Impacts of the health reform in the US

read the note here

New PAHO Director

The CISS congratulates Dr. Carissa F. Etienne for her new appointment as Director of the Pan American Health Organization (PAHO). Her first message can be read here.

On United States healthcare reform

The federal government will extend the period for the implementation of "insurance markets" in the context of the health reform. See the note here. To learn more about the US healthcare reform, and other recent reforms in the American continent, access our CISS Health Systems and Insurance Report. 2006-2010 reforms here.  

UN Resolution on universal health insurance

The UN has issued a resolution that supports universal coverage for health insurance. The Resolution can be read here, while the newspaper note here.

US elections and healthcare

See here what people think about healthcare during this election

"Health Savings Accounts in Brazil"

The financing of healthcare for pensioners, and elderly in general, is an unsolved topic. In Brazil there are discussion for the implementation of Health Savings Accounts. HSA will allow workers to contribute during their active live to an account (similar to an Individual Retirement Account), and at retirement withdraw the money to complement the healthcare provided by the State. Read the note here (in Portuguese).

Today begins the 28th Pan American Sanitary Conference

The official link here

Causal effects of publicly provided health insurance

In the past years several countries around the world have implemented publicly subsidized health insurance aiming at extending coverage (see a CISS report on recent reforms in the Continent here). it is expected that these programs increase access to healthcare services and reduce out of pocket payments. The Oregon Health Study implemented a randomized experiment to assess the causal effect of social health insurance on these two variables. Results are positive. You can read the note here and the academic paper here.

Colombian Healthcare system problems

Follow here the news of the problems faced by the Colombian healthcare system.

Design of primary health care

The study by Chan and others deals witht the problem of coordinating different "levels" of providers in the health system. This is one of the most complex challenges to tie the needs of patients with the capabilities of providers. Two extreme departures are systems of reference and counter-reference and the market. Each one has its own mechanisms to reduce or eliminate duplicate attentions, prevent hospitalizations, improve patient safety and reduce costs. Each has also shown its limitations, and each country has sought financial incentives to improve outcomes. One problem looming large is that in the absence of well-developed and standardized measures of care coordination it is not easy to link the conduct of doctors and hospitals with incentives. While there are expectations that electronic health records will support solutions, it will not be easy to identify the new forms of coordination, and not what has in the pre-digital era. For social insurance this is topic of central importance because it defines how to structure to primary health care and compensation to doctors and hospitals, as well as control how patients move or are moved within the health system.

Spain: More crisis effects

The cuts in social spending continue to affect services in Spain. In Catalonia this is meaning longer lines in the health services ...

Casual description of Korean health insurance

One of the systems considered more successful in achieving universal coverage of health insurance among emerging economies is South Korea. This is a casual although illustrative description.

Privacy in waiting lists

What is the value of privacy in waiting lists?

Managing regulations on patient admissions

With increasing regulations to contain cost of health insurance, hospitals face substantial pressure to comply with regulations to admit patients. "Over the last two decades, the demand for hospital services in the United States has been on the rise. Inpatient admissions have increased by 14 percent and emergency department (ED) visits by 40 percent, while the number of staffed hospital beds has dropped by 15 percent.". This has led to new forms of organization of hospitals, and an interesting application for a South-Side hospital in Chicagto can be found here.

South Africa launches National Health Insurance

Following other countries in several parts of the World, South Africa approved the implementation of a National Health Insurance. See note here.

Lockout of pharmacies in Spain, Castilla-La Mancha

Against liquidity constraints, health systems tend to cut variable expenses to balance their finances. Sometimes, these are critical to the welfare of patients. In Spain, a community facing problems and a lockout of pharmacies due to delays in payments is Castilla-La Mancha.

US healthcare reform and Social Security

The discrepancies in the health insurance premium that have to pay one persons with a pension and the other one receiving his full income from his job, but otherwise identical persons, illustrates how complex is the design of insurance markets or programs. See the complete note here.

Two recent interesting articles on social insurance

In the article Estimates of Crowd-Out from a Public Health Insurance Expansion Using Administrative Data NBER researchers find that after expansion of eligibility for public coverage in the United States, approximately 20% of new enrollees had access to private health insurance at the time of enrollment and that only 8% dropped this coverage (with the remaining 12% having both private and public coverage). Authors conclude that the crowding out effect is low. In this other article, Disability, Pension Reform and Early Retirement in Germany, author find that despite increasing life expectancy and better health old age Labor Force Participation (or conversely early retirement) is decreasing (increasing). The authors argue that the generosity of the pension system is the main factor that explains the results. This last topic is treated in detail in the CISS Social Security Report 2012 that will be available in the next weeks.

Slow implementation of the US Healthcare reform

States are moving slowly in implementing health insurance marketplaces, as mandated by the US healthcare reform (see the complete note here). Health insurance marketplaces is one of the key issues in the reform.

The value of life and health spending

Here the opinion of Posner and here the one of Becker regarding the dilemma where to invest health resources: in improving the quality of life, or extending life. These are relevant issues for social security. At the CISS we have worked on this area, specifically on health spending projections, see our 2010 Annual Report.