switzerland. Chapter three examines risk selection in a multiple insurance system. Risk-adjusters and equalization schemes in different countries are discussed as well as the resulting incentives for insurance companies to develop cost containment strategies. Chapter four discusses whether and how insurers compete for providers, including the different forms of managed care contracts that have evolved under multiple insurance and the impact of such contracts on policy goals. Chapter five describes consumer choice in different health financing systems and whether consumers are exercising their choice to switch insurers and plans. Chapter six presents an overview of the different options for insurance reforms. The final chapter will identify the main lessons drawn from the preceding chapters and will present potential policy solutions for increasing the effectiveness of insurance systems, including the necessary regulatory framework to prevent adverse effects, purchasing, improved risk pooling, and monitoring and evaluation systems.

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Bibliographic Details
Main Author: World Bank
Language:English
Published: World Bank 2009-05-05
Subjects:ADMINISTRATIVE COSTS, ADMINISTRATIVE EFFICIENCY, ADMINISTRATIVE EXPENSES, AGE GROUPS, AGED, AGENTS, ALTERNATIVE MEDICINE, ASSURANCE, BASIC HEALTH SERVICES, BUDGET CONSTRAINTS, CAPITATION, CARE INSTITUTIONS, CARE PLANS, CENTRAL GOVERNMENT, CITIES, COMMUNITY RATING, COMPENSATION, COMPETITION AMONG HEALTH CARE PROVIDERS, COMPETITION AMONG INSURERS, COMPETITION AMONG PROVIDERS, COMPETITION BETWEEN INSURERS, COMPETITIVE ENVIRONMENT, CONSUMER PROTECTION, CONSUMERS, CONTRIBUTION RATE, CONTRIBUTION RATES, COST CONTROL, COST SHARING, COST-SHARING ARRANGEMENTS, DEBT, DENTAL CARE, DIABETES, DOCTORS, EXPENDITURES, FEE-FOR-SERVICE, FEE-FOR-SERVICE SYSTEM, FINANCIAL CONTRIBUTIONS, FINANCIAL INCENTIVE, FINANCIAL INCENTIVES, FINANCIAL MANAGEMENT, FINANCIAL MARKETS, FINANCIAL RISK, FINANCIAL RISKS, FREE CHOICE, GENERAL PRACTITIONERS, GROUP INSURANCE, HEALTH CARE, HEALTH CARE CENTERS, HEALTH CARE COSTS, HEALTH CARE EXPENDITURE, HEALTH CARE EXPENDITURES, HEALTH CARE FINANCE, HEALTH CARE PERSONNEL, HEALTH CARE PRODUCTS, HEALTH CARE PROVIDERS, HEALTH CARE REFORM, HEALTH CARE REFORMS, HEALTH CARE SECTOR, HEALTH CARE SERVICES, HEALTH CARE SPENDING, HEALTH CARE SYSTEM, HEALTH CARE SYSTEMS, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FINANCING, HEALTH FINANCING SYSTEM, HEALTH INFORMATION, HEALTH INSURANCE, HEALTH INSURANCE EXPENDITURE, HEALTH INSURANCE FUND, HEALTH INSURANCE FUNDS, HEALTH INSURANCE POLICIES, HEALTH INSURANCE SCHEME, HEALTH INSURANCE SYSTEM, HEALTH INSURERS, HEALTH MANAGEMENT, HEALTH NEEDS, HEALTH PLAN, HEALTH PLANS, HEALTH POLICY, HEALTH SECTOR, HEALTH SERVICES, HEALTH SPENDING, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEMS, HMO, HMOS, HOSPITAL BEDS, HOSPITAL REVENUES, HOSPITAL ROOMS, HOSPITALIZATION, HOSPITALS, HOUSEHOLD INCOME, HUMAN DEVELOPMENT, INCENTIVES FOR EFFICIENCY, INCENTIVES FOR PROVIDERS, INCOME GROUPS, INFLATION, INPATIENT CARE, INSURANCE CLAIMS, INSURANCE COMPANIES, INSURANCE COMPETITION, INSURANCE COVERAGE, INSURANCE EXPENDITURES, INSURANCE INDUSTRY, INSURANCE LAW, INSURANCE PACKAGE, INSURANCE PLAN, INSURANCE PREMIUMS, INSURANCE REGULATION, INSURANCE RISK, INSURANCE SUPERVISION, INSURANCE SYSTEM, INSURANCE SYSTEMS, INSURERS, INTEGRATION, LAWS, LEGAL FRAMEWORK, LEVEL PLAYING FIELD, LIFE INSURANCE, MANAGED CARE, MANAGED CARE PLANS, MANAGED COMPETITION, MEDICAL CARE, MEDICAL CONDITIONS, MEDICAL EXPENSES, MEDICAL SERVICES, MEDICAL SPECIALISTS, MEDICAL TECHNOLOGY, MENTAL ILLNESS, MORTALITY, MULTIPLE INSURANCE SYSTEMS, MULTIPLE INSURERS, NATIONAL HEALTH, NATIONAL HEALTH INSURANCE, NATIONAL HEALTH SERVICE, NON-LIFE INSURANCE, NURSES, OUTPATIENT CARE, PATIENT, PATIENT TREATMENT, PATIENTS, PAYMENTS FOR HEALTH SERVICES, PHARMACEUTICAL EXPENDITURES, PHARMACIES, PHARMACISTS, PHARMACY, PHYSICIAN, PHYSICIANS, PHYSIOTHERAPISTS, PHYSIOTHERAPY, POCKET PAYMENTS, PRIMARY CARE, PRIMARY HEALTH CARE, PRIVATE HEALTH INSURANCE, PRIVATE HOSPITALS, PRIVATE INSURANCE, PRIVATE INSURANCE COMPANIES, PROGRAMS, PROVIDER PAYMENT, PROVISION OF CARE, PUBLIC HEALTH, PUBLIC HOSPITAL, PUBLIC INSURERS, PUBLIC PROVIDERS, QUALITY CONTROL, REGULATORY AGENCIES, REHABILITATION, RISK ADJUSTMENT, RISK EQUALIZATION, RISK FACTORS, RISK GROUPS, RISK MITIGATION, RISK PROFILES, SAVINGS, SICK LEAVE, SOCIAL ASSISTANCE, SOCIAL HEALTH INSURANCE, SOCIAL INSURANCE, SOCIAL INSURANCE CONTRIBUTIONS, SOCIAL SECURITY, SOLVENCY, SUPERVISORY AUTHORITIES, SURGERY, SUSTAINABILITY, UNEMPLOYMENT, USE OF HEALTH SERVICES, WORKERS, YOUNG ADULTS,
Online Access:http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000333037_20090709000918
https://hdl.handle.net/10986/3064
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