Recently, there has been a resurgence of interest in quality of care and health system changes. This paper examines the issue with an emphasis on those with private insurance in a national health system, using the results of two international surveys. The two surveys, sponsored by the Commonwealth Fund were conducted in 1998 and 1999 with approximately 1,000 respondents in each of the following countries: Australia, Canada, New Zealand,United Kingdom and the United States. The 1998 survey was conducted with the general public and the 1999 survey was done with respondents age 65 and older. The percentage of the general population with private coverage ranged from a low of 17 percent in the United Kingdom to 53 percent in Canada. In general, those with private coverage were older and had above average incomes. Bivariate analysis of the 1998 survey indicates that those with private coverage were more likely to be satisfied with the care they receive and less likely to report worries about obtaining and paying for care in the future. Preliminary multivariate analysis suggests that differences remain when other demographic variables are controlled. In contrast, elderly respondents with private coverage in the 1999 survey were not significantly more likely to exhibit differences on these measures. These findings have significant policy implications as the national system move to incorporate market strategies such as co-payments to control costs. These strategies may serve to increase the percentage of the population choosing private, supplemental coverage.
Learning Objectives: Identify the effect of private supplemental insurance in a national system on satisfaction with care and worries about the future and discusshow this might be influence by recent policy changes in these national health systems.
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.