How Health Insurance Design Affects Access to Care and Costs

The importance of health insurance cannot be overstated. It can help ensure you get the care you need, at a price that is fair.

There is a reason people spend a lot of time to make sure they can find the best plan. This can help you get the right plan for whatever your needs and budget are. 

When it comes to choosing a plan, two of the most important things to people are cost and access to care. When it comes to cost, you obviously want a plan you can afford and one that gives you good value for the money. You also want your plan to give you great access to healthcare in your area so you can get quick assistance when you need it.

In addition to the individual plan you get, the overall design of the health insurance system can also have an impact on your costs and access to care. See, the insurance design and system used in the USA isn’t the only one on the planet. There are several different designs, and this design can actually have an impact on things like cost and access to care.

Different Kinds of Health Insurance Designs

So what are the different health insurance designs out there? In general, there are two main systems often used, private and public. Private health insurance is provided by private companies and individuals can choose which type of plan they prefer from a list of available options.  

On the other hand, public insurance is where healthcare costs are covered by the government, and often paid for by slightly higher taxes. However, in many cases, a hybrid system is used. This uses aspects of both public and private systems, and their level of things like cost-sharing can differ from one area to another. For example, some nations might cover the basic medical needs and primary care, but still require people to pay out-of-pocket for things like prescriptions and vision/dental care.

How Health Insurance Design Affects Access to Care

So how does the type of health insurance design of your country impact your access to care? Well, to answer that question (and how they affect costs) we will be looking at the findings of a study done by several experts that looked at exactly that. They compared various countries across the world, who all have different systems, and asked respondents a series of questions. 

When it comes to access to care, normally insurance systems that offer largely private options have less wait times. This makes sense as public systems generally provide the same basic coverage for anyone. This means more people are able to use healthcare anytime without worrying, which can add to longer wait times. 

Of course, there are some outliers (such as low income individuals in the USA), but people who pay more for private coverage often get quicker access, especially when it comes to specialists. Though simply because people have access to care, that doesn’t always mean they are willing to use it more often.

How Health Insurance Design Affects Your Costs

Now that you have seen how the design of a health insurance system can affect access to care, what sort of impact does it have on costs? Well in general, areas that have things like cost sharing, deductibles and largely private insurance-run systems will pay more for health insurance. This is why places like the USA, Switzerland, Norway and others have the most expensive healthcare globally. 

However, those areas that have largely public healthcare and insurance systems will often pay higher taxes in order to help cover the costs. Think of it as everyone pitching in for the collective healthcare of the nation, rather than everyone paying for themselves.

Of course, in areas where not everything is covered by the government, there is generally supplemental insurance either provided by a company or their workplace. These can help lower these out-of-pocket costs not covered, but also come with their own costs.

We hope that the information included in this article has been able to help you learn more about how the design of health insurance can impact things like access to care and costs. Of course, each system has pros and cons, and this article isn’t meant to choose or decide which is better.  

We are simply going over how the design of these insurance systems has been able to impact both costs and access to care. Be sure to do your own research if you are interested in the specific healthcare systems in place around the world.