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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Risk equalisation in voluntary health insurance markets: A three country comparison
Health Policy, Volume 98, No. 1, Year 2010
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Description
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. © 2010 Elsevier Ireland Ltd.
Authors & Co-Authors
Armstrong, John
Ireland, Dublin
Institute of Public Administration, Ireland
Paolucci, Francesco
Australia, Canberra
The Australian National University
McLeod, Heather
South Africa, Stellenbosch
Stellenbosch University
van de Ven, Wynand P.M.M.
Netherlands, Rotterdam
Erasmus Universiteit Rotterdam
Statistics
Citations: 21
Authors: 4
Affiliations: 4
Identifiers
Doi:
10.1016/j.healthpol.2010.06.009
Research Areas
Health System And Policy
Study Locations
South Africa