Voluntary Health Insurance In Europe: Role And Regulation (a Euro Publication)
by Anna Sagan /
2016 / English / PDF
3.9 MB Download
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.
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..
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.
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.