Private Voluntary Health Insurance

This book aims to help countries design and implement a legal framework for a viable private health insurance market, with rationale for insurance regulation, institutions involved, and standards and protections used in regulating private health insurance.

No two markets for voluntary health insurance (VHI) are identical. All differ in some way because they are heavily shaped by the nature and performance of publicly financed health systems and by the contexts in which they have evolved. This volume contains short structured profiles of markets for VHI in 34 countries in Europe. These are drawn from European Union member states plus Armenia Iceland Georgia Norway the Russian Federation Switzerland and Ukraine. The book is aimed at policy-makers and researchers interested in knowing more about how VHI works in practice in a wide range of contexts. Each profile written by one or more local experts identifies gaps in publicly-financed health coverage describes the role VHI plays outlines the way in which the market for VHI operates summarises public policy towards VHI including major developments over time and highlights national debates and challenges. The book is part of a study on VHI in Europe prepared jointly by the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe. A companion volume provides an analytical overview of VHI markets across the 34 countries.

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.

Despite substantial progress towards peace, economic growth, and better governance since 2003, Liberia remains one of the poorest countries in the world. The objective of this study is twofold. First it is to provide a basic diagnostic of both consumption-based poverty and human development (especially education and health) in the country using the 2007 CWIQ (Core Welfare Indicators Questionnaire) survey. Second, it is to assess the likely impact on the poor of the recent economic crisis, and especially the increase in rice prices, and to document the targeting performance of various measures.

Financial protection against the cost of illness and inclusion of vulnerable groups will require better mobilization and use of private means. Private voluntary health insurance already plays an important role in mobilizing additional resources to the health sector and protecting against the catastrophic cost of illness in some countries. This review explores the context under which private voluntary health insurance could contribute to an improvement in the sustainability of the health sector and financial protection in other countries.

If public resources were unlimited there would be no gaps in health coverage and no real need for VHI. However most health systems face fiscal constraints and VHI is often seen as a way to address these pressures. This study draws from the experiences of 34 countries to assess VHI s contribution to health spending and to understand its role in Europe and in relation to publicly financed coverage. It looks at who sells VHI who purchases it and why. It also reviews public policy towards VHI at national and EU levels and the related national policy debates. The analysis shows that while the different markets for VHI vary considerably in size operation and regulation the vast majority are small. Where there are substantial markets these tend to be the oldest ones having a tradition of non-profit insurers and to be the most heavily regulated to ensure VHI policies are accessible and affordable. The study also suggests that VHI is normally a better way of meeting population health needs than out-of-pocket payments although there are notable exceptions. VHI can contribute to financial protection especially where it plays a substitutive and complementary role covering co-payments. However it is a complex challenging and highly context-specific policy instrument that may undermine other health system goals including equitable access efficiency transparency and accountability even where markets are well regulated. Policy-makers should therefore exercise real caution before expanding VHI to fill coverage gaps. This volume and its companion set of country profiles were developed jointly by the Observatory s LSE hub and the WHO Regional Office for Europe. The study draws on contributions from national experts from the EU EFTA and other countries in Europe.

This book presents an in-depth review on the role of health care financing in improving access for low-income populations to needed care, protecting them from the impoverishing effects of illness, and addressing the important issues of social exclusion in government financed programs.