Book chapter
Health plan payment in Australia
Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets, pp.181-208
Academic Press
2018
Abstract
The Australian healthcare system is characterized by a mix of public and private financing and provision of healthcare services. The health insurance system consists of a National Health Insurance/Service and voluntary private health insurance (PHI). The latter is regulated through the Private Insurance Act (2007) which established a complex mix of subsidies and regulatory instruments (e.g., community rating, open enrollment, ad valorem premium-subsidies and tax-incentives), and provides for the operation and administration of the Risk Equalization Trust Fund. The Australian health plan payment scheme constitutes a combination of risk sharing and risk equalization. The duplicative nature of the current private/public mix (those with PHI remain covered by the national public system) and the potentially inefficient mix of subsidies have contributed to some important issues such as overinsurance, a high market concentration, risk selection, market segmentation, and a misallocation of subsidies. Increasingly, concerns are rising about the affordability, efficiency, and sustainability of the Australian healthcare system.
Details
- Title
- Health plan payment in Australia
- Authors/Creators
- F. Paolucci (Author/Creator)A.R. Sequeira (Author/Creator)A. Fouda (Author/Creator)A. Matthews (Author/Creator)
- Contributors
- T.G. McGuire (Editor)R.C. van Kleef (Editor)
- Publication Details
- Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets, pp.181-208
- Publisher
- Academic Press
- Identifiers
- 991005543250207891
- Copyright
- © 2018 Elsevier Inc.
- Murdoch Affiliation
- Sir Walter Murdoch School of Public Policy and International Affairs
- Language
- English
- Resource Type
- Book chapter
Metrics
90 Record Views