Social Health Insurance for Developing Nations

Social Health Insurance for Developing Nations PDF

Author: R. Paul Shaw

Publisher: World Bank Publications

Published: 2007-01-01

Total Pages: 188

ISBN-13: 0821369504

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Specialist groups have often advised health ministers and other decision makers in developing countries on the use of social health insurance (SHI) as a way of mobilizing revenue for health, reforming health sector performance, and providing universal coverage. This book reviews the specific design and implementation challenges facing SHI in low- and middle-income countries and presents case studies on Ghana, Kenya, Philippines, Colombia, and Thailand.

Coverage Matters

Coverage Matters PDF

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2001-10-27

Total Pages: 204

ISBN-13: 0309076099

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Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

The Theory of Social Health Insurance

The Theory of Social Health Insurance PDF

Author: Peter Zweifel

Publisher: Now Publishers Inc

Published: 2007

Total Pages: 104

ISBN-13: 1601980167

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The Theory of Social Health Insurance develops the theory of social health insurance also known as public health insurance. While a good deal is known about the demand and supply of private insurance, the theoretical basis of social health insurance is much more fragile. The Theory of Social Health Insurance examines questions including why does social health insurance exist and even dominate private health insurance in most developed countries? What are the objectives and constraints of social health insurance managers? What is the likely outcome or "performance" of social health insurance? The Theory of Social Health Insurance reviews the conventional theory of demand for insurance and health insurance, the supply of health insurance in general and social health insurance in particular, the properties of the optimal health insurance contract, and whether there are factors limiting the growth of social health insurance.

Care Without Coverage

Care Without Coverage PDF

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2002-06-20

Total Pages: 213

ISBN-13: 0309083435

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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Impact of Health Insurance in Low- and Middle-income Countries

Impact of Health Insurance in Low- and Middle-income Countries PDF

Author: Maria-Luisa Escobar

Publisher: Brookings Institution Press

Published: 2010

Total Pages: 239

ISBN-13: 0815705468

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Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance-based care is key to the public policy debate of whether to extend insurance to low-income populationsand if so, how to do itor to serve them through other means.

Integrating Social Care into the Delivery of Health Care

Integrating Social Care into the Delivery of Health Care PDF

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2019-12-30

Total Pages: 195

ISBN-13: 0309493463

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Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.

The Affordable Care Act

The Affordable Care Act PDF

Author: Tamara Thompson

Publisher: Greenhaven Publishing LLC

Published: 2014-12-02

Total Pages: 130

ISBN-13: 0737776196

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The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination PDF

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-04-02

Total Pages: 161

ISBN-13: 030946921X

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The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Moving Toward Universal Coverage of Social Health Insurance in Vietnam

Moving Toward Universal Coverage of Social Health Insurance in Vietnam PDF

Author: Aparnaa Somanathan

Publisher: World Bank Publications

Published: 2014-07-07

Total Pages: 177

ISBN-13: 1464802610

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Over the past two decades Vietnam has made enormous progress to expand health insurance coverage to its population. Further progress will require significant additional public financing, as well as efforts improve efficiency and strengthen insurance organization and management. It contains recommendations and next steps for Vietnam to follow.