Private Health Insurance in the Post-Pandemic Era: Spatial Econometric Market Development Analysis

Eralda Xhafka, Jonida Teta, David I. Philippov, Evgeniy V. Kostyrin, Somsak Leelang, Irina V. Nikolaeva, Maksim S. Maramygin, Natalia V. Ruban-Lazareva, Iskandar Muda, Olesya V. Dudnik

Abstract


The post-COVID era has posed unprecedented challenges to healthcare systems worldwide, urging a reevaluation of healthcare financing mechanisms. This study investigates the evolving landscape of private health insurance markets in the aftermath of the pandemic while considering the influence of international sanctions. Employing a spatial lag model (SLM), data from Albania, Russia, and Malaysia were analyzed to uncover the intricate interplay of factors shaping private health insurance coverage rates. The findings reveal nuanced patterns and disparities across these countries. The significance of variables varies: while private insurance share and government health expenditure consistently exhibit positive and substantial impacts on coverage rates, the unemployment rate presents differential effects. COVID-19 deaths influence coverage in Russia, emphasizing the pandemic's specific impact. Moreover, hospital beds’ significance in Malaysia underscores healthcare infrastructure's varying importance. Importantly, the spatial lag effect is consistently significant, emphasizing regional interdependence. Collectively, our study highlights the multifaceted determinants of private health insurance coverage, revealing insights crucial for policymakers navigating post-pandemic healthcare financing challenges among international sanctions.

 

Doi: 10.28991/ESJ-2023-07-06-013

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Keywords


Private Health Insurance; Healthcare Financing; International Sanctions; Post-COVID; COVID-19 Deaths; Spatial Econometrics; Economic Indicators; Healthcare Infrastructure; Policy Recommendations.

References


Brown, J. R., & Finkelstein, A. (2008). The Interaction of public and private insurance: Medicaid and the long-term care insurance market. American Economic Review, 98(3), 1083–1102. doi:10.1257/aer.98.3.1083.

Islam, S., Islam, T., & Islam, M. R. (2022). New Coronavirus Variants are Creating More Challenges to Global Healthcare System: A Brief Report on the Current Knowledge. Clinical Pathology, 15, 2632010 2210755. doi:10.1177/2632010X221075584.

Sun, S., Xie, Z., Yu, K., Jiang, B., Zheng, S., & Pan, X. (2021). COVID-19 and healthcare system in China: challenges and progression for a sustainable future. Globalization and Health, 17(1), 14. doi:10.1186/s12992-021-00665-9.

Huyen, B. T., & Van Quyet, L. (2022). Russia’s Pivot to Asia and Russia-Vietnam Economic Relations in the Early 21st Century. Emerging Science Journal, 6(6), 1492-1506. doi:10.28991/ESJ-2022-06-06-017.

Haldane, V., De Foo, C., Abdalla, S. M., Jung, A. S., Tan, M., Wu, S., Chua, A., Verma, M., Shrestha, P., Singh, S., Perez, T., Tan, S. M., Bartos, M., Mabuchi, S., Bonk, M., McNab, C., Werner, G. K., Panjabi, R., Nordström, A., & Legido-Quigley, H. (2021). Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries. Nature Medicine, 27(6), 964–980. doi:10.1038/s41591-021-01381-y.

Driggin, E., Madhavan, M. V., Bikdeli, B., Chuich, T., Laracy, J., Biondi-Zoccai, G., Brown, T. S., Der Nigoghossian, C., Zidar, D. A., Haythe, J., Brodie, D., Beckman, J. A., Kirtane, A. J., Stone, G. W., Krumholz, H. M., & Parikh, S. A. (2020). Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems during the COVID-19 Pandemic. Journal of the American College of Cardiology, 75(18), 2352–2371. doi:10.1016/j.jacc.2020.03.031.

Roehr, B. (2020). The health of private insurance in the US during covid-19. BMJ, m2606. doi:10.1136/bmj.m2606.

Jakovljevic, M., Mouselli, S., Al Ahdab, S., & Hammoudi Halat, D. (2022). Editorial: Does healthcare financing explain different healthcare system performances and responses to COVID-19? Frontiers in Public Health, 10, 1062425. doi:10.3389/fpubh.2022.1062425.

Piech, K. (2022). Health Care Financing and Economic Performance during the Coronavirus Pandemic, the War in Ukraine and the Energy Transition Attempt. Sustainability (Switzerland), 14(17), 10601. doi:10.3390/su141710601.

Lexa, F. J., & Lexa, F. J. (2020). Private Equity–Backed Hospital Investments and the Impact of the Coronavirus Disease 2019 (COVID-19) Epidemic. Journal of the American College of Radiology, 17(8), 1049–1052. doi:10.1016/j.jacr.2020.05.023.

Williams, O. D. (2020). COVID-19 and Private Health: Market and Governance Failure. Development (Basingstoke), 63(2–4), 181–190. doi:10.1057/s41301-020-00273-x.

Jakovljevic, M., Groot, W., & Souliotis, K. (2022). Editorial: Health care financing and affordability in the emerging global markets, Volume II. Frontiers in Public Health, 10, 1054409. doi:10.3389/fpubh.2022.1054409.

Paudel, Y. (2012). A Comparative study of public-private catastrophe insurance systems: Lessons from current practices. Geneva Papers on Risk and Insurance: Issues and Practice, 37(2), 257–285. doi:10.1057/gpp.2012.16.

Doshmangir, L., Bazyar, M., Rashidian, A., & Gordeev, V. S. (2021). Iran health insurance system in transition: equity concerns and steps to achieve universal health coverage. International Journal for Equity in Health, 20(1), 37. doi:10.1186/s12939-020-01372-4.

Samsudin, A., & Prabowo, H. (2022). Community-based health coverage at the crossroad: The Muhammadiyah health fund in Indonesia. Indonesian Journal of Islam and Muslim Societies, 12(1), 111–138. doi:10.18326/ijims.v12i1.111-138.

Barasa, E., Kazungu, J., Nguhiu, P., & Ravishankar, N. (2021). Examining the level and inequality in health insurance coverage in 36 sub-Saharan African countries. BMJ Global Health, 6(4), 4712. doi:10.1136/bmjgh-2020-004712.

Chen, H., Ding, Y., Wang, X., & Yang, Y. (2023). The effect of public insurance policy on the private insurance market: New evidence from a quasi-experiment in China. Economic Analysis and Policy, 78, 937–953. doi:10.1016/j.eap.2023.04.031.

Xiao, R., Ross, J. S., Gross, C. P., Dusetzina, S. B., McWilliams, J. M., Sethi, R. K. V., & Rathi, V. K. (2022). Hospital-Administered Cancer Therapy Prices for Patients with Private Health Insurance. JAMA Internal Medicine, 182(6), 603–611. doi:10.1001/jamainternmed.2022.1022.

Batbold, O., & Pu, C. (2021). Willingness to pay for private health insurance among workers with mandatory social health insurance in Mongolia. International Journal for Equity in Health, 20(1), 1–14. doi:10.1186/s12939-020-01343-9.

Sajadi, H. S., Yahyaei, F., Ehsani-Chimeh, E., & Majdzadeh, R. (2023). The human cost of economic sanctions and strategies for building health system resilience: A scoping review of studies in Iran. International Journal of Health Planning and Management, 38(5), 1142–1160. doi:10.1002/hpm.3651.

Akbarialiabad, H., Rastegar, A., & Bastani, B. (2021). How sanctions have impacted Iranian healthcare sector: A brief review. Archives of Iranian Medicine, 24(1), 58–63. doi:10.34172/AIM.2021.09.

Gray, W. K., Navaratnam, A. V., Day, J., Babu, P., Mackinnon, S., Adelaja, I., Bartlett-Pestell, S., Moulton, C., Mann, C., Batchelor, A., Swart, M., Snowden, C., Dyer, P., Jones, M., Allen, M., Hopper, A., Rayman, G., Kar, P., Wheeler, A., … Briggs, T. W. R. (2021). Variability in COVID-19 in-hospital mortality rates between National Health Service trusts and regions in England: A national observational study for the Getting It Right First Time Programme. EClinicalMedicine, 35, 100859. doi:10.1016/j.eclinm.2021.100859.

Chaudhry, F. B., Raza, S., Raja, K. Z., & Ahmad, U. (2020). Covid 19 and Bame Health Care Staff: Wrong Place at the Wrong Time. Journal of Global Health, 10(2), 1–4. doi:10.7189/jogh.10.020358.

Costa-i-Font, J., & Vilaplana-Prieto, C. (2023). Health System Trust and Compliance with COVID-19 Restrictions. SSRN Electronic Journal. doi:10.2139/ssrn.4375376.

Warner, M. E., & Hefetz, A. (2012). Insourcing and outsourcing: The dynamics of privatization among U.S. Municipalities 2002-2007. Journal of the American Planning Association, 78(3), 313–327. doi:10.1080/01944363.2012.715552.

Abdrassilov, A., Orynbassarova, Y., & Tvaronaviciene, M. (2023). Exploring Environmental Factors for the Sports Clusters Development. Journal of Environmental Management and Tourism, 14(3), 799-810. doi:10.14505/jemt.v14.3(67).19.

Lambert, D. M., Brown, J. P., & Florax, R. J. G. M. (2010). A two-step estimator for a spatial lag model of counts: Theory, small sample performance and an application. Regional Science and Urban Economics, 40(4), 241–252. doi:10.1016/j.regsciurbeco.2010.04.001.

Belli, P., Gotsadze, G., & Shahriari, H. (2004). Out-of-pocket and informal payments in health sector: Evidence from Georgia. Health Policy, 70(1), 109–123. doi:10.1016/j.healthpol.2004.03.007.

Masiye, F., & Kaonga, O. (2016). Determinants of healthcare utilisation and out-of-pocket payments in the context of free public primary healthcare in Zambia. International Journal of Health Policy and Management, 5(12), 693–703. doi:10.15171/ijhpm.2016.65.

Cohidon, C., El Hakmaoui, F., & Senn, N. (2022). The role of general practitioners in managing the COVID-19 pandemic in a private healthcare system. Family Practice, 39(4), 586–591. doi:10.1093/fampra/cmab112.

Gruber, J. (1998). Unemployment insurance, consumption smoothing, and private insurance: Evidence from the PSID and CEX. Research in Employment Policy, 1, 1-43.

Atella, V., Piano Mortari, A., Kopinska, J., Belotti, F., Lapi, F., Cricelli, C., & Fontana, L. (2019). Trends in age-related disease burden and healthcare utilization. Aging Cell, 18(1), 12861. doi:10.1111/acel.12861.

Franco, C. M., Lima, J. G., & Giovanella, L. (2021). Primary healthcare in rural areas: Access, organization, and health workforce in an integrative literature review. Cadernos de Saude Publica, 37(7), 310520. doi:10.1590/0102-311X00310520.

Gao, C., Feng, Y., Tong, X., Lei, Z., Chen, S., & Zhai, S. (2020). Modeling urban growth using spatially heterogeneous cellular automata models: Comparison of spatial lag, spatial error and GWR. Computers, Environment and Urban Systems, 81, 101459. doi:10.1016/j.compenvurbsys.2020.101459.

Chen, X., Shao, S., Tian, Z., Xie, Z., & Yin, P. (2017). Impacts of air pollution and its spatial spillover effect on public health based on China’s big data sample. Journal of Cleaner Production, 142, 915–925. doi:10.1016/j.jclepro.2016.02.119.

Hou, H., & Zhu, Y. (2022). Analysis of spillover effects of regional environmental pollution: an interprovincial study in China based on spatiotemporal lag model. Environmental Science and Pollution Research, 29(1), 836–853. doi:10.1007/s11356-021-15739-9.

Bidanset, P. E., & Lombard, J. R. (2014). Evaluating spatial model accuracy in mass real estate appraisal: A comparison of geographically weighted regression and the spatial lag model. Cityscape, 16(3), 169-182.

Cheng, T. C. (2014). Measuring the effects of reducing subsidies for private insurance on public expenditure for health care. Journal of Health Economics, 33(1), 159–179. doi:10.1016/j.jhealeco.2013.11.007.


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DOI: 10.28991/ESJ-2023-07-06-013

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Copyright (c) 2023 Eralda Xhafka, Jonida Teta, David I. Philippov, Evgeniy V. Kostyrin, Somsak Leelang, Irina V. Nikolaeva, Maksim S. Maramygin, Natalia V. Lazareva, Iskandar Muda, Olesya V. Dudnik