Strategies to mitigate inequity within mandatory health insurance systems: A systematic review. Issue 2 (2nd June 2021)

• Record Type: Journal Article
• Authors: Vaidya, Shalvaree; Boes, Stefan
• Is Part Of: World medical & health policy. Volume 13:Issue 2(2021)
• Page Start: 272
• Page End: 292
• Publication Date: 2021-06-02
• Subjects: health inequity -- healthcare access -- insurance mandate -- mandatory health insurance -- social benefit schemes -- social health insurance; Medical policy -- Periodicals; 362.1
• DOI: 10.1002/wmh3.446
• Languages: English
• ISSNs: 2153-2028

Abstract

Abstract: Mandatory health insurance (MHI) systems carry potential inequities due to their infrastructures. However, they are difficult to categorize and compare due to a high level of global variation. Thus, we conducted a review to define MHI systems typology and set forth recommendations regarding health systems classifications. Subsequently, we also aimed to understand the strategies used within MHI systems to decrease inequity. Using a systematic literature review, we found that health system typologies tend to classify MHI systems within the overarching social health insurance category, thus using the MHI term more as a descriptor rather than an official grouping of systems. Additionally, mandatory payments toward insurance lead to vertical and horizonta\ inequities that impact health outcomes. Social benefit schemes within countries aim to mitigate these inequities, although success rates vary greatly. MHI has the potential to be highly effective in providing universal coverage, thus contributing directly to the health system goals.