Private Health Cover Research Articles

DOES HEALTHCARE SETTING INFLUENCE OUTCOMES FOLLOWING SHOULDER ARTHROPLASTY?

In Australia nearly two-thirds of arthroplasty procedures are performed in the private setting, which is disproportionate to the dimensioning 43.5% of the population with private health cover. The rapid growth of shoulder arthroplasty surgery will be absorbed by both private and public sectors. This study aimed to assess the influence of healthcare setting on elective shoulder arthroplasty outcomes, defined by revision rate, and functional measures.Data was collected on all primary procedures performed from 2004 – 2019 within a regional area of Victoria, Australia. Patients were categorised into private or public settings. Trauma cases for acute proximal humerus fractures were excluded. The primary outcome of revision surgery was recorded as a cumulative percentage, and survival analysis conducted to calculate a hazard ratio (HR). Functional outcomes were measured through range-of-motion (ROM) and multiple validated patient-reported-outcome-measures (PROMs).458 patients were identified in the study: 290 private and 168 public. There was no difference in the revision rate (3.8% private, 4.8% public), with an adjusted HR of 1.25 (p=0.66) for public compared to private. Baseline and post-operative functional measures were significantly greater in the private setting for ROMs and PROMs analysis, in particular post-operative QuickDASH (15.9±14.7 to 32.7±23.5; p<0.001) and Oxford Shoulder Score (42.6±6.3 to 35.7±11.2; p<0.001). However, there was no significant difference for any of the functional measures in the amount of change from baseline to 12-months between settings.Although healthcare setting does not appear to influence revision rate for shoulder arthroplasty, clear differences were demonstrated for functional measures both pre and post operatively. This may be attributed to factors such as access to perioperative rehabilitation and should be an area to target future investigations.

Australia - Another 50,000 Australians take out private health cover

Australia - Another 50,000 Australians take out private health cover

Unaffordable medical scheme contributions: A barrier to access to private health cover in South Africa

The purpose of the Medical Schemes Act, No. 131 of 1998 was inter alia to ‘promote non discriminatory access to privately funded health care’. A number of reforms were proposed as steps on a path to Social Health Insurance (SHI) with the ultimate goal of the reforms being to increase the number of people contributing to a private financing mechanism, thereby reducing the burden on the public sector.The increase in health care costs over time has been the focal point of industry discussions regarding affordability. In recent years the industry has responded positively to the affordability challenge by developing new products aimed at the lower end of the market. With medical inflation as a significant challenge, this paper argues that in 2003 the cost of entry-level medical scheme options was largely unaffordable and that this state of affairs has not improved over time. The proportion of the population covered by medical schemes declined marginally during the time period under review (2003 – 2006), despite the regulatory environment.The analysis, done from the perspective of a prospective medical scheme member, aims to identify the proportion of medical scheme options affordable to each of four ‘benchmark’ families.

Healthy, wealthy and insured? The role of self‐assessed health in the demand for private health insurance

Both adverse selection and moral hazard models predict a positive relationship between risk and insurance; yet the most common finding in empirical studies of insurance is that of a negative correlation. In this paper, we investigate the relationship between ex ante risk and private health insurance using Australian data. The institutional features of the Australian system make the effects of asymmetric information more readily identifiable than in most other countries. We find a strong positive association between self-assessed health and private health cover. By applying the Lokshin and Ravallion (J. Econ. Behav. Organ 2005; 56:141-172) technique we identify the factors responsible for this result and recover the conventional negative relationship predicted by adverse selection when using more objective indicators of health. Our results also provide support for the hypothesis that self-assessed health captures individual traits not necessarily related to risk of health expenditures, in particular, attitudes towards risk. Specifically, we find that those persons who engage in risk-taking behaviours are simultaneously less likely to be in good health and less likely to buy insurance.

Privacy, abortion, resource allocation and other ethical issues: the Thandi case (1).

Many developing countries have two-tier healthcare systems: the component provided by the state is often inadequate with primary healthcare clinics seeing most of the patients. These clinics are extremely busy often understaffed and under-resourced; medicines are scarce and laboratory facilities inadequate. Secondary and tertiary hospitals are usually short of adequately trained staff both nursing and medical. Private sector healthcare is of a generally higher standard but is expensive and beyond the reach of the vast majority of the population. A small proportion of the adult population is employed by firms large enough to provide healthcare insurance for their employees. Thandi is a 15 year old teenager. Although Thandis family has no private health cover her mother has by-passed the states clinic and has taken Thandi directly to a doctor in private practice Dr Smith - a radiologist. Given Thandis lower abdominal pain her mothers choice of a radiologist as a primary healthcare provider may be inappropriate but Dr Smith is a good caring doctor and does not strictly confine his practice to radiology. (excerpt)

Australian doctors attack health reforms

The Australian Medical Association (AMA) has stepped up its attack on the federal government's proposed health reforms, claiming that they will reduce the level of private health cover. The AMA's discussion paper, Right Problem - Wrong Answer, says that the Labor party's working party is considering reforms akin to the American system of managed care, in which 30 percent of insurance premiums are swallowed up by administrative costs. The package of changes from the health minister, Senator Graham Richardson, are designed to increase …

An econometric analysis of the demand for private health insurance in England and Wales

This paper discusses the nature of demand for private health, insurance in a health care market in which the consumer can neither opt out of tax payments for nor lose his entitlement to public health care. A single equation econometric model of the demand for private health cover is estimated using the 1982 General Household Survey. The results indicate that income and employment status are significant determinants of the probability of health insurance purchase