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At the start of the year 2020, World Health Organization declared a public health emergency of international concern about "The COVID-19 pandemic". During this pandemic, when the entire world was facing lockdown, and all industries were getting a setback, there was a spurt observed in the insurance industry. With the rise in COVID-19 cases in India, it became a wake-up call for people towards health insurance. Health Insurance is one of the critical elements for sustainable and inclusive development. A paradigm shift has been noticed among individuals towards health insurance during this pandemic time, especially to protect their families from unforeseen medical expenses. This paper identifies the impact of COVID-19 as a fear that leads to a change in behaviour towards health insurance products. This study is based on the primary data collected from Ahmedabad city showing behaviour towards purchasing an insurance product during the pandemic situation. A sample of 200 individuals from Ahmedabad city of Gujarat State in India has been surveyed. The Binary logistic model is used to analyse the significant factors for the purchase of health insurance and also to check whether fear has a significant impact on a purchase decision. [ABSTRACT FROM AUTHOR]

The purpose of this study is to conduct a cost–benefit analysis of orientation and mobility (O&M) programs from three perspectives: the general public, the experienced, and the potential users of O&M programs. Willingness-to-pay (WTP) for O&M programs was collected via a contingent valuation survey using a double-bound dichotomous choice approach. WTP was estimated using interval regression analyses, accounting for study arm, sex, occupation, income, and self-rated health. The cost data were estimated from a service provider's perspective. The net present value (NPV), variation if delivered by tele-O&M, was investigated. The adjusted mean NPV of O&M programs was $3857 (95% CI: $3760–$3954) per client, with highest NPV from the general public ($4289, 95% CI: $4185–$4392), followed by the experienced users ($3158, 95% CI: $2897–$3419) and the potential users ($2867, 95% CI: $2680–$3054). The NPV reached break-even for tele-O&M. There was strong community support for investment into O&M programs considering benefits for clients over and above the cost of providing the services. This study demonstrates the feasibility of using cost–benefit analysis with a contingent valuation approach to economically assess a rehabilitation intervention, where its multi-dimensional benefits cannot be fully captured by a conventional appraisal technique such as cost-effectiveness analysis. The high willingness-to-pay (WTP) values amongst the general public suggests that Australians perceive government's investment in orientation and mobility (O&M) rehabilitation as value for money and that individuals would be prepared to contribute to its costs. The lower WTP for O&M partially delivered via tele-practice (tele-O&M) indicates a lower acceptance of this innovation in comparison with the traditional face-to-face O&M. The estimated net present values of O&M programs, positive for traditional O&M and break-even for tele-O&M, can be of assistance to service planning and investment decisions within the Australian context. [ABSTRACT FROM AUTHOR]

Most analysts project that a reform like Medicare-for-All that lowers financial barriers to care would cause a surge in the utilization of services, raising costs despite stable or even reduced prices. However, the finite supply of physicians and hospital beds could constrain such utilization increases. We reviewed the effects of 13 universal coverage expansions in capitalist nations on physician and hospital utilization, beginning with New Zealand's 1938 Social Security Act up through the 2010 Affordable Care Act in the USA. Almost all coverage expansions had either a small (i.e., < 10%) or no effect on society-wide utilization. However, coverage expansions often redistributed care-increasing use among newly covered groups while producing small, offsetting reductions among those already covered. We conclude that in wealthy nations, large-scale coverage expansions need not cause overall utilization to surge if provider supply is controlled. However, such reforms could redirect care towards patients who most need it. [ABSTRACT FROM AUTHOR]

Since 1995 Australian health insurers have been able to purchase health services pro-actively through negotiating contracts with hospitals, but little is known about their experience of purchasing. This paper examines the current status of purchasing through interviews with senior managers representing all Australian private health insurers. Many of the traditional tools used to generate competition and enhance efficiency (such as selective contracting and co-payments) have had limited use due to public and political opposition. Adoption of bundled case payment models using diagnosis related groups (DRGs) has been slow. Insurers cite multiple reasons including poor understanding of private hospital costs, unfamiliarity with DRGs, resistance from the medical profession and concerns about premature discharge. Innovation in payment models has been limited, although some insurers are considering introduction of volume-outcome purchasing and pay for performance incentives. Private health insurers also face a complex web of regulation, some of which appears to impede moves towards more efficient purchasing. [ABSTRACT FROM AUTHOR]

Background: This paper is an edited version of an invited paper submitted to the Australian Health Care Summit on 17—19 August 2003. It comments upon the policies which have dominated recent debate and contrasts their importance with the importance of five issues which have received relatively little attention. Methods: Policy is usually a response to identified problems and the paper examines the nature and size of the problems which heave led to recent policy initiatives. These are contrasted with the magnitude and potential cost effectiveness policies to address the problems in five areas of comparative neglect. Results: It is argued that recent and proposed changes to the financing and delivery of health services in Australia have focused upon issues of relatively minor significance while failing to address adequately major inequities and system deficiencies. Conclusion: There is a need for an independent review of the health system with the terms of reference focusing attention upon large system-wide failures. [ABSTRACT FROM AUTHOR]

The state has played a critical role in defining the form and character of the labour market through its regulation of immigration. This paper considers the implications of the waves of migrant labour as driven by the state, with a special focus on overseas–qualified professionals. Emerging from this discussion is an assessment of the immigration and settlement policies which have established, reinforced and also reflected the dominant cultural milieu in the broader Australian society and the labour market. Following this is an exploration of the implications of the policy rhetoric on the labour market entry of overseas–qualified professionals, with a focus on overseas–trained doctors as a case in point. The paper seeks to answer the following question: How, if at all, have labour market practices—including accreditation and labour market entry—relating to overseas–qualified professionals been influenced by the shift in the official rhetoric dominating migrant settlement and labour market integration as driven by the changing nature of migration? To explore this question, this paper is divided into two sections. Part one examines the state–driven socio–cultural policy trends throughout the post World War II period and how and why these shifts in policy have directly shaped the labour market experience of skilled migrant labour. Following the examination of the dominant socio–cultural paradigm, part two explores the effect of the major state–driven policy shifts on overseas–qualified professionals—with a specific focus on overseas–trained doctors. The conclusion drawn is that the medical profession strictly directs the registration and labour market access of overseas–trained doctors based on factors that contravene the broader state policy, raising calls for a more active approach to monitoring professional practice by the state and related institutional bodies. [ABSTRACT FROM AUTHOR]

Under Australian casemix funding arrangements that use Diagnosis-Related Groups (DRGs) the average price is policy based, not benchmarked. Cost weights are too low for State-wide chronic disease services. Risk-adjusted Capitation Funding Models (RACFM) are feasible alternatives. A RACFM was developed for public patients with cystic fibrosis treated by an Australian Health Maintenance Organization (AHMO). Adverse selection is of limited concern since patients pay solidarity contributions via Medicare levy with no premium contributions to the AHMO. Sponsors paying premium subsidies are the State of Victoria and the Federal Government. Cost per patient is the dependent variable in the multiple regression. Data on DRG 173 (cystic fibrosis) patients were assessed for heteroskedasticity, multicollinearity, structural stability and functional form. Stepwise linear regression excluded non-significant variables. Significant variables were ‘emergency’ (1276.9), ‘outlier’ (6377.1), ‘complexity’ (3043.5), ‘procedures’ (317.4) and the constant (4492.7) (R2=0.21, SE=3598.3, F=14.39, Prob<0.0001. Regression coefficients represent the additional per patient costs summed to the base payment (constant). The model explained 21% of the variance in cost per patient. The payment rate is adjusted by a best practice annual admission rate per patient. The model is a blended RACFM for in-patient, out-patient, Hospital In The Home, Fee-For-Service Federal payments for drugs and medical services; lump sum lung transplant payments and risk sharing through cost (loss) outlier payments. State and Federally funded home and palliative services are ‘carved out’. The model, which has national application via Coordinated Care Trials and by Australian States for RACFMs may be instructive for Germany, which plans to use Australian DRGs for casemix funding. The capitation alternative for chronic disease can improve equity, allocative efficiency and distributional justice. The use of Diagnostic Cost Groups (DCGs) is a promising alternative classification system for capitation arrangements. [ABSTRACT FROM AUTHOR]

Reviews the place and role of specific purpose programs in the human services and health field in Australia. Rise of specific purpose programs; Questioning of specific purpose programs; Redesign of specific purpose programs; Specification of outputs and outcomes; Monitoring and evaluation; Regulatory frameworks; Resource allocation; Implementation.