Risk equalisation in voluntary health insurance markets: A three country comparison

Armstrong, John, Paolucci, Francesco, McLeod, Heather and van de Ven, Wynand (2010) Risk equalisation in voluntary health insurance markets: A three country comparison. Health Policy, 98 (1). pp. 39-49. ISSN 0168-8510

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Official URL: http://dx.doi.org/10.1016/j.healthpol.2010.06.009

Abstract

The paper summarises the conclusions for health policy from the experience of three countries who have introduced risk equalisation subsidies, in their voluntary health insurance (VHI) markets. The countries chosen are Australia, Ireland and South Africa. All of these countries have developed VHI markets and have progressed towards introducing risk equalisation. The objective of such subsidies is primarily to make VHI affordable while encouraging efficiency in health care production.

The paper presents a conceptual framework to understand and compare risk equalisation subsidies in VHI markets. The paper outlines how such subsidies are organised in each of the countries and identifies problems that arise in their implementation.

We conclude that the objectives of risk equalisation, in VHI markets are no different to those in countries with mandatory insurance systems. We find that the introduction of risk equalisation subsidies is complex and that countries seeking to introduce risk equalisation in VHI markets must carefully consider how such subsidies advance their overall health policy goals. Furthermore, we conclude that such subsidies must be structured correctly as otherwise incentives exist for risk selection which may threaten affordability and efficiency.

Our overall conclusion is that also in voluntary health insurance markets risk equalisation has a role in meeting the related public policy objectives of risk solidarity and affordability, and without it these objectives are severely undermined.

Item Type: Article
Uncontrolled Keywords: Affordable health care, universal coverage, competitive health insurance, claim equalisation, risk equalisation, community rating, risk rating, risk adjusted premium subsidies
Subjects: B900 Others in Subjects allied to Medicine
L100 Economics
N200 Management studies
Department: Faculties > Health and Life Sciences > School of Health, Community and Education Studies > Healthcare
Faculties > Health and Life Sciences > School of Health, Community and Education Studies > Public Health and Wellbeing
Depositing User: Ay Okpokam
Date Deposited: 19 Apr 2012 10:50
Last Modified: 10 Aug 2015 11:39
URI: http://nrl.northumbria.ac.uk/id/eprint/6302

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