Insurance Participation Research Articles

Does Family Migration Affect Access to Public Health Insurance? Medical Insurance Participation in the Context of Chinese Family Migration Flows.

Using 2017 Migrant Dynamic Survey (CMDS) data, logistic regression models were developed to explore the family migration rate on health care participation of floating population. The analysis reveals that 68.69% of the floating population in China moves with at least one family member, but the local health insurance participation rate of them are relative low. However, family migration rate has a significant positive correlation with the health insurance participation of the floating population at the destination, which explains by family support and social integration mechanisms. The higher the degree of family migration, the higher the likelihood of participating in local health insurance system. Age, labor contract types, migration range and cities numbers, health records, and the accessibility of health resources have a significant negative correlation with health care participation of the floating population at the destination; gender, health, marriage, education, hukou types, monthly income, migration history, and move duration have a significant positive correlation. The effect of family migration rate on health care participation is weaker in group in which people are low-educated and signs non-fixed-term contract or gets bottom 50% monthly income or under the no-kids family structure. Potential policies informed by these findings are also explored.

Empirical Study on the Impact of Urban and Rural Resident Basic Medical Insurance on Children's Educational Outcomes.

This paper employs data from the 2016 and 2018 China Family Panel Studies (CFPS) to study the impact of participation in Urban and Rural Resident Basic Medical Insurance (URRBMI) on children's educational outcomes by using the logit model, double selection Lasso model, and propensity score matching. It is found that participating in URRBMI has no significant effect on children's Chinese performance, but has a significant negative effect on children's mathematics performance. The negative effect is more obvious for children who participating in the New Cooperative Medical Scheme (NCMS). The paper also studies the channel effects of participation in URRBMI on children's educational outcomes trough two different ways. It is noticed that both channel effects are not significant, that is, participation in URRBMI neither improves children's health nor changes household education expenditures.

Women's Health Insurance Status in Senegal West Africa

Senegalese women of childbearing age continue to be disproportionately affected by communicable and noncommunicable disease, yet still face reduced health care access despite the expanding coverage of universal health insurance schemes. There is need to understand the role of women's socio-demographic positioning and household decision-making autonomy on their health care insurance participation.

The Impacts of Benefits Perception and Risks Awareness on Participating In Voluntary Social Insurance - A Study on Informal Workers in Hanoi Area

Voluntary social insurance is the type of social insurance that an employee voluntarily participates in, it is allowed the employee to choose the payment rate and method of payment in accordance with his/her income, based on the general regulations of the State. Accordingly, this is an additional form of compulsory social insurance in the context of not implementing compulsory social insurance for all employees. This is an opportunity for employees to have an additional means of ensuring their financial condition against risks and incidents in life. However, the actual results indicate that the number of voluntary social insurance participants has increased rapidly but is not commensurate with its potential. This study aims to examine the effects of perceptions of benefits and perceptions of risk on attitudes towards voluntary social insurance based on a survey conducted on 245 workers in the informal sectors in Hanoi. The research results show that, as expected and consistent with previous studies, the attitude towards participating in social insurance is actually influenced by the participants' perception of benefits and risks. Accordingly, it is necessary to focus on increasing these perceptions for employees as the solutions to change attitudes with voluntary social insurance. This will promote the intention and behavior of employees to participate in social insurance in the informal sector, thereby contribute to ensure social security.

Who buys crop insurance? Predictors of the participation gap between organic and conventional farms

AbstractThis study examines the participation gap in crop insurance between organic and conventional producers. To solicit input from producers of organic and diversified crop production systems, we developed a national survey through the Organic Agriculture Research and Education Initiative (OREI) that resulted in over 1,000 valid responses, as well as data from the Agricultural Resource Management Survey (ARMS). Results suggest a high degree of correlation between crop insurance participation with respect to the degree of commercialization of a farm. Additionally, small and diversified operations report that the complexity and record keeping associated with crop insurance is often not worthwhile. This paper concludes with a discussion regarding future risk management education programs and how they can be better targeted by combining the use of crop insurance in conjunction with improved record keeping and a better understanding of loan requirements and documentation.

Voluntary Social Insurance Policy Through the Evaluation of Workers in Tay Ho District, Hanoi City, Vietnam

Vietnam’s voluntary social insurance (VSI) policy has been in force since 2008 and by 2018 included 270,000 participants (accounting for 0.79% of the labor force). Hanoi City is the capital of Vietnam, with 21,156 participants (0.56%). The proportion of people participating in VSI is still very low. Workers who have at least 20 years of participation will receive a monthly pension and their beneficiaries will receive a death benefit in case of their demise. The opinions of workers about VSI policies are presented in the report through interviews with 170 voluntary social insurance participants and 168 non-participants in Tay Ho District, Hanoi City. The research results in new findings using comparison between participants and non-participants. In addition, in-depth interviews were conducted with 40 people, including social insurance officials in Tay Ho District, ward officials, and workers, to clarify why the number of VSI participants is low. Based on the research and evaluation of workers concerning VSI policies and regulations, we identify the main causes of this situation, as well as the policy- and communication-related shortcomings, and suggest solutions for improving the social insurance participation rate of individuals in Hanoi City in particular, and Vietnam in general.

Does crop insurance reduce pesticide usage? Evidence from China

We test how crop insurance participation affects the intensity of pesticide use in China using data on staple crop production from eight provinces. Our preferred specification instruments farmers' decisions of participation in insurance by village-level intensities of promotional activities and controls for province fixed effects. We find crop insurance participation significantly reduces pesticide use intensity. The reduction effect is greater for smaller plots, older farmers, and farmers who are more risk averse.

Determinants and perception of health insurance participation among healthcare providers in Nigeria: A mixed-methods study

BackgroundTo accelerate universal health coverage, Nigeria’s National Health Insurance Scheme (NHIS) decentralized the implementation of government health insurance to the individual states in 2014. Lagos is one of the states that passed a State Health Insurance Scheme into law, in order to expand the benefits of health insurance beyond the few residents enrolled in community-based health insurance programs, commercial private health insurance plans or the NHIS. Public and private healthcare providers are a critical component of the Lagos State Health Scheme (LSHS) rollout. This study explored the determinants and perception of provider participation in health insurance programs including the LSHS.MethodsThis study used a mixed-methods cross sectional design. Quantitative data were collected from 60 healthcare facilities representatively sampled from 6 Local Government Areas in Lagos state. For the qualitative data, providers were interviewed using structured questionnaires on selected characteristics of each health facility in addition to the managers’ opinions about the challenges and benefits of insurance participation, capacity pressure, resource availability and financial management consequences.ResultsA higher proportion of provider facilities participating in insurance relative to non-participating facilities were larger with mid to (very) high patient volume, workforce, and longer years of operation. In addition, a greater proportion of private facilities compared to public facilities participated in insurance. Furthermore, a higher proportion of secondary and tertiary facilities relative to primary facilities participated in insurance. Lastly, increase in patient volume and revenue were motivating factors for provider facilities to participate in insurance, while low tariffs, delay and denial of payments, and patients’ unrealistic expectations were mentioned as inhibiting factors.ConclusionFor the Lagos state and other government insurance schemes in developing countries to be successful, effective contracting and quality assurance of healthcare providers are essential. The health facilities indicated that these would require adequate and regular provider payment, investments in infrastructure upgrades and educating the public about insurance benefit plans and service expectations.

Warming Temperatures, Yield Risk and Crop Insurance Participation

Abstract Previous literature have shown that warming temperatures due to climate change are likely to decrease mean crop yields and increase crop yield risk. However, there is limited understanding of how crop insurance participation can potentially affect the adverse crop yield impacts of warming (or extreme heat). This study specifically examines whether crop insurance participation influences the impact of extreme heat on yield risk (i.e. yield variance, skewness and kurtosis). We utilise a parametric moment-based method and county-level panel data to evaluate how crop insurance participation affects the relationship between warming temperatures and the moments of crop yield distributions. Our results indicate that the yield risk increasing effect of warming is further magnified under high levels of crop insurance participation. This result still holds even when allowing for long-run adaptation (although the crop insurance effect tends to be weaker in this case). In general, our results indicate that not only does crop insurance participation adversely impact mean yields under climate change, it also influences the extent by which warming affects yield variability over time. This supports the notion that crop insurance can serve as a disincentive for climate change adaptation in agriculture.

The Impact of Medical Insurance on Household Stock Market Participation: Evidence From China Household Finance Survey.

This paper explores the impact of medical insurance on the possibility of household participation in the stock market and the portfolio share of equity, applying Probit, and Tobit models with the data from China Household Finance Survey (CHFS). The empirical results highlight that participating in medical insurance can significantly increase the possibility of households participating in the stock market and the portfolio share of equity, and have passed the robustness tests, including propensity score matching (PSM), altering estimation methods, replacing explained variables, and eliminating samples. Besides, heterogeneity analysis shows that the impact of medical insurance on household stock market participation is more significant in eastern region, urban areas, and households with higher income level. Further mechanism analysis implies that household participation in medical insurance mainly affects their stock market participation through preventive savings effect. It is necessary to improve the medical insurance system and encourage household participation in stock market so as to further promote financial development in China.

Behavior Paying Premium to the Independent Participants in Healthcare Social Insurance Administration Office

Premiums non-compliance leads to the Healthcare Social Insurance Administration Office (henceforth, will be referred to as BPJS Kesehatan) budget deficit, resulting in an accumulation of debt claims in various health facilities and an impact on the quality and quantity of health services in health facilities. As of March 2019, 38% of independent National Health Insurance (JKN) participants in Gorontalo City were not compliant to pay dues. This study objective to assess the relationship between willingness to pay with compliance behavior to pay premiums for BPJS Kesehatan independent participants. This study uses a cross-sectional study design. The population was 8,594 people who were independent BPJS Kesehatan participants with a sample of 95 people using accidental sampling techniques. Data were collected through interviews using a questionnaire, data analysis using Chi-Square test. The results showed that the distribution of the level of compliance paying BPJS premiums independently was still 64.2%. Distribution of the willingness to pay by 85%. There is a significant relationship between Willingness To Pay (WTP) with compliance paying dues with p = 0.031. There is a relationship between WTP with compliance to pay the premiums of BPJS Kesehatan independent participants in the inpatient installation at RSUD Prof. Dr. H. Aloei Saboe in Gorontalo City.

WHAT DRIVES PEOPLE'S INTEREST IN SHARIA INSURANCE? EVIDENCE FROM PALANGKA RAYA

This studi aims to analyze factors affecting people become member of sharia insurance in Palangka Raya, Central Borneo, Indonesia. This research approach uses a quantitative approach. The variables used in this study, product, price, promotion, lifestyle and economic conditions. The method used in data collection using purposive sampling method, by distributing online questionnaires. The number of samples in this study were 42 respondents. The analytical tool used to determine the public's interest in participating in Prudential sharia insurance in Palangka Raya City is to use SPSS 23. The results of this study indicate that there is a significant positive effect on promotion and lifestyle variables on interest in Prudential sharia insurance, this is evidenced by the F test, which shows a significance level of 0.000. This is because the magnitude of the significance level of the F test from the F count value of 16,215 with the F table value of 2.5, this indicates that the F count value is greater than the F table value (16, 215 > 2.5). In this study, the magnitude of the influence of the Adjusted R Square of the promotion and lifestyle variables is 0,650 or 65% which affecting become sharia insurance participant in Palangka Raya. Meanwhile, based on the results of the T test, it shows that the variables of product, price and economic conditions are not significant. This is because the Palangka Raya is not as big as the cities in the capital, so people who use the services of Sharia Insurance are still not priority for the people of Palangka Raya. This study contributes empirically to the describe sharia insurance in Palangka Raya. In addition, the existing sharia insurance in the Palangka Raya should be re-socialized so that people are more familiar and using sharia insurance services compared to using conventional insurance. Islamic insurance uses the concept of protecting each other. This concept is different from conventional insurance, where participants pay premiums to insurance companies.

Preferences for crop insurance attributes among cocoa farmers in Ghana

PurposeThis article analyzes farmers' preferences for different nonindexed crop insurance alternatives, using discrete choice experiment data on cocoa farmers from southern Ghana. We examine farmers' attendance to attributes by comparing self-reported attribute nonattendance (ANA) to the behavior inferred from the choices.Design/methodology/approachWe utilize the latent class endogenous attribute attendance (EAA) model to address potential endogeneity by jointly modelling farmers' attribute processing strategies with their choice of attributes of the insurance products.FindingsThe results show that premium levels, mode and length of indemnity payouts tend to influence farmers' preferences for crop insurance products. The findings also reveal that credit-constrained farmers attend more to premium and payment mode attributes of the crop insurance products and that credit-constrained farmers tend to exhibit lower willingness-to-pay estimates for the crop insurance attributes.Research limitations/implicationsThe findings from the study suggest that credit constraints do not only limit input use, but also tend to have statistically significant impact on farmers' cocoa insurance participation decisions.Originality/valueThe study examines the impact of credit constraints on farmers' crop insurance preferences while accounting for ANA.

Compulsory insurance in the provision of insurance protection

The transition to a digital economy in a «risk society» is transforming financial institutions, changing their social significance and strategic development goals. The development of insurance in general, and compulsory insurance in particular, is influenced by two global factors: changing the risk situation, including qualitative changes in the nature of the risk; and the growth of public consciousness in the field of risk management, awareness of the need for insurance protection. Compulsory insurance aimed at protecting the public interest in this situation becomes of particular importance. The structure of threats and new phenomena in the realization of risk require at this stage more than the current state participation in compulsory insurance.

Pengaruh Pendapatan, Pengetahuan Dan Kerentanan Penyakit Terhadap Willingness To Pay (WTP) Premi Jaminan Kesehatan Pada Pekerja Sektor Informal


 Background:
 The Indonesian Government's target of Universal Coverage or 100% Health Insurance participation by 2019 failed to be achieved, even until the end of October 2020. The failure of universal coverage resulted in BPJS Health's finances getting worse after experiencing a deficit. Informal sector workers are the most dominant sector that has not participated in the Health Insurance scheme, totaling 30,487,891 workers. Low income, uncertainty each month, and the increase in contributions resulted in a decrease in Willingness to pay Health Insurance contributions.
 Research purposes:
 The purpose of this study is to analyze the effect of income, knowledge, and disease susceptibility to the willingness to pay (WTP) of health insurance contributions to informal sector workers.
 Method:
 This cross-sectional research was conducted in Kudus Regency, Central Java in January-February 2020. Sampling used purposive sampling with a total of 200 informal sector workers who had not yet participated in BPJS Kesehatan. The dependent variable is a willingness to pay. The independent variables are income, knowledge, and disease susceptibility. Data collection using a questionnaire and data analysis with logistic regression.
 Result:
 Willingness To Pay health insurance contributions for informal sector workers increased in income ≥Rp 2,218,451 (b = 2.02; 95% CI = 1.01-3.55; p = 0.044), high knowledge (b = 4.64; 95% CI = 2.36-8.31; p <0.001), high disease susceptibility (b = 3.01; 95% CI = 0.26-5.75; p = 0.031).
 Conclusion:
 Income, knowledge, and disease vulnerability have a significant effect on the willingness to pay for health insurance contributions for informal sector workers.
 
 Keywords: Universal Health Coverage; Willingness To Pay; Health Insurance; informal sector workers.

EVALUASI IMPLEMENTASI KEBIJAKAN TATA KELOLA KEPESERTAAN PBI DAERAH JAMINAN KESEHATAN NASIONAL DI KABUPATEN KAYONG UTARA DAN KABUPATEN KETAPANG PROVINSI KALIMANTAN BARAT

Background: 
 The management of the Regional Health Insurance was merged into BPJS Health after the implementation of the 2014 National Health Insurance program. Kayong Utara Regency and Ketapang Regency are part of the Regency that combines regional
 health insurance participation into BPJS Health. The implementation of regional PBI governance needs to be supported by adequate regulations, a strong stakeholder vision, communication between stakeholders that is in line with the policies of regional leaders.
 Objective: The general objective of this research was to explore the ability of stakeholders in implementing the governance of PBI participation in the National Health Insurance Region.
 Methods: This study used a realist evaluation approach with a descriptive case study design. The study used purposive sampling, the research subjects were 24 people. Data was collected by means of in-depth interviews and document review.
 Results: The implementation of the JKN Program is a strategic policy. North Kayong Regency insures the rich and the poor at BPJS Health, while Ketapang Regency only insures the poor or the poor. Based on the Context, Mechanism, and Outcome hypothesis, the management of PBI participants responded differently in the two
 districts. In the implementation of non-comprehensive regulatory influences, the Regional PBI Management had not been good in the two districts, a strategic vision that was not accompanied by a strategic plan and partial communication (mechanism) contributes to the results or in ensuring health insurance for the poor (outcomes).
 Conclusion: The government of Kayong Utara and Kabupaten Ketapang have a strong commitment to managing health insurance for the poor. The implementation of the Regional PBI in the two districts faces challenges in the form of regulations that are not yet comprehensive. Comprehensive regulations, clear targets, and cross-structure coordination are needed in the management of Regional PBI in North Kayong Regency and Ketapang Regency so that it can be carried out properly.
 

Competing for seafaring labour: Social security and agency employment in Chinese shipping

AbstractThis paper discusses one strategy that Chinese crewing agencies adopt to compete with each other in the global seafarer labour supplying market. This strategy is related to Chinese seafarers’ social insurance participation. It shows that crewing agencies utilised a dual workforce – ‘company‐owned seafarers’ and ‘externally hired seafarers’. Externally hired seafarers, though in precarious employment, are offered higher salaries in place of social insurance coverage. By contrast, company‐owned seafarers are paid less, though enjoy social insurance arranged by agencies. This strategy serves to segment the seafarer labour market, conceal the level playing field and help agencies recruit seafarers cost‐effectively, though in violation of labour rights. This paper argues that this strategy grows out of the competitive landscape co‐shaped by the national regulatory and institutional settings and the global structure of the shipping industry.

Risk, ambiguity and willingness to participate in crop insurance programs: Evidence from a field experiment*

This paper analyses smallholder farmers’ willingness to participate in crop insurance programs, using recent data from cocoa farmers in Ghana. Given the significance of output uncertainty and imperfect capital and insurance markets, we develop a theoretical framework to analyse how risk and ambiguity aversion, and liquidity constraints influence farmers’ crop insurance participation decisions. We employ field experiments to elicit farmers’ ambiguity and risk aversion, the stated preference approach to obtain information on farmers’ willingness to participate in crop insurance programs, and a discrete choice model to examine the factors that influence their participation decisions. We find that risk preferences, ambiguity aversion, and liquidity constraints influence farmers’ willingness to participate in crop insurance programs. The results also reveal that the probability of participating in crop insurance programs is positively influenced by wealth, trust and education of the farmers.

Аналіз іноземного досвіду ризик-менеджменту при страхуванні у сільськогосподарському виробництві

Abstract. Introduction. The question of the expediency of regulating insurance relations in a transition economy can arise only if the world experience is ignored. Another thing is that the forms and methods, the degree of distribution, the details of such regulation differ depending on the characteristics of the country, the degree of its economic development, national traditions, integration into the world community and other characteristics. To improve the quality of insurance for agricultural producers, it is necessary to form a systematic approach to its development. Agricultural production is a sector of the economy with the highest risk of losses from production and economic activities, because the final result of agricultural production depends not only on compliance with production technology, but also depends on the impact of risks not related to the production process. Purpose. To study the vision of domestic scientists and foreign experience of effective organization in insurance of agricultural producers, which will formulate proposals for improving the quality in insurance of agricultural producers in Ukraine. Prove the feasibility of state participation as one of the main participants in agricultural insurance. Conclusions. To improve the quality of insurance for agricultural producers, it is necessary to form a systematic approach to its development. The systems approach should take into account the interaction between the participants in the insurance process of this area: the state, insurers and agricultural producers. The leading place in the system, based on capabilities and interests, should be occupied by the state, which through the implementation of state policy to support agricultural insurance, should ensure the interconnection of interests of the system and unite their efforts to achieve the system. The current state of development in the agricultural insurance system dictates the need to form a systematic approach to its development, which provides for the definition and legislative design forms of interaction between the three main participants in agricultural insurance - agricultural producers, insurance companies and the state. Therefore, the development of agricultural insurance is impossible without significant state support. Important areas are also - the perfection of information, voluntary participation in insurance, the development of insurance against certain risks. Thus, the main task, in our opinion, is the interest in this type of insurers’ insurance, policyholders and the state.

Who Experience Out-of-Pocket Expenditures for Modern Contraceptive Use in Indonesian Universal Health Coverage System?

Integration of family planning programs into the universal health coverage system is expected to improveaccess toreproductive health services. All people should have access to sufficient and qualified family planningservices they need without financial hardship. This study aimed to examine out-of-pocket expenditures ofcontraceptive services and the associated factors among fertile age couples that influence their access tomodern contraceptive services.It was quantitative research with a cross-sectional design. Data obtained fromthe Health and Demographic Surveillance System 2016 of Sleman Regency, Indonesia, were analyzed usingmultiple logistic regression to determine factors associated with out-of-pocket expenditures for contraceptiveservices. This study revealed that more than 70% of people should pay for contraceptive services eventhough they had registered as health insurance members. Public non-subsidized and private health insurancemembers were more likely to experience OOP expenditures than public-subsidized participants (AOR=3.12;95%CI=2.25-4.30 and AOR=3.47; 95%CI=1.60-7.52, respectively). Short-term contraception users weremore likely to experience out-of-pocket expenditures thanlong-term users(AOR=6.38; 95%CI=4.79-8.50).Nearly three-quarters of health insurance participants experience out-of-pocket expenditures forcontraceptive services. Out-of-pocket expenditures of contraceptive services significantly associate with thetype of health insurance owned and the types of contraceptive methods used.