Starr began by describing four "encumbrances of history" that have shaped delivery of health care in America. One he termed the "welfare piggyback," referring to the channeling of governmental health services for the poor through public assistance rather than through a universal social insurance system or a national public health service, the two systems employed in Europe. The social insurance...

BACKGROUND Cancer accounts for one-fifth of the total deaths in China and brings heavy financial burden to patients and their families. Chinese government has made strong commitment to develop three types of social medical insurance since 1997 and recently, more attempts were invested to provide better financial protection. To analyze health services utilization and financial burden of insured ...

BACKGROUND Forty-one million Americans have no health insurance and, despite the growth of managed care, medical costs are again increasing rapidly. One proposed solution is a single-payer health care financing system with universal coverage. Yet, physicians' views of such a system have not been well studied. METHODS We surveyed a random sample of physicians (from the American Medical Associa...

Background: Most of the previous epidemiologic studies on atopic dermatitis were based on the analysis of young patients excluding adults, and the target population was confined to a certain area. Korea has a national health insurance system, which covers the entire population and all medical facilities. Details of every medication, medical service, and diagnosis can be obtained in the Korean h...

OBJECTIVE To promote managed competition in Dutch health insurance, the insured are now able to change health insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to another, we investigated their reasons for selecting their health insurer and assessed the importa...

BACKGROUND Moral hazard or utilization hazard refers to the phenomenon during which patients overuse medical services under national health insurance (NHI) because the services are free or the patients are required to pay only a portion of the utilization costs. The aim of this study is to investigate how NHI and private health insurance (PHI) systems influence increases in health care utilizat...

The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business le...

BACKGROUND China has recently adopted the "TB designated hospital model" to improve the quality of tuberculosis (TB) treatment and patient management. Considering that inpatient service often results in high patient financial burden, and therefore influences patient adherence to treatment, it is critical to better understand the TB patient admission rate and TB inpatient service cost, as well a...

Background Thailand has three main health insurance schemes: Universal Coverage Scheme (UCS), Social Security Scheme (SSS) and Civil Servant Medical Benefit Scheme (CSMBS). Health benefits of these schemes are different, which could lead to inequity in access to care and quality of care. Medical emergency care was the first healthcare programme that was implemented towards harmonization of the ...