Private voluntary health insurance in development : friend or foe? / editors, Alexander S. Preker, Richard M. Scheffler, and Mark C. Bassett.

Format:

Book

Government document

Contributor:

Preker, Alexander S., 1951-

Scheffler, Richard M.

Bassett, Mark C., 1957-

Language:

English

Subjects (All):

Health insurance--Developing countries.

Health insurance.

Developing countries.

Physical Description:

xxvii, 424 pages : illustrations ; 26 cm

Place of Publication:

Washington, D.C. : World Bank, [2007]

Summary:

Private voluntary health insurance already plays an important role in the health sector of many low and middle income countries. The book reviews the context under which private insurance could contribute to an improvement in the financial sustainability of the health sector, financial protection against the costs of illness, household income smoothing, access to care, and market productivity. This volume is the third in aseries of in-depth reviews of the role of health care financing in providing access for low-income populations to needed healthcare, protecting them from the impoverishing effects of illness, and addressing the important issues of social exclusion in government financed programs.

Contents:

1 The Evolution of Health InsuranceinDeveloping Countries / Alexander S. Preker 1

Objectives of Review 6

Methodology 7

Review of Opportunities for Expanding VHI Markets 12

Annex: Model Specification for Impact Evaluation Studies 16

Part I Economic Underpinnings 23

2 Insights on Demand for Private Voluntary Health Insurance in Less Developed Countries / Mark V. Pauly 25

Toward an Applicable Theory of Medical Insurance Demand 26

The Theory of Insurance Demand 27

When Is Insurance Most Valuable? 31

Moral Hazard: What If Insurance Affects the Amount of Loss? 32

Insurance Demand- and Supply-Side Cost Sharing 36

Adverse Selection and Voluntary Insurance Markets 36

Cream Skimming and Demand 39

Insurance Reserves and Demand 39

Group Insurance Demand 41

Effect of Insurance Subsidies on Demand 42

Demand for Protection against Risk Reclassification 42

Health Insurance, Income, and Demand 43

New Technology, Cost Containment, and Insurance Demand 44

Other Reasons for Nonpurchase of Insurance or Market Failure 45

Applying Theory to Demand for Health Insurance in Developing Countries 48

3 Supply of Private Voluntary Health Insurance in Low-Income Countries / Peter Zweifel, Boris B. Krey, Maurizio Tagli 55

Benefit Package 56

Risk Selection Effort 65

Loading 68

Vertical Restraints/Vertical Integration 78

Annex 3A Types and Efficiency Effects of Regulation 100

Annex 3B Corruption 105

Annex 3C Quality of Governance 106

4 Market Outcomes, Regulation, and Policy Recommendations / Peter Zweifel, Mark V. Pauly 115

Market Equilibria in Voluntary Insurance Markets 116

Structure and Intensity of Regulation of Health Insurance 117

Policy Recommendations 125

Subsidized and Regulated Insurance 134

Ideal and Alternative Public-Private Combinations 135

Ideal Model of Private Insurance Purchasing and Markets in LICs 141

5 Provision of a Public Benefit Package alongside Private Voluntary Health Insurance / Peter C. Smith 147

The Model 151

A Public Choice Perspective 160

6 Economics of Private Voluntary Health Insurance Revisited / Philip Musgrove 169

Why Is Demand for Insurance So Low? 170

What to Regulate and How to Regulate It 172

What Is the Optimal Subsidy? 174

How Might Voluntary Insurance Affect the Public Package of Care? 176

Part 2 Empirical Evidence 179

7 Scope, Limitations, and Policy Responses / Denis Drechsler, Johannes P. Jutting 181

Data and Methodology 182

Growth of Private Health Insurance in Low- and Middle-Income Countries 183

Regional Challenges to Integrating Private Health Insurance into a Health System 202

Conclusions and Outlook 205

8 Lessons for Developing Countries from the OECD / Francesca Colombo 211

Roles and Scope of Private Health Insurance in OECD Countries 212

Lessons for Developing Countries 229

9 Trends and Regulatory Challenges in Harnessing Private Voluntary Health Insurance / Neelam Sekhri, William D. Savedoff 241

Patterns of Health Financing 242

Experience with Private Health Insurance 246

Using Private Health Insurance to Serve the Public Interest 251

Part 3 From Theory to Practice 265

10 Financial and Management Best Practice in Private Voluntary Health Insurance / Roger Bowie, Gayle Adams 267

Voluntary Health Financing: Institutional Capacity from a Management Perspective 272

Institutional Capacity from a Technical, Financial, and Balance Sheet Perspective 279

Solvency 288

Regulation 289

Best Practices for Individual Insurers 291

Best Practices for an Insurance Industry 292

Voluntary Health Insurance in Developing Countries 293

11 Opportunities and Constraints in Management Practices in Sub-Saharan Africa / Ladi Awosika 297

Context of Voluntary Health Insurance in Sub-Saharan Africa 298

Voluntary Health Insurance in South Africa and in the Countries of West Africa and East Africa 301

Issues in South Africa 302

Issues in West Africa 303

Issues in East Africa 305

12 Facilitating and Safeguarding Regulation in Advanced Market Economies / Scott E. Harrington 309

Overview of Regulation in Advanced Market Economies 310

Solvency Regulation 311

Regulation of Pricing and Risk Selection 317

13 Financial and Other Regulatory Challenges in Low-Income Countries / Hernan L. Fuenzalida-Puelma, Vijay Kalavakonda, Monica Caceres 325

Out-of-Pocket Payments and Private Voluntary Health Insurance 325

General Challenges in Developing a PVHI Market 326

Regulatory Issues and Challenges in LICs 328

Regulatory and Supervisory Authority 332

Appendix Review of the Literature on Voluntary Private Health Insurance / Mark C. Bassett, Vincent M. Kane 335

Methods and Results 338

Definitions and Frameworks 343

Demand for Voluntary Health Insurance 354

Supply of Voluntary Health Insurance 361

Performance and Impact of Voluntary Health Insurance 366.

Notes:

Includes bibliographical references and index.

ISBN:

082136619X

0821366203

OCLC:

70167819

Publisher Number:

9780821366196