World Bank2012-03-192012-03-192009-05-05https://hdl.handle.net/10986/3064Health financing systems in some Europe and Central Asia (ECA) countries are undergoing some major reforms. In parallel with the transition from central planning to develop market-based economies, countries in Central Europe have moved within a relatively short period of time from having health systems that were government managed and funded by taxes to single health insurance systems that are payroll-funded. The next chapter (chapter two) describes the insurance context in Austria, the Netherlands, Slovakia, and Switzerland. Chapter three examines risk selection in a multiple insurance system. Risk-adjusters and equalization schemes in different countries are discussed as well as the resulting incentives for insurance companies to develop cost containment strategies. Chapter four discusses whether and how insurers compete for providers, including the different forms of managed care contracts that have evolved under multiple insurance and the impact of such contracts on policy goals. Chapter five describes consumer choice in different health financing systems and whether consumers are exercising their choice to switch insurers and plans. Chapter six presents an overview of the different options for insurance reforms. The final chapter will identify the main lessons drawn from the preceding chapters and will present potential policy solutions for increasing the effectiveness of insurance systems, including the necessary regulatory framework to prevent adverse effects, purchasing, improved risk pooling, and monitoring and evaluation systems.CC BY 3.0 IGOADMINISTRATIVE COSTSADMINISTRATIVE EFFICIENCYADMINISTRATIVE EXPENSESAGE GROUPSAGEDAGENTSALTERNATIVE MEDICINEASSURANCEBASIC HEALTH SERVICESBUDGET CONSTRAINTSCAPITATIONCARE INSTITUTIONSCARE PLANSCENTRAL GOVERNMENTCITIESCOMMUNITY RATINGCOMPENSATIONCOMPETITION AMONG HEALTH CARE PROVIDERSCOMPETITION AMONG INSURERSCOMPETITION AMONG PROVIDERSCOMPETITION BETWEEN INSURERSCOMPETITIVE ENVIRONMENTCONSUMER PROTECTIONCONSUMERSCONTRIBUTION RATECONTRIBUTION RATESCOST CONTROLCOST SHARINGCOST-SHARING ARRANGEMENTSDEBTDENTAL CAREDIABETESDOCTORSEXPENDITURESFEE-FOR-SERVICEFEE-FOR-SERVICE SYSTEMFINANCIAL CONTRIBUTIONSFINANCIAL INCENTIVEFINANCIAL INCENTIVESFINANCIAL MANAGEMENTFINANCIAL MARKETSFINANCIAL RISKFINANCIAL RISKSFREE CHOICEGENERAL PRACTITIONERSGROUP INSURANCEHEALTH CAREHEALTH CARE CENTERSHEALTH CARE COSTSHEALTH CARE EXPENDITUREHEALTH CARE EXPENDITURESHEALTH CARE FINANCEHEALTH CARE PERSONNELHEALTH CARE PRODUCTSHEALTH CARE PROVIDERSHEALTH CARE REFORMHEALTH CARE REFORMSHEALTH CARE SECTORHEALTH CARE SERVICESHEALTH CARE SPENDINGHEALTH CARE SYSTEMHEALTH CARE SYSTEMSHEALTH EXPENDITUREHEALTH EXPENDITURESHEALTH FINANCINGHEALTH FINANCING SYSTEMHEALTH INFORMATIONHEALTH INSURANCEHEALTH INSURANCE EXPENDITUREHEALTH INSURANCE FUNDHEALTH INSURANCE FUNDSHEALTH INSURANCE POLICIESHEALTH INSURANCE SCHEMEHEALTH INSURANCE SYSTEMHEALTH INSURERSHEALTH MANAGEMENTHEALTH NEEDSHEALTH PLANHEALTH PLANSHEALTH POLICYHEALTH SECTORHEALTH SERVICESHEALTH SPENDINGHEALTH STATUSHEALTH SYSTEMHEALTH SYSTEMSHMOHMOSHOSPITAL BEDSHOSPITAL REVENUESHOSPITAL ROOMSHOSPITALIZATIONHOSPITALSHOUSEHOLD INCOMEHUMAN DEVELOPMENTINCENTIVES FOR EFFICIENCYINCENTIVES FOR PROVIDERSINCOME GROUPSINFLATIONINPATIENT CAREINSURANCE CLAIMSINSURANCE COMPANIESINSURANCE COMPETITIONINSURANCE COVERAGEINSURANCE EXPENDITURESINSURANCE INDUSTRYINSURANCE LAWINSURANCE PACKAGEINSURANCE PLANINSURANCE PREMIUMSINSURANCE REGULATIONINSURANCE RISKINSURANCE SUPERVISIONINSURANCE SYSTEMINSURANCE SYSTEMSINSURERSINTEGRATIONLAWSLEGAL FRAMEWORKLEVEL PLAYING FIELDLIFE INSURANCEMANAGED CAREMANAGED CARE PLANSMANAGED COMPETITIONMEDICAL CAREMEDICAL CONDITIONSMEDICAL EXPENSESMEDICAL SERVICESMEDICAL SPECIALISTSMEDICAL TECHNOLOGYMENTAL ILLNESSMORTALITYMULTIPLE INSURANCE SYSTEMSMULTIPLE INSURERSNATIONAL HEALTHNATIONAL HEALTH INSURANCENATIONAL HEALTH SERVICENON-LIFE INSURANCENURSESOUTPATIENT CAREPATIENTPATIENT TREATMENTPATIENTSPAYMENTS FOR HEALTH SERVICESPHARMACEUTICAL EXPENDITURESPHARMACIESPHARMACISTSPHARMACYPHYSICIANPHYSICIANSPHYSIOTHERAPISTSPHYSIOTHERAPYPOCKET PAYMENTSPRIMARY CAREPRIMARY HEALTH CAREPRIVATE HEALTH INSURANCEPRIVATE HOSPITALSPRIVATE INSURANCEPRIVATE INSURANCE COMPANIESPROGRAMSPROVIDER PAYMENTPROVISION OF CAREPUBLIC HEALTHPUBLIC HOSPITALPUBLIC INSURERSPUBLIC PROVIDERSQUALITY CONTROLREGULATORY AGENCIESREHABILITATIONRISK ADJUSTMENTRISK EQUALIZATIONRISK FACTORSRISK GROUPSRISK MITIGATIONRISK PROFILESSAVINGSSICK LEAVESOCIAL ASSISTANCESOCIAL HEALTH INSURANCESOCIAL INSURANCESOCIAL INSURANCE CONTRIBUTIONSSOCIAL SECURITYSOLVENCYSUPERVISORY AUTHORITIESSURGERYSUSTAINABILITYUNEMPLOYMENTUSE OF HEALTH SERVICESWORKERSYOUNG ADULTSEurope and Central Asia - Health insurance and competitionWorld Bank10.1596/3064