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Voluntary Health Insurance in Europe: Role and Regulation
If public resources were unlimited, there would be no gaps in health coverage and no real need for VHI. However, most health systems face fiscal constraints and VHI is often seen as a way to address these pressures. This study draws from the experiences of 34 countries to assess VHI's contribution to health spending and to understand its role in Europe and in relation to publicly financed coverage. It looks at who sells VHI, who purchases it and why. It also reviews public policy towards VHI at national and EU levels and the related national policy debates.

The analysis shows that while the different markets for VHI vary considerably in size, operation and regulation the vast majority are small. Where there are substantial markets these tend to be the oldest ones, having a tradition of non-profit insurers, and to be the most heavily regulated to ensure VHI policies are accessible and affordable. The study also suggests that VHI is normally a better way of meeting population health needs than out-of-pocket payments, although there are notable exceptions. VHI can contribute to financial protection, especially where it plays a substitutive and complementary role covering co-payments. However, it is a complex, challenging and highly context-specific policy instrument that may undermine other health system goals, including equitable access, efficiency, transparency and accountability, even where markets are well regulated. Policy-makers should therefore exercise real caution before expanding VHI to fill coverage gaps..

This volume and its companion set of country profiles were developed jointly by the Observatory's LSE hub and the WHO Regional Office for Europe. The study draws on contributions from national experts from the EU, EFTA and other countries in Europe.
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Voluntary Health Insurance in Europe: Role and Regulation
If public resources were unlimited, there would be no gaps in health coverage and no real need for VHI. However, most health systems face fiscal constraints and VHI is often seen as a way to address these pressures. This study draws from the experiences of 34 countries to assess VHI's contribution to health spending and to understand its role in Europe and in relation to publicly financed coverage. It looks at who sells VHI, who purchases it and why. It also reviews public policy towards VHI at national and EU levels and the related national policy debates.

The analysis shows that while the different markets for VHI vary considerably in size, operation and regulation the vast majority are small. Where there are substantial markets these tend to be the oldest ones, having a tradition of non-profit insurers, and to be the most heavily regulated to ensure VHI policies are accessible and affordable. The study also suggests that VHI is normally a better way of meeting population health needs than out-of-pocket payments, although there are notable exceptions. VHI can contribute to financial protection, especially where it plays a substitutive and complementary role covering co-payments. However, it is a complex, challenging and highly context-specific policy instrument that may undermine other health system goals, including equitable access, efficiency, transparency and accountability, even where markets are well regulated. Policy-makers should therefore exercise real caution before expanding VHI to fill coverage gaps..

This volume and its companion set of country profiles were developed jointly by the Observatory's LSE hub and the WHO Regional Office for Europe. The study draws on contributions from national experts from the EU, EFTA and other countries in Europe.
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Voluntary Health Insurance in Europe: Role and Regulation

Voluntary Health Insurance in Europe: Role and Regulation

Voluntary Health Insurance in Europe: Role and Regulation

Voluntary Health Insurance in Europe: Role and Regulation

Overview

If public resources were unlimited, there would be no gaps in health coverage and no real need for VHI. However, most health systems face fiscal constraints and VHI is often seen as a way to address these pressures. This study draws from the experiences of 34 countries to assess VHI's contribution to health spending and to understand its role in Europe and in relation to publicly financed coverage. It looks at who sells VHI, who purchases it and why. It also reviews public policy towards VHI at national and EU levels and the related national policy debates.

The analysis shows that while the different markets for VHI vary considerably in size, operation and regulation the vast majority are small. Where there are substantial markets these tend to be the oldest ones, having a tradition of non-profit insurers, and to be the most heavily regulated to ensure VHI policies are accessible and affordable. The study also suggests that VHI is normally a better way of meeting population health needs than out-of-pocket payments, although there are notable exceptions. VHI can contribute to financial protection, especially where it plays a substitutive and complementary role covering co-payments. However, it is a complex, challenging and highly context-specific policy instrument that may undermine other health system goals, including equitable access, efficiency, transparency and accountability, even where markets are well regulated. Policy-makers should therefore exercise real caution before expanding VHI to fill coverage gaps..

This volume and its companion set of country profiles were developed jointly by the Observatory's LSE hub and the WHO Regional Office for Europe. The study draws on contributions from national experts from the EU, EFTA and other countries in Europe.

Product Details

ISBN-13: 9789289050388
Publisher: World Health Organization
Publication date: 08/11/2016
Series: Salty Splashes Collection
Pages: 136
Product dimensions: 6.20(w) x 9.40(h) x 0.30(d)

About the Author

Anna Sagan

Sarah Thomson

Table of Contents

Acknowledgements vii

List of tables, boxes and figures xi

List of abbreviations xv

Note xvii

Chapter 1 Introduction 1

Chapter 2 VHI at a glance 3

Chapter 3 Why do people buy VHI? 29

3.1 What drives demand for VHI? 29

3.2 VHI plays different roles 32

Chapter 4 Who buys VHI? 49

4.1 Share of the population covered by VHI 49

4.2 Individuals versus groups 51

4.3 The socio-economic status of VHI policyholders 52

Chapter 5 How do markets for VHI work? 57

5.1 Type and number of entities selling VHI 57

5.2 Policy conditions, premiums and benefits 61

5.3 Consumer choice and information 74

5.4 Purchasing health services 77

5.5 VHI spending on health services and administration 82

Chapter 6 Public policy towards VHI 85

6.1 EU regulation 85

6.2 National regulation 89

6.3 Tax policy 94

6.4 National policy developments and concerns 97

References 101

Appendix A Data on health spending in the European Region 111

Appendix B Information on the availability of data and on data assumptions made for figures based on WHO (2016) 115

Appendix C Country codes 115

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