Supplemental health insurance: did Croatia miss an opportunity? (9/30)

Croatia continues to face a health-funding crisis. A recent supplemental health insurance law increases revenues through first increasing co-payments, then raising the payroll tax to cover those co-payments. This public finance "slight-of-hand" will not solve the system's structural issues and may worsen system performance both in terms of efficiency and equity. Should Croatia have considered private supplemental insurance as an alternative? There is a new single private supplemental health insurance market now evolving over the EU countries and into Eastern Europe. Croatians could take advantage of lowered costs due to larger risk pooling and the lower administrative overhead of mature insurance organizations. Private supplemental insurance, when designed well, can address several objectives, including a) increased revenues into the health sector; b) removal of the public burden of coverage of selected services for certain population groups; and c) encourage new management and organizational innovations into the sector. Private and multiple company insurance markets are thought to be superior in terms of consumer responsiveness; choice of benefits; adoption of new, more expensive technology; and use of private sector providers. Private sector insurers may also encourage "spillover" effects encouraging reforms with public sector insurance performance. There is already an emerging private insurance market in Croatia, but can it be expanded and properly regulated? The private insurance companies might capture as much as 30-70% of the market for certain services, such as high cost procedures, preferred providers, and hotel amenities. But the Government will need to strengthen the regulatory framework for private insurance and assure that there is adequate regulatory capacity.  (+info)

The role of public policies in reducing mental health status disparities for people of color. (10/30)

Ethnic and racial disparities in mental health are driven by social factors such as housing, education, and income. Many of these social factors are different for minorities than they are for whites. Policies that address gaps in these social factors therefore can address mental health status disparities. We analyze three policies and their impact on minorities: the Individuals with Disability Education Act, Section 8 housing vouchers, and the Earned Income Tax Credit. Two of the three policies appear to have been effective in reducing social inequalities between whites and minorities. Expansion of public policies can be the mechanism to eliminate mental health status disparities for minorities.  (+info)

Creating consensus on coverage choices. (11/30)

The framework for reaching near-universal coverage outlined in this paper combines tax credits for private insurance and public program expansions. It illustrates how a series of incremental steps could be phased in to achieve near-universal coverage. Hallmarks include creation of a Congressional Health Plan; use of the income tax system to provide tax credits and enroll uninsured people; creation of a state Family Health Insurance Program open to everyone below 150 percent of poverty; and creation of a Medicare Part E, open to the disabled and uninsured older adults. The paper provides coverage and cost estimates and identifies potential sources of revenue to finance coverage.  (+info)

Use of subsidies to low-income people for coverage through small employers. (12/30)

If tax credits or other public subsidies are made available only for health insurance that is not employment-based, serious erosion of employer coverage could result. To prevent this, public subsidies targeted to low-income workers and families could be applied in ways that broaden employer coverage for low-income workers and their families by encouraging small employers with largely low-wage workforces to offer and partially fund health coverage for their workers. To accomplish this, such employers--very few of which now provide health coverage--must be allowed to contribute much less than normally required in the commercial market.  (+info)

Medical savings accounts: what story do the data tell? (13/30)

Fewer than a quarter-million tax units had reported a medical savings account (MSA) by the end of 2001. Nearly one-quarter of those having an MSA reported being previously uninsured. The tax data support the prediction that higher-income taxpayers are more likely than others to be MSA consumers. Surprisingly, the middle-aged had the greatest predicted MSA demand, even after income and marginal tax rate were controlled for. There is mixed evidence as to whether the account was treated as a savings vehicle. For those who continued their accounts, their build-up was generally sufficient to offset a year or two of future medical expenses below the deductible.  (+info)

Tax subsidies for employment-related health insurance: estimates for 2006. (14/30)

Employment-related health insurance is subsidized through exemptions from federal and state income taxes, as well as from taxes for Social Security and Medicare. Proposals to modify this subsidy are a perennial subject of policy debate. We present tax-subsidy projections from a new data resource constructed using a statistical linkage between the establishment and household components of the Medical Expenditure Panel Survey (MEPS). We project that the total federal and state tax subsidy in 2006 for employment-related coverage of active workers will exceed 200 billion dollars. We present per worker tax-subsidy estimates and an analysis of insurance incidence by establishment characteristics.  (+info)

An analysis of equity in Brazilian health system financing. (15/30)

Health care in Brazil is financed from many sources--taxes on income, real property, sales of goods and services, and financial transactions; private insurance purchased by households and firms; and out-of-pocket payments by households. Data on household budgets and tax revenues allow the burden of each source except firms' insurance purchases for their employees to be allocated across deciles of adjusted per capita household income, indicating the progressivity or regressivity of each kind of payment. Overall, financing is approximately neutral, with progressive public finance offsetting regressive payments. This last form of finance pushes some households into poverty.  (+info)

The 'millionaires tax' and mental health policy in California. (16/30)