PHA-Exchange> In preparation of PHA II (10)

[Claudio]

Private Health Insurance in OECD Countries. The Benefits and Costs for Individuals and Health SystemsFrom: Ruggiero, Mrs. Ana Lucia (WDC) 

Private Health Insurance. The Benefits and Costs for Individuals and Health Systems
Francesca Colombo and Nicole Tapay 
OECD Health Working Paper No. 15, 2004
Organisation for Economic Co-operation and Development, Paris 
Available online as PDF file at:  http://www.oecd.org/dataoecd/34/56/33698043.pdf 

"...Governments often look to private health insurance (PHI) as a possible means of addressing some health system challenges. For example, they may consider enhancing its role as an alternative source of health financing and a way to increase system capacity, or promoting it as a tool to further additional health policy goals, such as enhanced individual responsibility. In some countries policy makers regard PHI as a key element of their health coverage systems.

While private health insurance represents, on average, only a small share of total health funding , it plays a significant role in health financing in some OECD countries and it covers at least 30% of the population in a third of the OECD members. It also plays a variety of roles, ranging from primary coverage for particular population groups to a supporting role for public systems.

This paper assesses evidence on the effects of PHI in different national contexts and draws conclusions about its strengths and weaknesses. Private health insurance presents both opportunities and risks for the attainment of health system performance goals. For example, in countries where PHI plays a prominent role, it can be credited with having injected resources into health systems, added to consumer choice, and helped make the systems more responsive. However, it has also given rise to considerable equity challenges in many cases and has added to health care expenditure (total, and in some cases, public) in most of those same countries. 



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