Publication:
Private Voluntary Health Insurance : Consumer Protection and Prudential Regulation

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dc.contributor.authorBrunner, Greg
dc.contributor.authorGottret, Pablo
dc.contributor.authorHansl, Birgit
dc.contributor.authorKalavakonda, Vijayasekar
dc.contributor.authorNagpal, Somil
dc.contributor.authorTapay, Nicole
dc.date.accessioned2013-04-09T16:02:05Z
dc.date.available2013-04-09T16:02:05Z
dc.date.issued2012-05-14
dc.description.abstractHealth care expenditures can be financed through a mix of public resources and private spending. Private spending is a much larger share of total health spending in low- and middle-income countries than in higher income countries. Moreover, a significant percentage of private spending in those countries is out-of-pocket direct payments for health care services by individuals. Out of pocket expenditures account for more than 60 percent of the total health care spending in low-income countries and 40 percent of total health care spending in middle-income countries. A growing number of low- and middle-income governments are considering private health insurance as a way of both reducing the risk that individuals will have a catastrophic financial burden and achieving other public health care goals. Among these goals are reducing the financial burden on overstretched public health financing, achieving more equitable access to health care, and improving quality and efficiency in the delivery of health care services. An important component of a successful private health insurance market, however, is its legal framework. As discussed in detail later in this book, countries regulate insurance companies to counter systemic market failures that lead to an inefficient and inequitable market. In particular, insurance laws are designed to prevent insurers from becoming insolvent and from engaging in unfair practices and discriminatory behavior. When private health insurance serves as a significant source of financing in a nation's health care system, usually insurance laws also include a range of consumer protection laws that enhance both access to the services covered by private health insurers and the adequacy of the benefits provided by the insurer. This chapter provides a general overview of private health insurance. It begins with a discussion of the definition of private health insurance and the potential roles of private health insurance as part of a nation's health care financing system. In addition, the chapter reviews the variety of entities that sell private health insurance.en
dc.identifier.doi10.1596/978-0-8213-8756-6
dc.identifier.isbn978-0-8213-8756-6
dc.identifier.otherDOI:10.1596/978-0-8213-8756-6
dc.identifier.urihttps://hdl.handle.net/10986/13093
dc.language.isoen_US
dc.publisherWashington, DC: World Bank
dc.rightsCC BY 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo
dc.subjectaccess to health care
dc.subjectaccess to health services
dc.subjectaccident insurance
dc.subjectactuaries
dc.subjectadministrative costs
dc.subjectadverse selection
dc.subjectAgents
dc.subjectambulance
dc.subjectannual financial statements
dc.subjectAssurance
dc.subjectauditors
dc.subjectbeneficiaries
dc.subjectCapital Requirements
dc.subjectcapitation
dc.subjectcapitation payment
dc.subjectcapitation payments
dc.subjectcare plans
dc.subjectchoice of provider
dc.subjectclinics
dc.subjectcoinsurance
dc.subjectcommissions
dc.subjectcompensation
dc.subjectcomplementary medicine
dc.subjectConsumer Protection
dc.subjectconsumers
dc.subjectcontracts with providers
dc.subjectcost of health care
dc.subjectCost sharing
dc.subjectcosts of health care
dc.subjectCoverage
dc.subjectcredit risk
dc.subjectdelivery of health care
dc.subjectdental care
dc.subjecteconomies of scale
dc.subjectequitable access to health care
dc.subjectexpenditures
dc.subjectFamilies
dc.subjectfiduciary
dc.subjectfinancial incentive
dc.subjectfinancial incentives
dc.subjectFinancial Information
dc.subjectfinancial management
dc.subjectfinancial resources
dc.subjectfinancial risk
dc.subjectfinancing health care
dc.subjectgeneral insurance
dc.subjecthealth budgets
dc.subjecthealth care
dc.subjecthealth care costs
dc.subjecthealth care expenditures
dc.subjecthealth care financing
dc.subjecthealth care needs
dc.subjecthealth care provider
dc.subjecthealth care providers
dc.subjecthealth care services
dc.subjecthealth care spending
dc.subjecthealth care system
dc.subjecthealth expenditures
dc.subjecthealth financing
dc.subjectHealth Industry
dc.subjectHealth Institutions
dc.subjectHealth Insurance
dc.subjecthealth insurance coverage
dc.subjecthealth insurance fund
dc.subjecthealth insurance industry
dc.subjecthealth insurance market
dc.subjecthealth insurance markets
dc.subjecthealth insurance policies
dc.subjecthealth insurance regulation
dc.subjecthealth insurance scheme
dc.subjecthealth insurance schemes
dc.subjecthealth insurance system
dc.subjectHealth maintenance
dc.subjectHealth maintenance organization
dc.subjecthealth maintenance organizations
dc.subjecthealth plans
dc.subjectHealth Policy
dc.subjecthealth reforms
dc.subjecthealth service
dc.subjecthealth services
dc.subjecthealth spending
dc.subjecthealth status
dc.subjectHealth Systems
dc.subjectHMO
dc.subjectHMOs
dc.subjecthospitalization
dc.subjecthospitals
dc.subjecthuman resources
dc.subjectillness
dc.subjectincome
dc.subjectincome countries
dc.subjectincome groups
dc.subjectincome population
dc.subjectIndemnity
dc.subjectinformal sector
dc.subjectinformation systems
dc.subjectinspections
dc.subjectinsurance activities
dc.subjectinsurance benefits
dc.subjectInsurance brokers
dc.subjectinsurance buyers
dc.subjectinsurance claims
dc.subjectInsurance Commissioners
dc.subjectinsurance companies
dc.subjectinsurance contracts
dc.subjectinsurance coverage
dc.subjectinsurance function
dc.subjectinsurance industries
dc.subjectinsurance industry
dc.subjectinsurance law
dc.subjectinsurance licenses
dc.subjectinsurance market
dc.subjectinsurance markets
dc.subjectinsurance policies
dc.subjectinsurance premium
dc.subjectinsurance premium rates
dc.subjectinsurance premiums
dc.subjectinsurance products
dc.subjectinsurance rates
dc.subjectinsurance regulation
dc.subjectinsurance risk
dc.subjectinsurance supervision
dc.subjectinsurance supervisors
dc.subjectinsurance systems
dc.subjectinsurance­risk
dc.subjectinsurers
dc.subjectintegrity
dc.subjectIntermediaries
dc.subjectinternal controls
dc.subjectintervention
dc.subjectinvestigations
dc.subjectlaws
dc.subjectlegal framework
dc.subjectlevel playing field
dc.subjectLife Insurance
dc.subjectlow-income countries
dc.subjectmanaged care
dc.subjectmanaged care plans
dc.subjectmarket failures
dc.subjectmarket forces
dc.subjectmarketing
dc.subjectmedical care
dc.subjectmedical conditions
dc.subjectmedical expenses
dc.subjectmedical insurance
dc.subjectMedicare
dc.subjectmoral hazard
dc.subjectmutual insurance companies
dc.subjectnational health
dc.subjectNational Health Insurance
dc.subjectNational Health Policy
dc.subjectnational health services
dc.subjectNon-Life Insurance
dc.subjectnongovernmental organizations
dc.subjectNutrition
dc.subjectpatient
dc.subjectpayments for health care
dc.subjectpolicyholders
dc.subjectprice competition
dc.subjectprimary care
dc.subjectprivate health coverage
dc.subjectPrivate Health Insurance
dc.subjectprivate health insurers
dc.subjectprivate hospitals
dc.subjectprivate insurance
dc.subjectprivate insurers
dc.subjectPrivate Sector
dc.subjectprivate spending
dc.subjectprograms
dc.subjectprovision of health services
dc.subjectpublic health
dc.subjectpublic health care
dc.subjectPublic health insurance
dc.subjectpublic health system
dc.subjectpublic insurance
dc.subjectpublic insurer
dc.subjectpublic providers
dc.subjectpublic sector
dc.subjectrehabilitation
dc.subjectReinsurance
dc.subjectreinsurance companies
dc.subjectreinsurers
dc.subjectrenewals
dc.subjectReserves
dc.subjectRisk Factors
dc.subjectrisk management
dc.subjectrisk managers
dc.subjectsmoking
dc.subjectsocial health insurance
dc.subjectSolvency
dc.subjectSolvency Requirements
dc.subjectsupervisory agencies
dc.subjectsupervisory authorities
dc.subjectsupervisory framework
dc.subjectsupervisory infrastructure
dc.subjectsupervisory system
dc.subjectsurgery
dc.subjectunderwriting
dc.subjectworkers
dc.subjectworkers compensation
dc.titlePrivate Voluntary Health Insurance : Consumer Protection and Prudential Regulationen
dspace.entity.typePublication
okr.date.disclosure2012-05-17
okr.doctypePublications & Research::Publication
okr.doctypePublications & Research
okr.globalpracticeFinance and Markets
okr.globalpracticeGovernance
okr.globalpracticeFinance and Markets
okr.globalpracticeHealth, Nutrition, and Population
okr.guid774881468149697802
okr.identifier.doi10.1596/978-0-8213-8756-6
okr.identifier.report68964
okr.language.supporteden
okr.sectorFinance
okr.sectorFinance :: Non-compulsory health finance
okr.sectorFinance :: Non-compulsory pensions, insurance and contractual savings
okr.themeFinancial and private sector development :: Regulation and competition policy
okr.themeHuman development :: Health system performance
okr.topicFinance and Financial Sector Development::Insurance & Risk Mitigation
okr.topicHealth, Nutrition and Population::Health Economics & Finance
okr.topicHealth, Nutrition and Population::Health Monitoring & Evaluation
okr.topicHealth, Nutrition and Population::Health Systems Development & Reform
okr.topicLaw and Development::Insurance Law
okr.unitSocial Protection (SASSP); Health, Nutrition & Popultn Team (HDNHE)
relation.isAuthorOfPublication3c78a7a8-4100-50c1-9f9b-2719e91cf386
relation.isAuthorOfPublication.latestForDiscovery3c78a7a8-4100-50c1-9f9b-2719e91cf386
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