SIRN: Health Insurance (Topic)最新文献

{"title":"The CADES: It’s Found Again. What? – Eternity","authors":"Eric Pichet","doi":"10.2139/ssrn.3618985","DOIUrl":"https://doi.org/10.2139/ssrn.3618985","url":null,"abstract":"When France launched the CADES Welfare Debt Repayment Fund and the CRDS Welfare Debt Repayment Tax in 1996, the idea was this fiscal construct would enable a full redemption, by the year 2008, of all outstanding debt that the different branches of the French Social Security system had accumulated over the period 1993-1995. After several decisions pushing the Fund’s dissolution date back to 2024, the COVID-19 crisis having to contend with terrifying deficits in the country’s Health Insurance system, another reopening of the CADES fund was decided in May 2020 to 2033. What we announced in 2003 is now a reality de facto, the CADES fund and the CRDS tax are being turned into permanent fixtures in France’s budgetary and fiscal landscape.","PeriodicalId":423793,"journal":{"name":"SIRN: Health Insurance (Topic)","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123175868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financing State-Dependent Indivisible Expenses With Insurance","authors":"Markus Fels","doi":"10.2139/ssrn.3587649","DOIUrl":"https://doi.org/10.2139/ssrn.3587649","url":null,"abstract":"Standard economic theory interprets insurance as a means for risk-averse individuals to transfer risk. I argue that another important function of insurance is to optimally finance indivisible expenses that only have value in particular states of nature. Contrary to traditional predictions, insurance is then a normal good, the additional consumption of the covered goods and services by the insured is not a sign of inefficiency, and the marginal-utility gap between states is not informative about the value of insurance. Acknowledging this additional purpose of insurance requires a novel understanding of risk attitudes in general, and a reconsideration and possibly reevaluation of previous policy advice.","PeriodicalId":423793,"journal":{"name":"SIRN: Health Insurance (Topic)","volume":"12 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131893033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information Gaps and Health Insurance Enrollment: Evidence from Affordable Care Act Assister Programs","authors":"R. Myerson","doi":"10.2139/ssrn.3384980","DOIUrl":"https://doi.org/10.2139/ssrn.3384980","url":null,"abstract":"I study changes in health insurance coverage associated with a large government initiative to help people understand and compare their health insurance options. Funding for the initiative was not associated with increased rates of marketplace coverage, but was associated with increased uptake of free Medicaid coverage in expansion states. Novel data on the policy’s target population, people with low insurance literacy, show potential mechanisms: 69% had over-estimated the generosity of insurance, and 36% were income eligible for Medicaid but unaware. These findings demonstrate the importance of measuring the beliefs and characteristics of the targeted individuals when designing and evaluating policy.","PeriodicalId":423793,"journal":{"name":"SIRN: Health Insurance (Topic)","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131804855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incentivizing Efficient Utilization Without Reducing Access: The Case Against Cost-Sharing in Insurance","authors":"Markus Fels","doi":"10.2139/ssrn.2998636","DOIUrl":"https://doi.org/10.2139/ssrn.2998636","url":null,"abstract":"Cost-sharing is regarded as an important tool to reduce moral hazard in health insurance. Contrary to standard prediction, however, such requirements are found to decrease utilization both of efficient and of inefficient care. I employ a simple model that incorporates two possible explanations-consumer mistakes and limited access-to assess the welfare implications of different insurance designs. I find cost-sharing never to be an optimal solution as it produces two novel inefficiencies by limiting access. An alternative design, relying on bonuses, has no such side effects and achieves the same incentivization. I show how the optimal design can be deduced empirically and discuss possible impediments to its implementation.","PeriodicalId":423793,"journal":{"name":"SIRN: Health Insurance (Topic)","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123428125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cadillac Tax and Its Potential to Transform How Americans Purchase Health Care Services","authors":"R. Kaplan","doi":"10.2139/SSRN.2865794","DOIUrl":"https://doi.org/10.2139/SSRN.2865794","url":null,"abstract":"This Article examines one of the most contentious provisions of the Affordable Care Act – namely, the 40% excise tax on high-value health insurance provided by employers. This levy, commonly denominated the “Cadillac” tax, is scheduled to take effect in 2020 but has already induced many employers to raise annual deductibles on the health insurance they provide to reduce the value of such insurance and thereby lower their exposure to this new tax. After analyzing the administrative guidance proposed since the Cadillac tax’s enactment, this Article considers how that tax’s effective encouragement of high-deductible health insurance plans has inadvertently made the Health Savings Accounts that President George W. Bush promoted 15 years earlier much more appealing.","PeriodicalId":423793,"journal":{"name":"SIRN: Health Insurance (Topic)","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115950600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Do People Decide on Life Insurance and Long-Term Disability Insurance Coverage?","authors":"Norma B. Coe, Anek Belbase","doi":"10.2139/SSRN.2613065","DOIUrl":"https://doi.org/10.2139/SSRN.2613065","url":null,"abstract":"The group benefits landscape is changing dramatically. The menu of available options has grown; employers are paying for fewer benefits; and the responsibility for selecting the benefit package has been increasingly left to the employee. However, unlike in the pension world, very little is known about how individuals select their benefits packages, if their selections are optimal for their situations, or what employers can do to encourage the optimal benefit package selection. In this changing benefit landscape, it is important to determine three things: (1) What are current employer practices and their resulting take-up and coverage patterns?; (2) Which practices influence employees’ selections?; and (3) What can employers do to make the employees’ selections closer to the employees’ optimal choices? This first analysis allows us to peer into the black box of employee decision-making and identify what behavioral finance concepts are at play in the group benefits arena. Using information from 24 in-depth telephone interviews, we gain important insight into how employees determine whether to buy supplemental life and supplemental long-term disability insurance, how they decide how much to buy, what they liked and understood from their employer’s presentation, and what features might make these insurance benefits more appealing to the individual.","PeriodicalId":423793,"journal":{"name":"SIRN: Health Insurance (Topic)","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121478865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-of-Pocket Expenditures in Thailand","authors":"S. Limwattananon, Sven Neelsen, O. O’Donnell, P. Prakongsai, V. Tangcharoensathien, E. van Doorslaer, V. Vongmongkol","doi":"10.2139/ssrn.2265867","DOIUrl":"https://doi.org/10.2139/ssrn.2265867","url":null,"abstract":"We estimate the impact on health care utilization and out-of-pocket (OOP) expenditures of a major reform in Thailand that extended health insurance to one-quarter of the population to achieve universal coverage while keeping health spending below 4% of GDP. Identification is through comparison of changes in outcomes of groups to whom coverage was extended with those of public sector employees and their dependents whose coverage was not affected. The reform is estimated to have reduced the probability that a sick person goes without formal treatment by 3.2 percentage points (11%). It increased the probability of receiving public ambulatory care by 2.7 ppt (5%) and of admission to a public hospital by 1 ppt (18%). OOP expenditures were reduced by one-third on average, as was the probability of spending more than 10% of the household budget on health care, while spending at the very top of the OOP distribution was reduced by one-half representing substantial reductions in exposure to medical expenditure risk. Supply-side measures implemented with the coverage extension are likely to have helped realize these effects from an increased, but still very tight, budget.","PeriodicalId":423793,"journal":{"name":"SIRN: Health Insurance (Topic)","volume":"440 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132819650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"US Efforts to Realise the Right to Health Through the Patient Protection and Affordable Care Act","authors":"B. Meier, Lance Gable","doi":"10.1093/HRLR/NGS036","DOIUrl":"https://doi.org/10.1093/HRLR/NGS036","url":null,"abstract":"The political acceptance and policy implementation of the right to health long remained uncertain in the United States, leaving it until recently as the only developed nation without policies to realise universal health coverage. By reengaging longstanding debates on government obligations to secure the health of every American, the 2010 Patient Protection and Affordable Care Act (Affordable Care Act or ACA) draws on an internationally recognised conception of a human right to health, seeking to progressively realise the ‘highest attainable standard of physical and mental health’ through policies that ensure the availability, accessibility, acceptability, and quality of health care. With the US Supreme Court upholding the constitutionality of most key aspects of the Affordable Care Act, this precedent-setting decision has created an imperative for health care reform in the United States and a model for realising universal health coverage pursuant to the right to health. This article examines the evolution, implementation, and implications of US efforts to realise health-related rights through health care policy. In the evolution of norms for health, Part 2 examines the intertwined history of US development of a right to health in international law and implementation through national health care reforms. Culminating in the promulgation of the 2010 Affordable Care Act, Part 3 analyses how this national policy effort corresponds with the principles of the international right to health – even as it neglects any explicit recognition of the right to health. With the Affordable Care Act immediately challenged as a violation of the US Constitution, Part 4 looks to the first major challenges to the Affordable Care Act, analysing the Supreme Court’s decision on these challenges. As the Supreme Court has now largely upheld the government’s constitutional authority for health care reform, Part 5 considers the continuing challenges to the Affordable Care Act and the precedential impact of this decision on rights-based health reforms throughout the world. This article concludes with a hopeful assessment of the role of the United States as it moves progressively toward universal health coverage and frames an agenda for renewed American participation in global efforts to realise the highest attainable standard of health.","PeriodicalId":423793,"journal":{"name":"SIRN: Health Insurance (Topic)","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126552368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}