Private Health Insurance

The OECD Study on Private Health Insurance is one component of the OECD Health Project, carried out jointly by the Health Policy Unit of the Directorate for Employment, Labor and Social Affairs and the Insurance Committee of the Directorate for Fiscal and Financial Affairs. The work was commenced in 2001 and completed in 2004. The final report, Private Health Insurance in OECD Countries, was released in November 2004.

The study has assesses the role that private health insurance (PHI) plays in OECD member countries. The main aims of the study were:

To identify policy issues arising from the interdependence of private health insurance with public health coverage schemes; 

- To assess mixed models of private/public health insurance against health policy objectives; 

- To assess the impact of governmental regulation on health systems performance; 

- To analyze the challenges and benefits related to private health insurance in different insurance mixes, and the preconditions for the development of an efficient and equitable health insurance market. 

The main policy questions addressed have included:

1. What is the impact of PHI markets and different insurance mixes on equity in the health system? 

2. What risks and opportunities does PHI pose to cost pressures on health systems? 

3. How does PHI improve responsiveness of health systems? 

4. What regulatory mechanisms and financial incentives can deliver equity, efficiency, and responsiveness from different insurance mixes and PHI markets? 

The role of private health insurance can vary considerably across OECD countries, due to the historical, political and market factors that have influenced the development of health systems. In order to collect information and data on PHI, the study has:

Developed a taxonomy of private health insurance schemes in OECD countries, which has set a framework for collecting data on various types of health insurance schemes. 

Developed two survey instruments:

a) On statistics, which gathered data on private health insurance markets,  such as premiums, claims, population coverage and share of total health expenditure;

b) On regulations, which gathered detailed information on governmental interventions towards PHI. Collected an extensive literature.