Objectives of this Element :
Objectives of this Element Identify different types of populations to be covered by health insurance (the beneficiaries)
Determine how to plan for the expansion of health insurance to new beneficiary groups
Understand the factors that need to be considered when expanding health insurance to new beneficiary groups
Universal Coverage :
Universal Coverage Population coverage
Benefit coverage
Trade-off between population coverage and benefit coverage
Trade-off between Population and Benefit Coverage :
Trade-off between Population and Benefit Coverage Population coverage Benefit coverage
Adverse Selection :
Adverse Selection When potential consumers know their own risk levels but insurers are unable to distinguish among risks
High-risk consumers are able to purchase insurance at a premium that is based on a lower-risk group
Death Spiral can happen due to adverse selection (Rothschild & Stiglitz 1976, Feldstein 1993, Pauly 1999)
A Case from China: Types of Health Insurance :
A Case from China: Types of Health Insurance
System Equity :
System Equity Financial contributions based on wealth- vertical equity in financing
Service utilization based on need - horizontal equity in service
Discussion Questions :
Discussion Questions Is it possible to increase both population and benefit coverage without increasing the total financing resources and how to do it?
How can we mitigate/eliminate adverse selection?
What other options exist to identify groups in the population-service matrix?
Thank you :
Thank you