Search

Background: Spurred by the WHO's endorsement of universal health coverage as a goal of all health systems, many countries are undertaking health financing reforms. The nature of these reforms, and the policy processes by which they are achieved, will depend on context-specific factors, including the history of reform efforts and the political imperatives driving reforms. South Africa's pursuit of universal health coverage through a National Health Insurance is the latest in a nearly 100-year history of health system reform efforts shaped by social and political realities. Methods: We conducted an interdisciplinary, retrospective literature review to explore how these reform efforts have unfolded, and been shaped by the contextual realities of the moment. We began the review by identifying peer-reviewed literature on health system reform in South Africa, and iteratively expanded the search through author tracking, citation tracking and purposeful searches for material on particular events or processes referenced in the initial body of evidence. Data was extracted and organised chronologically into nine periods. Results: The analysis suggests that in South Africa politics; the power of the private sector; competing policy priorities and budgetary constraints; and ideas, values and ideologies have been particularly important in constraining, and sometimes spurring, health system reform efforts. Political transitions and pressures - including the introduction of apartheid in 1948, anti-apartheid opposition, the transition to democracy, and corruption and governance failures - have alternately created political imperatives for reform, and constrained reform efforts. In addition, the country's political history has given rise to dominant ideas, values and ideologies that imbue health system reform with a particular social meaning. While these ideas and values increase opposition and complicate reform efforts, they also help to expose the inequities of the current system as problematic and re-emphasise the need for reform. Conclusion: Ultimately, this analysis demonstrates the context-specific nature of health system reform processes and the influence of history on what sorts of reforms are politically feasible and socially acceptable, even in the context of a global push for universal health coverage. [ABSTRACT FROM AUTHOR]

Introduction: Zimbabwe has one of the highest rates of private health insurance (PHI) expenditures as a share of total health expenditures in the world. The perfomamce of PHI, known as Medical Aid Societies in Zimbabwe, requires close monitoring since market failures and weaknesses in public policy and regulation can affect overall health system performance. Despite the considerable influence of politics (stakeholder interests) and history (past events) in shaping PHI design and implementation, these factors are frequently sidelined when analyzing PHI in Zimbabwe. This study considers the roles of history and politics in shaping PHI and determining its impact on health system performance in Zimbabwe. Methods: We reviewed 50 sources of information using Arksey & O'Malley's (2005) methodological framework. To frame our analysis, we used a conceptual framework that integrates economic theory with political and historical aspects developed by Thomson et al. (2020) to analyze PHI in diverse contexts. Results: We present a timeline of the history and politics of PHI in Zimbabwe from the 1930s to present. Zimbabwe's current PHI coverage is segmented along socio-economic lines due to a long history of elitist and exclusionary politics in coverage patterns. While PHI was considered to perform relatively well up to the mid-1990s, the economic crisis of the 2000s eroded trust among insurers, providers, and patients. That culminated in agency problems which severely lessened PHI coverage quality with concurrent deterioration in efficiency and equity-related performance dimensions. Conclusion: The present design and performance of PHI in Zimbabwe is primarily a function of history and politics rather than informed choice. Currently, PHI in Zimbabwe does not meet the evaluative criteria of a well-performing health insurance system. Therefore, reform efforts to expand PHI coverage or improve PHI performance must explicitly consider the relevant historical, political and economic aspects for successful reformation. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has wrought fundamental changes in the US workplace, placing employer-sponsored health insurance (ESI) in disarray. Before the pandemic, ESI was the single largest share of private health insurance in the country, including some 150 million Americans. Even before the pandemic, however, ESI had become increasingly volatile and more unaffordable for both employers and employees. During the pandemic, many workers found that they could work at home remotely. Job losses during the pandemic left many millions uninsured, with many jobs lost indefinitely. Today, many Americans are rethinking how and where they want to be involved in the workplace, while many businesses are considering a future when more people are working from home or being replaced by robots, placing ESI in further jeopardy. This article brings historical perspective to these problems, showing how the private health insurance industry has failed the public interest by being too fragmented and unreliable to be afforded or depended upon. Three major reform alternatives are described, only 1 of which—single-payer improved Medicare for All—can provide stable universal coverage that meets the needs of all Americans while being affordable for patients, families, and taxpayers. [ABSTRACT FROM AUTHOR]

An increasing interest in initiating and expanding social health insurance through labor taxes in low- and low-middle-income countries goes against available empirical evidence. This article builds on existing recommendations by leading health financing experts and summarizes recent research that makes the case against labor-tax financing of health care in low- and low-middle-income countries. We found very little evidence to justify the pursuit of labor-tax financing for health care in these countries and persistent evidence that such policies could lead to increased inequality and fragmentation of the health system. We recommend that countries considering such policies heed the evidence on labor-tax financing and seek alternative approaches to health financing: primarily using general taxes or, depending on the context, general taxes combined with adequately regulated insurance premiums. [ABSTRACT FROM AUTHOR]

Policy Points"Medicare for All" is an increasingly common term in US health care reform debates, yet widespread confusion exists over its meaning.The various meanings of Medicare for All and other related terms reflect divergent political and philosophical assumptions about the preferred direction of health care reform, as well as the hybrid structure of the current Medicare program. [ABSTRACT FROM AUTHOR]

Mutual societies have been recognised for their ability to mitigate information asymmetry. Although successful in reducing sickness claims, the exclusion of women was common. Health insurance societies argued the exclusion was a means to reduce adverse selection and moral hazard since women were regarded as higher risk. In this paper, we explore differences in organisational characteristics between societies that excluded and societies that did not exclude women as members between 1901 to 1910. Based on panel data, the study shows that societies that excluded women were less successful in keeping down sickness claims, in relation to benefits, than gender-mixed societies. [ABSTRACT FROM AUTHOR]

The article discusses the rise of drug companies in late 19th century Austria through to 1920. Topics include the expansion of drug companies as a result of a thriving public press, the institution of compulsory health insurance for workers in Austria beginning in 1888, capitalism, free markets, socialism, and the creation of the Social Democratic Party

Abstract: In this article national statistics from Swedish sickness funds are analysed from 1892 to 1954. The study is intended to provide better knowledge of changes in sickness claims, and to contribute to the discussion of morbidity trends. National statistics on sickness benefits are available from 1892, and are studied until the introduction of mandatory health insurance in 1955. Membership of Swedish sickness funds increased more than tenfold between 1900 and 1950. Just a small portion of members were women in 1900; however, women constituted the majority of members by 1941. There was a gender difference in morbidity, but this variation was not consistent over time. Before 1935 men had more but shorter sickness episodes; however, after 1935 women had significantly higher sickness rates. The law in 1931 meant that the recruitment of members was widened and compensation for longer periods of illness was made possible. The continuous increase in sick days can be partly explained by legislative changes; however, the increase in the period 1910–32 cannot. The study thereby highlights the importance of incorporating legislative changes into the interpretation. This increased understanding of trends in sick leave provides a sound basis for extending the study to the analysis of individual‐level data. [ABSTRACT FROM AUTHOR]

Background: The primary reason cited by many scholars for the defeat of the Clinton Administration's 1994 health care reform bill has long been identified as Health Insurance Association of America and National Federation of Independent Businesses opposition to the bill. Given this predominant consensus combined with sizeable proposed funding for the bill by a large tobacco product tax, this manuscript examined what the tobacco industry's role was in whole or part in defeating the Clinton health care bill.Methods: This research occurred through crosschecking internal tobacco industry documents and Clinton White House documents.Results: Prior to the passage of the bill, the tobacco industry accepted a compromise of 45 cents per pack increase phased in over five years. Due to this compromise, the industry or third party allies had no role in the ultimate defeat in the bill.Conclusions: The primary reason for the bill's ultimate defeat was general business (but not tobacco industry and third party ally) opposition, the bill running out of time, and conflicting bills. Secondary reasons for the bill's defeat included issues with: employer mandates, high taxes on insurance plans, impacts on medical research and education, Congressional attention to other issues, election year politics, and possible future excise tax possibilities. [ABSTRACT FROM AUTHOR]

Background: Systems of governance play a key role in the operation and performance of health systems. In the past six decades, China has made great advances in strengthening its health system, most notably in establishing a health insurance system that enables residents of rural areas to achieve access to essential services. Although there have been several studies of rural health insurance schemes, these have focused on coverage and service utilization, while much less attention has been given to the role of governance in designing and implementing these schemes. Methods: Information from publications and policy documents relevant to the development of two rural health insurance policies in China was obtained, analysed, and synthesise. 92 documents on CMS (Cooperative Medical Scheme) or NCMS (New Rural Cooperative Medical Scheme) from four databases searched were included. Data extraction and synthesis of the information were guided by a framework that drew on that developed by the WHO to describe health system governance and leadership. Results: We identified a series of governance practices that were supportive of progress, including the prioritisation by the central government of health system development and certain health policies within overall national development; strong government commitment combined with a hierarchal administrative system; clear policy goals coupled with the ability for local government to adopt policy measures that take account of local conditions; and the accumulation and use of the evidence generated from local practices. However these good practices were not seen in all governance domains. For example, poor collaboration between different government departments was shown to be a considerable challenge that undermined the operation of the insurance schemes. Conclusions: China's success in achieving scale up of CMS and NCMS has attracted considerable interest in many low and middle income countries (LMICs), especially with regard to the schemes' designs, coverage, and funding mechanisms. However, this study demonstrates that health systems governance may be critical to enable the development and operation of such schemes. Given that many LMICs are expanding health financing system to cover populations in rural areas or the informal sectors, we argue that strengthening specific practices in each governance domain could inform the adaptation of these schemes to other settings. [ABSTRACT FROM AUTHOR]

This article presents an institutionalist perspective on the relationship between policy failure and policy learning. It contributes both to our understanding of different patterns institutional change as well as the conditions for policy learning at the system-wide level. The first section elaborates the concept of policy failure in terms of type, value and timing. Next, how policy failure may trigger a process of deinstitutionalisation and in turn create conditions for subsequent policy learning is described. These contributions to theory are explored through selected evidence from the reform trajectory of Australian health insurance policy from the mid-1970s to late-1990s. [ABSTRACT FROM AUTHOR]

The authors reflect on Japan's efforts to sustain its health system as it faces serious fiscal pressure due to a slow economy and the rapid aging and low birth rate of its population. Topics cited include Japan's adherence of a nonlinear path to universal coverage, its achievements in health status, and the rising health care costs in the country. It also presents case studies in Tokyo that are related to myocardial infarction and pregnancy and childbirth.

The article discusses the impact of the Affordable Care Act (ACA) on the provision and accessibility of rehabilitative care services, including history of U.S. government-sponsored health care coverage, barriers preventing equal access , and barriers affecting habilitation and rehabilitation.

This article describes the way in which 'Anstie's Limit' - a particular definition of moderate drinking first defined in Britain in the 1860s by the physician Francis Edmund Anstie (1833-1874) - became established as a useful measure of moderate alcohol consumption. Becoming fairly well-established in mainstream Anglophone medicine by 1900, it was also communicated to the public in Britain, North America and New Zealand through newspaper reports. However, the limit also travelled to less familiar places, including life assurance offices, where a number of different strategies for separating moderate from excessive drinkers emerged from the dialogue between medicine and life assurance. Whilst these ideas of moderation seem to have disappeared into the background for much of the twentieth century, re-emerging as the 'J-shaped' curve, these early developments anticipate many of the questions surrounding uses of the 'unit' to quantify moderate alcohol consumption in Britain today. The article will therefore conclude by exploring some of the lessons of this story for contemporary discussions of moderation, suggesting that we should pay more attention to whether these metrics work, where they work and why. [ABSTRACT FROM AUTHOR]

The article focuses on the Children's Health Insurance Program (CHIP) in the context of pediatric coverage in the U.S. and the Patient Protection & Affordable Care Act (ACA). It informs that the program created by the Balanced Budget Act of 1997, insure children in families with household incomes exceeded qualification for Medicaid but not able to afford private coverage. It discusses decrease in clarity of ACA's approach to the continuation of CHIP, after the extension of its authorization.

Introduction In order to alleviate the problem of "Kan Bing Nan, Kan Bing Gui" (medical treatment is difficult to access and expensive) and improve the equity of health service utilisation for urban residents in China, the Urban Employee Basic Medical Insurance scheme (UEBMI) and Urban Resident Basic Medical Insurance scheme (URBMI) were established in 1999 and 2007, respectively. This study aims to analyse the effects of UEBMI and URBMI on the equity of outpatient and inpatient utilisation in Shaanxi Province, China. Methods Using the data from the fourth National Health Services Survey in Shaanxi province, the method of Propensity Score Matching was employed to generate comparable samples between the insured and uninsured residents, through a one-to-one match algorithm. Next, based on the matched data, the method of decomposition of the concentration index was employed to compare the horizontal inequity indexes of health service utilisation between the UEBMI/URBMI insured and the matched uninsured residents. Results For the UEBMI insured and matched uninsured residents, the horizontal inequity indexes of outpatient visits are 0.1256 and -0.0511 respectively, and the horizontal inequity indexes of inpatient visits are 0.1222 and 0.2746 respectively. Meanwhile, the horizontal inequity indexes of outpatient visits are -0.1593 and 0.0967 for the URBMI insured and matched uninsured residents, and the horizontal inequity indexes of inpatient visits are 0.1931 and 0.3199 respectively. Conclusions The implementation of UEBMI increased the pro-rich inequity of outpatient utilisation (rich people utilise outpatient facilities more than the poor people) and the implementation of URBMI increased the pro-poor inequity of outpatient utilisation. Both of these two health insurance schemes reduced the pro-rich inequity of inpatient utilisation. [ABSTRACT FROM AUTHOR]

This article presents an examination of Japan's epoch-making health-insurance reforms undertaken during the Asia-Pacific War between 1937 and 1945. These reforms culminated in amendments to the Health Insurance Law and the National Health Insurance Law in 1942, along with the enactment of the National Medical Treatment Law. The issues addressed in this article are, firstly, the kind of reforms of Japan's health-insurance programs that took place during this period, and secondly, the historical significance of these reforms. Focusing on three elements of the wartime health-insurance reforms – expansion of the number of insured people, transformation of payment system to physicians and provision of easy access to medical institutions – this article examines the following hypothesis: Japanese Health Insurance, established in 1922, which primarily aimed at maintaining and restoring workers’ health and physical work capability, and providing them with economic assistance during those times when they suffered from sickness or injury, was qualitatively transformed to quasi-public-assistance programs with financial dependence on the state during wartime, which established an institutional setting that contributed to the rise of health-insurance expenditure in the post-war era. [ABSTRACT FROM PUBLISHER]

Shrinking dollars increase the need for health care stakeholders to clearly understand nursing's worth. For nursing to assure an adequate investment in nurses, it needs to articulate its value drivers. Nursing revenue offers a data source that reflects stakeholder choices and patient needs. The daily nursing billing supports hospital payment and provides cost data, important for hospital financial decision making. This revenue is a tangible asset reflecting nursing value and can be used to justify an investment in the profession. Nursing leadership can use this daily nursing charge data to monitor and measure the impact of efficiencies related to patient care. [ABSTRACT FROM AUTHOR]

This study examines the Indian health insurance market by empirically observing the provider’s perceptions and its relationship with the insured, the insurer and the third party administrators (TPAs). The study tries to find out the awareness level among the insured population and their attitude towards treatment cost. It then examines the role of TPAs and the impact of cashless services on the cost of treatment by studying a few cost drivers. Apart from studying the provider’s per-ceptions it also tries to look at some of the evidence of moral hazards and that of fraudulent activity. The findings suggest that the awareness level regarding policy terms and condition is low among the insured population and most of them do not care for the cost of treatment. The providers increase their rates quite frequently and prefer the middle income group for extending cashless benefits. The TPA model has not been successful in bringing down the claim cost but has helped in providing unbiased services including cashless benefits. The price structure of healthcare services are linked to the room rent category and most of the insured patients, who are more demanding, prefer staying in higher category rooms. The concept of cost-sharing by the insured will help tackle this issue to some degree. The Indian health insurance market is not immune from supply-side moral hazards and fraudulent activities and there is a need to craft different strategies to tackle them. There exists an opportunity for the insurance companies to build long-term relationships with the preferred healthcare providers by using technology and by understanding each other’s roles in serving the common client. [ABSTRACT FROM PUBLISHER]

Unlike pain practitioners, health care insurers in the United States are not expected to function according to a system of medical ethics. Rather, they are permitted to function under the business 'ethic' of cost-containment and profitability. Despite calls for balancing the disparate agendas of stakeholders in pain management in a pluralistic system, the health insurance industry has continued to fail to take the needs of suffering chronic pain patients into consideration in developing and enacting their policies that ultimately dictate the quality and quantity of pain management services available to enrollees. This essay examined these self-serving strategies, which include failure to reimburse services and certain medications irrespective of their evidence-bases for clinical efficacy and cost-efficiency; 'carving out' specific services from interdisciplinary treatment programs; and delaying and/or interrupting the provision of medically necessary treatment. Blatant and more subtle strategies utilized by insurers to achieve these ethically questionable goals are examined. Additionally, this essay addressed some of the insurance industry's efforts to delegitimize chronic pain and its treatment as a whole. The author concludes that the outlook for chronic pain sufferers is not particularly bright, until such time that a not-for-profit single-payer system replaces the current treatment/reimbursement paradigm. [ABSTRACT FROM AUTHOR]

This article chronicles the political history of efforts by the U.S. Congress to enact a law requiring 'parity' for mental health and addiction benefits and medical/surgical benefits in private health insurance. The goal of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity (MHPAE) Act of 2008 is to eliminate differences in insurance coverage for behavioral health. Mental health and addiction treatment advocates have long viewed parity as a means of increasing fairness in the insurance market, whereas employers and insurers have opposed it because of concerns about its cost. The passage of this law is viewed as a legislative success by both consumer and provider advocates and the employer and insurance groups that fought against it for decades. Twenty-nine structured interviews were conducted with key informants in the federal parity debate, including members of Congress and their staff; lobbyists for consumer, provider, employer, and insurance groups; and other key contacts. Historical documentation, academic research on the effects of parity regulations, and public comment letters submitted to the U.S. Departments of Labor, Health and Human Services, and Treasury before the release of federal guidance also were examined. Three factors were instrumental to the passage of this law: the emergence of new evidence regarding the costs of parity, personal experience with mental illness and addiction, and the political strategies adopted by congressional champions in the Senate and House of Representatives. Challenges to implementing the federal parity policy warrant further consideration. This law raises new questions about the future direction of federal policymaking on behavioral health. [ABSTRACT FROM AUTHOR]

The article discusses the health care position and policies of the 2016 U.S. presidential candidates Donald Trump and Hillary Clinton. Trump has promised to repeal Affordable Care Act (ACA) and replace it with more modest programs while Clinton has proposed to augment the coverage provisions of ACA. The author states that the presidential campaign policy must not be confused with presidential health care governance because health care issues must be confronted regardless of the elected party.

Discusses the evolution of the Committee on the Costs of Medical Care and the U.S. Health Insurance system. History of health insurance from 1883 until 1917; Recognition for the need of a national policy to solve escalating health care costs; Formation of the Committee as a method to organize the health care system; Aim of the group to investigate economic solutions and establish an organizational structure; Recommendations.

The article discusses whether statutory German health insurance conforms to constitutional law in the wake of a court ruling about financing the insurance. The alternative of private insurance is presented. After giving a brief history of applicable law, the author discusses the insurance premium assessment and the notion of solidarity underpinning social insurance. Demographic changes are said to make social security law changes likely.

Outlines the history of Medicare in the United States. Reason for former President Franklin D. Roosevelt's decision not include health insurance in his proposed Social Security Act in 1934; Social conditions of the elderly in 1965; Insurance coverage for the aged; Discussion on Medicare's benefit package, administration and payment methods.

Discusses the contributions of the labor movement to the campaign for health insurance legislation in the mid-twentieth century. Aim of social unionists to emulate the social democratic policies of the West European nations; Activity of the American Federation of Labor on health care matters; Drive for national health insurance when Harry S. Truman assumed the presidency.

Focuses on health insurance coverage in the United States. Medicine and health coverage prior to the Great Depression; Beginning of health insurance; Growth of private health insurance in the 1940s; Trends in U.S. health care financing.

Tracks the development and growth of employer-provided health insurance from its beginning as sickness insurance to its current form. Early coverage, dating to 1798; Blue Cross and other plans; Managed care plans; Glossary of terms.

The article discusses the 100 year history of Germany's health insurance law, tracing it back to 1883. Its early provisions served a wide social spectrum, primarily among the working classes, and featured wage replacement or sick pay during times of illness. Particular demographic and economic challenges to contemporary health insurance are identified.

The article focuses on a law highlighting health insurance for laborers in Germany that was enacted in 1883. Social laws from the time period of the German Empire (Kaiserreich) are discussed and a particular focus is given to the "Freie Hilfskassen" which are health insurance agencies that are financed and administrated by their members in order to give them freedom from corporate or state insurance companies.

The article focuses on the establishment of health insurance agencies in German cities between 1869 and 1883. In addition, a June 15, 1883 law on the health insurance of laborers is discussed and a historical overview of compulsory health insurance in Germany is presented. Research on the administration of health insurance is analyzed.

The article focuses on the history of social policy in Germany, specifically with regard to its compulsory health insurance system. The era between 1845 and 1869 in Prussia is marked by the establishment of health insurance companies that were created in order to support factory workers and laborers. Various goals of state intervention in health insurance and the financing of health services are examined.

The article reviews the history of the relations between German health insurers and salaried physicians and proposals for reforming those relations. Changes sought by the Bundesverbände der Orts- und Betriebskrankenkassen (Federation of Health Insurers) include contractually uniform doctors' fees across health insurance companies and creation of a dispute arbitration procedure.

Purpose – The purpose of this paper is to describe divergent recent developments in provision of reproductive health services to North Americans. Design/methodology/approach – Narrative review. Findings – Two North American countries with very different histories present similar governance challenges today. The challenge is to provide all women with the full range of reproductive health options to which they are legally entitled now. In Canada, those contraception and abortion options are covered under the medical service plan insurance but not always available in convenient locations. In USA, those options are not uniformly covered under health insurance plans due to statutory limitations. In Canada, where federal law limiting abortion was struck down as unconstitutional, the leader of one of its three major federal political parties sees the way forward being to limit his party to pro-choice candidates. In USA, where new laws limiting abortion have been introduced at an unprecedented rate, the judiciary is being asked to define the way forward. Originality/value – Clinical governance needs to balance the moral beliefs of individual providers against the rights of patients to have their lawful choices available within reasonable convenience. Progress has been made but needs are still not adequately met, in these North American examples. [ABSTRACT FROM AUTHOR]

The article discusses family aid in German health insurance, which grants the entitlement of ill family members to medical benefits of the insured. The author reviews the history of such dependent medical benefits from 1911 forward. Inconsistencies in regulations cited show that the system in place has socially unfair effects. This family health insurance is said to be in need of legal reform.

The article presents a brief history of health insurance in Austria and its covered members, especially government officials, as well as its expansion into other areas and clients of social welfare, such as casualty insurance and the working citizenry. The structure of insurance administration is described as well as the conditions that obtain with the injury or death of a socially insured person.

The article discusses a speech by Dr. Walter Bogs on "Health Insurance for Retirees" and what differentiates those pensioned benefit recipients from others. Bogs sketched the history of German health insurance through its statutory reform in 1956 and the controversy over current employees' paying premiums to support the retired population's health care partly from pension insurance.

History helps us to better understand the particulars of the form and functions of institutions. In this paper we present the case study of the evolution of health care financing in the Netherlands over the past 150 years, through the lens of incremental institutional change. Our historical and political analysis is based on a review of secondary literature as well as relevant policy documents, parliamentary debates and archival material. We use the conceptual framework of incremental institutional change (i.e. layering, conversion, drift and displacement) for our analysis. The constitutional program of the mid-nineteenth century laid down the foundations of a 'private initiative first, government last'-approach to health care financing in the Netherlands. Over the course of 150 years this led to the evolution of a complex layered system of financial arrangements consisting of direct public funding, national, social and private health insurance with complex interdependencies. This was not a conscious strategy, but a result of the fact that the central government in the Netherlands preferred to tackle specific problems in health care financing with very specific measures, so as not to intrude on the trade of civil society and commercial business in health care. Regulatory authority and statist power in and over health care financing is not something that was created through dramatic reform in the Netherlands, but came about through many decades of small, incremental, yet accumulating changes. This provides a case study for further analysis of incremental versus rapid change in health care systems internationally. • Health insurance in the Netherlands expanded gradually, not through big changes. • Dutch politics has always favoured 'private initiative' over state intervention. • The Dutch health care market is far more public than it seems. [ABSTRACT FROM AUTHOR]

Copyright of Sozialer Fortschritt is the property of Duncker & Humblot GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses the statutory history of health insurance for pensioners in Germany from 1941. The particular problems posed by retirees' increasing numbers and high medical risk are reviewed. Statutory reform proposals are discussed respecting obligatory health insurance, premium amount calculations, and alternative financing measures.

The article covers "Health Insurance and the Medical Profession," an article by Dr. Alexander Lambert in the January 27, 1917 issue of "JAMA: Journal of the American Medical Association."

An excerpt from the April 2016 issue of "American Journal of Public Health" is presented concerning health insurance, the slow pace of social legislation, and the need to convince businessmen that their workers' health is identical with his business interests.