Following the introduction of life-saving glucocorticoid replacement 60 years ago, congenital adrenal hyperplasia (CAH) has evolved from being perceived as a paediatric disorder to being recognized as a lifelong, chronic condition affecting patients of all age groups. Increasing evidence suggests that patients with CAH have an increased risk to develop ...

The continued preponderance of large health budget deficits in low-income countries has led to increasing international debate over the role that private health insurance could play in providing additional financing for health. However, the market failures inherent to insurance constitute a major concern and proponents are now advocating that states ...

This 2010 survey examines the insurance-related experiences of adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United States, and the United Kingdom. The countries all have different systems of coverage, ranging from public systems to hybrid systems of public and private insurance, and with ...

Previous studies reported that immigrants' health worsens with acculturation to US lifestyle; however, role of health insurance has not been investigated. We used cross-sectional National Immigrant Survey (n = 6,381) to examine the potential moderating effect of health insurance on the association between time in the US and self reported changes in ...

SUMMARYInadequate notification is a recognized problem of measles surveillance systems in many countries, and it should be monitored using multiple data sources. We compared data from three different surveillance sources in 2007: (1) the sentinel surveillance system mandated by the Act on Prevention of Infectious Diseases and Medical Care for ...

South Africa intends implementing major reforms in the financing of healthcare. Free market reforms in private health insurance in the late 1980s have been reversed by the new democratic government since 1994 with the re-introduction of open enrolment, community rating and minimum benefits. A system of national health insurance with ...

Under the newly enacted health reform law, millions of lower- and middle-income Americans will purchase individual or family health insurance through state-based markets for private health insurance called insurance "exchanges," which consolidate and regulate the market for individual and small-group health insurance. The authors consider options for structuring choice and ...

High copayments for medical services can cause patients to underuse essential therapies. Value-based health insurance design attempts to address this problem by explicitly linking cost sharing and value. Copayments are set at low levels for high-value services. The Mercer National Survey of Employer-Sponsored Health Plans demonstrates that value-based insurance design ...

Value-based insurance designs frequently lower consumers' cost sharing to motivate healthy behavior, such as adhering to medication regimens. Few health care purchasers have followed the more controversial approach of using increased cost sharing to temper demand for high-cost, low-value medical care. Yet there is evidence that when health care's affordability ...

In 2006, the Netherlands passed the Health Insurance Act requiring all legal residents to obtain health insurance from private insurance companies. The reform created a national health insurance system guaranteed to all citizens regardless of income or labor force status and introduced a market orientation that makes private insurance companies ...

This document announces maintenance changes to some of the Health Insurance Portability and Accountability Act of 1996 standards made by the Designated Standard Maintenance Organizations. The maintenance changes are non-substantive changes to correct minor errors, such as typographical errors, or to provide clarifications of the standards adopted in our regulations ...

Many developing countries are trying to expand health insurance to achieve universal coverage, yet enrolling informal sector workers and the rural population remains a challenge. A good knowledge of factors driving demand for health insurance among these groups is therefore important. The current study contributes to this body of knowledge ...

The purpose of this study was to examine the outreach effort and impact of a joint federal-state campaign, Own Your Future, promoting awareness and planning for long-term care (LTC) in the state of Washington. The study applied survey methodology to evaluate the extent of campaign dissemination, evidence of its impact ...

For most insurers, traditional methods of controlling health-care demand include deductibles, co-payments, stop-losses, and insurance ceilings. This paper examines the effect of the patient reimbursement method of health insurance (immediate reimbursement or later reimbursement) on individuals' health-care utilization decisions. We find that immediate reimbursement significantly increases the likelihood of patients ...

As the first provisions of the healthcare reform law kick in, insurers are signaling they'll simply abandon business lines that are troublesome, such as child-only policies. America's Health Insurance Plans defends the moves as necessary in the wake of additional, mandated benefits. AHIP's "math doesn't make sense," says J. James ...

Like many other countries, the Netherlands has a health insurance system that combines mandatory basic insurance with voluntary supplementary insurance. Both types of insurance are founded on different principles. Since basic and supplementary insurance are sold by the same health insurers, both markets may interact. This paper examines to what ...

The latest Census Bureau figures on the number of uninsured Americans gave more fuel to those behind the new healthcare law. The statistics show 50.7 million had no health insurance in 2009. "The economic downturn has affected everyone so it is not surprising that more people are without insurance," says ...

In 2003 the Government of Ghana established a National Health Insurance Scheme (NHIS) to improve health-care access for Ghanaians and eventually replace the cash-and-carry system. This study evaluates an important aspect of its promise in the context of the Millennium Development Goals #4 and #5 which deal with the health ...

To determine the individual- and neighborhood-level predictors of frequent nonprescription in-pharmacy counseling. Descriptive, nonexperimental, cross-sectional study. New York City (NYC) during January 2008 to March 2009. 130 pharmacies registered in the Expanded Syringe Access Program (ESAP) completed a survey. 477 pharmacists, nonpharmacist owners/managers, and technicians/clerks. Frequent counseling on medical conditions, ...

This article presents the results from an experimental evaluation of a voluntary health insurance program for informal sector workers in Nicaragua. Costs of the premiums as well as enrollment location were randomly allocated. Overall, take-up of the program was low, with only 20% enrollment. Program costs and streamlined bureaucratic procedures ...

In Germany, employees are generally obliged to participate in the public health insurance system, where coverage is universal, co-payments and deductibles are moderate, and premia are based on income. However, they may buy private insurance instead if their income exceeds the compulsory insurance threshold. Here, premia are based on age ...

 This longitudinal study examined the role of health insurance in access to health care among older immigrants.   Using data from the Second Longitudinal Study of Aging, the longitudinal trajectories of having a usual source of care were compared between 3 groups (all 70+ years): (a) late-life immigrants with less than ...

This study was designed to identify barriers and facilitators to enrollment in public health insurance programs in immigrant adolescents and young adults. Focus groups were held in English, Spanish and Mandarin to assess barriers and facilitators to insurance enrollment. Twenty-nine students participated in the focus groups, 11 Chinese speakers, 13 ...

This article simulates the pricing-out effect due to various user-fee policies under Taiwan's National Health Insurance. Our simulation results indicate that the lower income group is more likely to be priced out of the healthcare system than the higher income group. On average, pricing-out effects are 0.04, 0.21, 0.52 and ...

This paper exploits a major mid-1990s expansion in the U.S. Department of Veterans Affairs health care system to provide evidence on the labor market effects of expanding health insurance availability. Using data from the Current Population Survey, we employ a difference-in-differences strategy to compare the labor market behavior of older ...

The AIDS pandemic in sub-Saharan Africa puts increasing pressure on the buffer capacity of low- and middle-income households without access to health insurance. This paper examines the relationship between health shocks, insurance status and health-seeking behaviour. It also investigates the possible mitigating effects of insurance on income loss and out-of-pocket ...

The aim of this study was to assess the general attitudes of health insurants with chronic conditions towards a health coaching and their reasons for participation in or refusal of the telephone health coaching provided by their sickness fund. The survey was designed as a cross-sectional study on insurants who ...

Ireland has a system of private health insurance (PHI) which acts as a voluntary alternative to the benefits provided under the Irish public health system. As part of this, community rating has long been a cornerstone of the Irish private health insurance market with the objective to make PHI affordable ...

This document contains interim final regulations implementing the requirements regarding internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets under the Patient Protection and Affordable Care Act. The regulations will generally affect health insurance issuers; group health ...

In April 2007, Australia introduced a risk equalisation (RE) scheme (de facto a claims equalisation scheme), which replaced an extant reinsurance scheme that had operated since 1976. This scheme is one of a number of policy measures that the Australian Government has instituted to support the voluntary private health insurance ...

Increasing living kidney donation mandates ongoing assessment of living donors for future health risks and revision of national health policy. Living kidney donors as reported to the Organ Procurement and Transplant Network database from January 1988 through December 2008 were reviewed for minor medical abnormalities, presence of donor health care ...

Background  As each clinical procedure must be justified by a corresponding diagnosis in Japanese health insurance claim (HIC), unconfirmed diagnoses marked as rule-out diagnoses will be written on an HIC. However, little is known about the statistical profiles of such rule-out diagnoses. Objectives  To illustrate the basic statistical profiles of ...

In France, in the early 2000s, legislators ordered that the National Health Insurance regime develop an inter-regime information system (SNIIR-AM) aimed at better understanding and evaluating beneficiaries' health care consumption and associated expenditures. In 2009, it contained data from the general health insurance regime that covers 86% of the French ...

In Germany, population-based data on the epidemiology of psoriasis are still rare. This study aims to assess the prevalence of psoriasis in the total population as well as for subgroups relevant to health care. As further epidemiological parameters the severity and regional distribution of psoriasis were analysed. A secondary analysis ...

To develop a framework that parsimoniously explains divergent patient mobility in the United States and Europe. Review of studies of patient mobility; data from the 2007 Flash Eurobarometer and the 2001 California Health Interview Survey was analyzed; and we reviewed government policies and documents in the United States and Europe. ...

OBJECTIVES: This article looks at the factors that influence the transferability of different types of occupational safety and health (OSH) economic incentives from one country to another. METHODS: To review the legal, political, and cultural framework conditions for economic incentive schemes in the European Union (EU), the European Agency for ...

Health system reforms that introduce insurance principles into public health systems (such as national health insurance, internal markets, and separation of purchasers and providers) have been popular in the last two decades. Little is known, however, about the political complexities of transforming existing health services into health insurance systems in ...

The Patient Protection and Affordable Care Act contains three different forms of reinsurance, covering individual insurers, small-group insurers, and employers that insure early retirees. Each reinsurance program has a distinctive structure that serves a unique purpose. Each also has predecessors in various forms of public reinsurance implemented previously by state ...

The Patient Protection and Affordable Care Act creates a host of new rules for all entities in health care, but especially for health insurers. The statute itself, and the regulations to which it gives rise, will change the nature of the insurance business, particularly in the small-group and individual markets. ...

A Dutch-supported foundation is 'exporting' private health insurance to Nigeria, selling a US$ 30 health-care package for US$ 3. Gary Humphreys reports.

Health insurance and the consequent risk pooling are believed to be essential components of a sustainable healthcare financing system. We sought to determine the profile of Singaporeans who had not procured health insurance over and above MediShield, the national government-spearheaded health insurance program and the factors associated with insurance procurement. ...

To examine health insurance companies' role in employee wellness. Case studies of eight insurers. Wellness activities in work, clinical, online, and telephonic settings. Senior executives and wellness program leaders from Blue Cross Blue Shield health insurers and from one wellness organization. Telephone interviews with 20 informants. Health insurers were engaged ...

Ensuring follow-up of living kidney donors (LKDs) is essential to long-term preventive care. We sought information on health insurance status of US LKDs, with particular attention to age, gender, and ethnicity. The United Network for Organ Sharing/Organ Procurement Transplantation Network database was queried for associations among age at donation, race, ...

Previous research on health and life insurers' financial investments has highlighted the tension between profit maximization and the public good. We ascertained health and life insurance firms' holdings in the fast food industry, an industry that is increasingly understood to negatively impact public health. Insurers own $1.88 billion of stock ...

Little is known about how health insurance status affects decisions to seek care during emergency medical conditions such as acute myocardial infarction (AMI). To examine the association between lack of health insurance and financial concerns about accessing care among those with health insurance, and the time from symptom onset to ...

The effects of supplemental health insurance on health-care consumption crucially depend on specific institutional features of the health-care system. We analyse the situation in Belgium, a country with a very broad coverage in compulsory social health insurance and where supplemental insurance mainly refers to extra-billing in hospitals. Within this institutional ...

OBJECTIVE: To monitor the impact of auto insurance regulatory reforms on the no-fault injury claims experience of Alberta auto insurers. METHODS: Retrospective file review and abstraction of data from individual auto insurer claim files. RESULTS: Reforms were associated with change in diagnostic frequencies as well as higher health utilization, average ...

OBJECTIVE: To explore the disparities in colorectal cancer (CRC) screening based on health insurance status. METHOD: We reviewed 382 medical records of asymptomatic patients aged 50-80 years, who completed their screening colonoscopies between January 2000 and May 2007. Medical records were abstracted from a private primary-care clinic and a university ...

The pilot project Lörrach-Basel was implemented in 2007 to reduce the border effect in respect to the health care services for the citizens of the region. The study deals with the questions as to which patient groups utilise cross-border health care, with special regard to the accompanying financial streams, and ...

The financial burden of health care--the ratio of total out-of-pocket spending for health care services and premiums to total family income--continues to increase nationally. As a result of this trend, more people have been exposed to high costs and lack essential services. This study examines trends nationally and among selected ...