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私人医疗保险监管中的紧张关系。

Tensions in private health insurance regulation.

作者信息

Willcox Sharon

机构信息

Victorian Department of Human Services, Level 17/555 Collins St, Melbourne, Vic. 3000, Australia.

出版信息

J Law Med. 2003 Feb;10(3):325-38.

Abstract

This article provides an analysis of the regulatory framework of Australian private health insurance linked to four major implicit regulatory objectives: promoting access to health insurance for consumers; promoting financial solvency and industry viability of registered health benefits organisations; promoting competition between registered health benefits organisations; and promoting accountability to consumers. Through an analysis of regulatory changes, case law and policy documents on the performance of the health insurance industry, it is argued that existing health insurance regulation exhibits inevitable tensions due to shifting and often conflicting government objectives about the role of private health insurance.

摘要

本文分析了澳大利亚私人医疗保险的监管框架,该框架与四个主要的隐性监管目标相关:促进消费者获得医疗保险;促进注册健康福利组织的财务偿付能力和行业生存能力;促进注册健康福利组织之间的竞争;以及促进对消费者的问责。通过对医疗保险行业绩效的监管变化、判例法和政策文件的分析,有人认为,由于政府对私人医疗保险作用的目标不断变化且常常相互冲突,现有的医疗保险监管存在不可避免的矛盾。

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