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Opting out of mandatory health insurance in Latin American countries: implications for policy and decision making in Russian Federation (Russo)

This paper explores the Latin American structure and experience on opting out from mandatory health insurance, focusing on the following aspects and impacts that could be useful for policy decision-making in the context of Russian Federation insurance reform proposals, including: access and quality; utilization; impact on public insurance programs, especially costs; regulatory apparatus necessary; any policy initiatives to change the regulation in the past or present; and, issues related to social insurance and pension insurance funds. In principle, everybody has to participate in mandatory health insurance: public and private employees, the self-employed, pensioners, students, and the unemployed. There maybe legal exceptions, such as the military (Chile) that would keep their own parallel health care financing and delivery system. In other cases, retired military personnel participate in the national social health insurance system (Israel) with contributions paid by the Ministry of Defense on behalf on behalf of the pensioners. Large State enterprises may keep their own health care financial schemes contracting services with both the private and the public sector (Petroleos de Mexico) after signing agreements with the Mexican Institute of Social Security that de facto allows the opting out.


  • Autor

    Fuenzalida-Puelma,Hernan L.

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    Documento de Trabalho

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  • País

    Federação Russa,

    América Latina,

  • Região

    Europa e Ásia Central,

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  • Nome do documento

    Opting out of mandatory health insurance in Latin American countries: implications for policy and decision making in Russian Federation

  • Palavras-chave

    access to health care, basic health, basic health care, clinics, Decision Making, Discrimination, employment, families, financial risk, formal labor market, general insurance, group health insurance, health care, health care delivery, health care expenditures, health care financing, health care plans, health care providers, health care provision, health care sector, health care spending, Health Insurance, health insurance coverage, health insurance industry, health insurance policies, Human Development, income, Informal sector, insurance benefits, insurance companies, insurance contributions, insurance funds, Insurance Law, insurance premiums, Insurance Supervision, laws, life insurance, managed care, marketing, medical equipment, ministries of health, Nutrition, Pension Funds, physicians, premiums, private insurance, private insurance companies, private sector, programs, public health, public health care, public health care services, public insurance, public sector, quality of care, rates, reserves, right to health care, social insurance, Social Security, sustainability, transition economies, unemployment, unemployment insurance



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