Health Insurance Concepts Quiz

Health insurance that individuals or employers choose to purchase and pay for, including the state as an employer. It can be provided by public, quasi-public, for-profit, or non-profit organizations, even if private insurers offer statutory coverage.

The tendency for individuals with higher health risks to be more likely to purchase insurance, leading to higher costs and potential market instability.

A type of health insurance plan where all members pay the same premium, regardless of their individual health risk.

A situation where, due to adverse selection, premiums in voluntary health insurance markets rise so high that only individuals with the highest health risks remain, leading to a potential collapse of the market.

Individuals are placed in different risk groups based on characteristics such as age, gender, occupation, family history, and prior illnesses.

A cost associated with using healthcare services, directly paid by the patient.

A financing mechanism where individuals contribute to a pool of funds to cover healthcare costs, with reimbursements determined by the system's rules.

The allocation of financial burden for healthcare, considering fairness and equity in how costs are distributed.

Premiums are set based on the average expected medical costs of the entire group of insured people, not on individual health history.

When individuals consume more healthcare services due to having insurance, often leading to higher costs.

A fixed amount that the insured person must pay before the insurance company starts covering costs.

A fixed amount you pay for each medical service (like a doctor's visit) after the deductible is met.

A percentage of the cost of medical services that you are responsible for paying after the deductible is met.

The maximum amount of out-of-pocket costs an insured person has to pay in a year.

A type of insurance pricing where the premium decreases as the amount of coverage increases.

Private supplementary insurance is when individuals choose to purchase additional health insurance on top of their social health insurance (SHI) coverage. It adds extra benefits and often reduces waiting times for healthcare services.

In Germany's social health insurance (SHI) system, the amount individuals contribute is capped, even if their income exceeds a certain limit. This means they don't pay more once they reach a certain level of earnings.

This refers to the shift in Germany where people are switching from social health insurance (SHI) to private health insurance (PHI).

The prevalence refers to the proportion of people who experience certain health conditions or use particular health services. These statistics show that those with private health insurance (VHI) in Germany tend to be younger, healthier, and have less difficulty accessing care.

Germany has regulations in place for people over 55 who decide to switch to private health insurance. These regulations aim to ensure fairness and stability within the system.

In Chile, the public health insurance system covers a large portion of the population while the private insurance system covers a smaller percentage. The private system offers more varied plans but at a higher cost.

This is a feature of some health insurance plans that allows people to join or exit the plan at specific times, often without restrictions.

Spending per capita refers to the average amount of money that is spent on healthcare for each person in a population. It gives an idea of how much is invested in healthcare in different countries.

Voluntary Health Insurance (VHI) might not address major health problems and may create new challenges for the healthcare system.

Voluntary Health Insurance (VHI) can increase fiscal pressure, potentially leading to higher government spending, especially if it replaces existing public insurance.

VHI can harm equity in healthcare by favoring those who can afford private insurance, potentially widening disparities in access and quality.

Larger markets for Voluntary Health Insurance (VHI) can lead to more significant challenges, like increased complexity and potential market failures.

When designing healthcare policy, it's important to clearly define goals and understand how VHI complements public healthcare.

VHI should be carefully designed to anticipate and minimize risks, such as adverse selection and moral hazard.

VHI requires strong regulation and oversight to ensure it functions properly and doesn't undermine public health goals.

A single-payer system involves a single public entity covering healthcare costs for all citizens, typically funded through taxes.

When VHI covers services that are not already covered by a universal healthcare system, it can lead to inequities in access and financial protection. It also raises the issue of potential market instability.

A situation where individuals choose to purchase VHI because they believe it will give them faster access to healthcare and more choices regarding their treatment.

User charges are direct payments made by patients for healthcare services. They are often used to supplement government funding of healthcare systems, but can be controversial as they can lead to financial barriers and inequities in access.

When access to healthcare services is dependent on the ability to pay, this can result in individuals forgoing essential care due to financial constraints.

The practice of insurers setting premiums based on an individual's health risks, resulting in higher costs for individuals with pre-existing conditions or a higher likelihood of future health issues.

The potential for VHI markets to collapse when only individuals with high health risks remain, leading to rising premiums and ultimately making insurance unaffordable for most.

In France, the growing policy concerns with VHI are driven by factors such as persistent barriers to access, declining quality of coverage, regressive premiums, and increased transaction costs.

A healthcare financing system combining public and private insurance, where the public system covers high-risk individuals (e.g., elderly, disabled) and private insurance covers lower-risk individuals (e.g., employed people).

The option for individuals to opt out of a public health insurance system and choose private insurance instead, leading to potential risk segmentation and weakening of the public system.

A policy question that considers how fairly a health financing system distributes the burden of healthcare costs across different income levels.