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Development of voluntary private health insurance in Nordic countries – An exploratory study on country-specific contextual factors

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  • Tynkkynen, Liina-Kaisa
  • Alexandersen, Nina
  • Kaarbøe, Oddvar
  • Anell, Anders
  • Lehto, Juhani
  • Vrangbӕk, Karsten

Abstract

The Nordic countries are healthcare systems with tax-based financing and ambitions for universal access to comprehensive services. This implies that distribution of healthcare resources should be based on individual needs, not on the ability to pay. Despite this ideological orientation, significant expansion in voluntary private health insurance (VPHI) contracts has occurred in recent decades. The development and role of VPHIs are different across the Nordic countries. Complementary VPHI plays a significant role in Denmark and in Finland. Supplementary VPHI is prominent in Norway and Sweden. The aim of this paper is to explore drivers behind the developments of the VPHI markets in the Nordic countries. We analyze the developments in terms of the following aspects: the performance of the statutory system (real or perceived), lack of coverage in certain areas of healthcare, governmental interventions or inability to reform the system, policy trends and the general socio-cultural environment, and policy responses to voting behavior or lobbying by certain interest groups. It seems that the early developments in VPHI markets have been an answer to the gaps in the national health systems created by institutional contexts, political decisions, and cultural interpretations on the functioning of the system. However, once the market is created it introduces new dynamics that have less to do with gaps and inflexibilities and more with cultural factors.

Suggested Citation

  • Tynkkynen, Liina-Kaisa & Alexandersen, Nina & Kaarbøe, Oddvar & Anell, Anders & Lehto, Juhani & Vrangbӕk, Karsten, 2018. "Development of voluntary private health insurance in Nordic countries – An exploratory study on country-specific contextual factors," Health Policy, Elsevier, vol. 122(5), pages 485-492.
    • Handle: RePEc:eee:hepoli:v:122:y:2018:i:5:p:485-492
    DOI: 10.1016/j.healthpol.2018.03.008
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    1. Tynkkynen, Liina-Kaisa & Chydenius, Miisa & Saloranta, Anna & Keskimäki, Ilmo, 2016. "Expanding choice of primary care in Finland: much debate but little change so far," Health Policy, Elsevier, vol. 120(3), pages 227-234.
    2. Søgaard, Rikke & Pedersen, Morten Saaby & Bech, Mickael, 2013. "To what extent does employer-paid health insurance reduce the use of public hospitals?," Health Policy, Elsevier, vol. 113(1), pages 61-68.
    3. Joan Costa‐Font & Mireia Jofre‐Bonet, 2008. "Is There A ‘Secession Of The Wealthy’? Private Health Insurance Uptake And National Health System Support," Bulletin of Economic Research, Wiley Blackwell, vol. 60(3), pages 265-287, July.
    4. Siciliani, Luigi & Moran, Valerie & Borowitz, Michael, 2014. "Measuring and comparing health care waiting times in OECD countries," Health Policy, Elsevier, vol. 118(3), pages 292-303.
    5. repec:adr:anecst:y:2006:i:83-84:p:10 is not listed on IDEAS
    6. Pierson, Paul, 2000. "Increasing Returns, Path Dependence, and the Study of Politics," American Political Science Review, Cambridge University Press, vol. 94(2), pages 251-267, June.
    7. Omar Paccagnella & Vincenzo Rebba & Guglielmo Weber, 2013. "VOLUNTARY PRIVATE HEALTH INSURANCE AMONG THE OVER 50s IN EUROPE," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 289-315, March.
    8. Karl Ove Aarbu, 2010. "Demand Patterns for Treatment Insurance in Norway," CESifo Working Paper Series 3021, CESifo.
    9. Joan Costa-Font & Valentina Zigante, 2016. "The choice agenda in European health systems: the role of middle-class demands," Public Money & Management, Taylor & Francis Journals, vol. 36(6), pages 409-416, September.
    10. Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November.
    11. Astrid Kiil & Kurt Houlberg, 2014. "How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 813-828, November.
    12. Saltman, Richard B. & Teperi, Juha, 2016. "Health reform in Finland: current proposals and unresolved challenges," Health Economics, Policy and Law, Cambridge University Press, vol. 11(3), pages 303-319, July.
    13. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    14. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income‐related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608, July.
    15. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 55(1), pages 85-106.
    16. Hurd, Michael D. & McGarry, Kathleen, 1997. "Medical insurance and the use of health care services by the elderly," Journal of Health Economics, Elsevier, vol. 16(2), pages 129-154, April.
    17. Vrangbaek, Karsten & Robertson, Ruth & Winblad, Ulrika & Van de Bovenkamp, Hester & Dixon, Anna, 2012. "Choice policies in Northern European health systems," Health Economics, Policy and Law, Cambridge University Press, vol. 7(1), pages 47-71, January.
    18. Besley, Timothy & Coate, Stephen, 1991. "Public Provision of Private Goods and the Redistribution of Income," American Economic Review, American Economic Association, vol. 81(4), pages 979-984, September.
    19. Andrew M. Jones & Xander Koolman & Eddy Van Doorslaer, 2006. "The impact of having supplementary private health insurance on the uses of specialists," Annals of Economics and Statistics, GENES, issue 83-84, pages 251-275.
    20. Francesca Colombo & Nicole Tapay, 2004. "Private Health Insurance in OECD Countries: The Benefits and Costs for Individuals and Health Systems," OECD Health Working Papers 15, OECD Publishing.
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    2. Aaltonen, Katri & Vaalavuo, Maria, 2024. "Financial burden of medicines in five Northern European countries: A decommodification perspective," Social Science & Medicine, Elsevier, vol. 347(C).
    3. Kullberg, Linn & Blomqvist, Paula & Winblad, Ulrika, 2019. "Health insurance for the healthy? Voluntary health insurance in Sweden," Health Policy, Elsevier, vol. 123(8), pages 737-746.
    4. Lavaste, Konsta, 2023. "Private health insurance in the universal public healthcare system: The role of healthcare provision in Finland," Health Policy, Elsevier, vol. 132(C).
    5. Marenzi, Anna & Rizzi, Dino & Zanette, Michele, 2021. "Incentives for voluntary health insurance in a national health system: Evidence from Italy," Health Policy, Elsevier, vol. 125(6), pages 685-692.
    6. Saunes, Ingrid Sperre & Vrangbæk, Karsten & Byrkjeflot, Haldor & Jervelund, Signe Smith & Birk, Hans Okkels & Tynkkynen, Liina-Kaisa & Keskimäki, Ilmo & Sigurgeirsdóttir, Sigurbjörg & Janlöv, Nils & R, 2022. "Nordic responses to Covid-19: Governance and policy measures in the early phases of the pandemic," Health Policy, Elsevier, vol. 126(5), pages 418-426.

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