M. Tech. Organisational Leadership / The objective of this research is to assess the perceptions held by the medical aid schemes and the general public on the National Health Insurance (NHI). It also identifies areas that need attention to improve service delivery through the National Health Insurance model.

Die Arbeit beschäftigt sich mit dem Thema "Vergleich der Krankenversicherungssysteme in der Tschechischen Republik und in der Bundesrepublik Deutschland". Zwischen den gesetzlichen Krankenversicherungssystemen der Tschechischen Republik und der Bundesrepublik Deutschland bestehen viele Unterschiede und Besonderheiten. Es zeigt sich, dass beide Systeme auch eine ganze Reihe von gemeinsamen Aspekten aufweisen. Die Arbeit besteht aus sieben Kapiteln, wobei sich jedes Kapitel einem besonderen Aspekt der gesetzlichen Krankenversicherung widmet. Im ersten Kapitel wird eine historische Entwicklung erklärt, wobei im Unterabschnitt 1 dieses Kapitels die historische Entwicklung in der Tschechischen Republik behandelt wird, während der Unterabschnitt 2 sich der Entwicklung in der Bundesrepublik Deutschland widmet. Das zweite Kapitel setzt sich mit der rechtlichen Regelung beider Staaten auseinander. Dieses Kapitel ist in zwei Teile untergliedert, wobei der erste Teil sich mit der Regelung in der Tschechischen Republik beschäftigt und der zweite Teil die Situation in der Bundesrepublik Deutschland beschreibt. Das dritte Kapitel befasst sich mit der Problematik der Krankenkassen in beiden Staaten. Die folgenden zwei Kapitel analysieren den Umfang der gesetzlichen Krankenversicherung, und zwar zum einen des...

BACKGROUND: In order to accelerate universal health coverage, Nigeria’s National Health Insurance Scheme (NHIS) decentralized the implementation of government health insurance to the States in 2014. Lagos has passed its State Health Scheme (LSHS) into law with a statewide roll out set to commence in 2018. The LSHS aims to improve access to quality care by reducing the financial burden of obtaining care for Lagos residents. Public and private healthcare providers are a critical component of this ambitious insurance roll out. Yet, little or no understanding exists on how to engage providers, the factors that influence their participation in insurance and expectations from the LSHS. In addition, little is known about the geographic distribution of NHIS accredited facilities and enrollees in Lagos State. METHODS: This study used a mixed-methods cross sectional design to analyze primary and secondary data. Primary data included both quantitative and qualitative data and were collected from representatively selected 60 healthcare providers in 6 Local Government Areas (LGAs) in Lagos State through questionnaires probing issues on the challenges and benefits of insurance participation, capacity pressure, resource availability and changes in financial management. Secondary data were obtained from NHIS and Lagos State inventory of health facilities, and household survey reports, and were visually mapped using a geographic information system (GIS) software. RESULTS: Facilities participating in insurance were more likely to be bigger with mid to very high patient volume and workforce. In addition, private were more likely than public facilities to participate in insurance. Furthermore, increase in patient volume and revenue were motivating factors for providers to participate in insurance, while low tariffs, delay and denial of payments, and patients’ unrealistic expectations were inhibiting factors. Also, NHIS enrollees were more likely to be located in the urban than rural LGAs. However, many urban LGAs have larger population sizes and as a result, were also characterized with higher number of non-NHIS enrollees and fewer NHIS accredited facilities. For the LSHS, many private facilities anticipate an increased patient volume and revenue but also worry that low tariffs without guaranteeing a high patient volume would be a major challenge. For many public facilities, inadequate infrastructure, lack of workforce, and insufficient drugs and commodities remain major challenges. CONCLUSION: For the LSHS to be successful, effective contracting of healthcare providers especially those in the low income and densely populated LGAs is essential. However, this would require that provider payment is adequate and regular. In addition, the government would need to invest heavily in improving the infrastructure and the amount of workforce, drugs and commodities available to public facilities.

Health insurance stands at the center of global debates on how nations can ensure equitable access to health care, especially for countries like Vietnam whose integration into the global economy has boosted economic development but intensified social inequality. When health insurance is promoted to low- to middle-income country contexts by development agencies such as the World Health Organization and the World Bank, what embedded cultural values accompany this? How do locally specific historical, political, and ethical concepts for managing vulnerability and uncertainty shape public understanding of insurance? To date, empirical research on health insurance’s impact has tended to examine its relation to health outcomes, service utilization patterns, or health care delivery rather than its cultural effects. As health insurance initiatives have expanded to at least 27 countries within the last decade, the universality of insurance’s value to local populations cannot be assumed. This ethnographic research investigates the cultural mediators and effects as a factor for understanding public responses to health insurance. It documents how this financial technology is transforming knowledge about how to care and manage health vulnerability. With the support of international organizations, the Vietnamese government began its universal health insurance enrollment campaign in 2015. State officials, however, identify the “Vietnamese habit” of purchasing insurance only when ill as both a technical and cultural problem to achieving universal coverage. To better understand this process, I investigated how strategies to “change the mindset of citizens” were deployed by state media and personnel, and then actively resisted, incorporated, or transformed by community members. The study took place in Vinh Long Province, an agricultural area in the Mekong Delta with one of the highest uninsured rates in the country. I conducted twelve months of ethnographic research, including 60 semi-structured interviews with community members, health insurance professionals, and health care professionals; and extended participant observation in government health facilities, insurance offices, and the homes of community members. The study analyzes the social consequences of new health insurance initiatives, the temporality of care, everyday dimensions of health care uncertainty, and their relevance to concerns within medical anthropology. I demonstrate how Vietnam’s insurance reform affected the terms through which people understood their social relations and risk subjectivities. By detailing the dynamic processes of a health insurance campaign aimed at changing health behaviors, the research reveals how financial policies are not value neutral. Rather, they reshape local moral worlds, social relations, and practices for managing uncertainty in late socialist Vietnam.

Thesis (M.A.)--West Virginia University, 2004. / Title from document title page. Document formatted into pages; contains vii, 135 p. : ill. (some col.). Includes abstract. Includes bibliographical references.

In the first chapter, I investigate the welfare effect of the government subsidizing medical insurance. To that extent, I construct and simulate a partial equilibrium computational model of medical care consumption and choice of insurance contracts. I use the overall utility of agents as a welfare measure and find that it is not welfare improving to subsidize uninsured agents by taxing insured ones. In addition I use the framework to verify the insurance contract choice effect and find a strong insurance contract choice effect. In Chapter 2, I investigate the effect of the price setting process under managed health care plans, such as HMOs and PPOs, on prices, profits of insurance companies and medical care providers, and household’s welfare compared to the indemnity plans prevalent before the advent of managed care. I construct a simple game played between a representative insurance company and a medical care provider to determine the price of medical care paid by insured and uninsured households. In addition, insurance companies set premiums not through solving the usual principal-agent problem which forces a zero profit condition, but rather and more realistically by optimizing profits. The outcome of this game is compared to the outcome of the indemnity plans where no price negotiations would occur. In Chapter 3, I investigate the effect of the suggested reform to the United States’ tax code in treatment of housing assets. In particular, I study the effect of the abolishment of the preferential tax treatment of housing assets (tax deductible mortgage interest payments and tax-free imputed rents) on the ownership and foreclosure rates in the housing market. I construct a model where heterogeneous agents decide on housing tenure in which default on housing mortgages occurs in equilibrium. I use this model to quantify the effect of this preferential tax treatment. I find that the elimination of the preferential tax treatment of housing assets results in a 33.4% reduction in foreclosures. Specifically, only eliminating the tax deductibility of interest on mortgage payments leads to a 12.4% reduction in foreclosure rates, while only taxing imputed rents generates a 32.5% reduction in foreclosure rates. / text

Kiekvienas Lietuvos gyventojas, dirbantis pagal darbo sutartį ar savarankiškai, valstybei moka nema.us mokesčius. Be to, mokesčius moka ir ūkine komercine veikla užsiimantys ūkio subjektai. Dalis mokesčių iš karto yra skirti konkrečiai sričiai finansuoti, kita dalis skirstoma vėliau, jau surinkus tam tikrą sumą. Tai tiksliniai mokesčiai, kurie yra kaupiami tam skirtuose fonduose, pavyzdžiui, valstybinio socialinio draudimo fonde, Garantiniame fonde. Tačiau didžioji dalis surinktų mokesčių kiekvienais metais LR valstybės biudžeto ir savivaldybių biudžetų finansinių rodiklių patvirtinimo įstatymu paskirstomi įvairioms reikmėms - švietimui, gynybai, socialinėms reikmėms, prie kurių priskiriama ir sveikatos apsauga. Iš komandinės ekonomikos Lietuva paveldėjo gana gremėzdišką ir neefektyvią sveikatos apsaugos sistemą, kuri ir buvo finansuojama iš visų mokėtojų surinktomis lėšomis. / Health system reforms have been talked about since 1988. The aim of these reforms was development of health insurance; therefore the first draft Law on Health Insurance was passed. It gave the start to legal regulations of mandatory health insurance. After restoration of independence in Lithuania, the first steps in this direction were made. On October 23, 1990 the Seimas of the Republic of Lithuania (the then Supreme Board) adopted a law on the basics of social welfare. Six months later, these general provisions of the law were further developed in the Law on Social Insurance. In this way health insurance became a constituent part of social insurance. On May 21, 1996, the Seimas adopted final version of the Health insurance Law.

Thesis (Ph. D.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references. / Also available by subscription via World Wide Web / vii, 188 leaves, bound ill. (some col.) 29 cm

Zugl.: Bayreuth, Universiẗat, Diss., 2007. / Includes bibliographical references (p. 249-275).

Universiẗat, Diss., 2006--Berlin.