Barnes Andrew J, Hanoch Yaniv
Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, 830 E Main St, 9th Floor, Richmond, Virginia, 23219, USA.
School of Psychology, Plymouth University, B204, Portland Square, Drake Circus, Plymouth, Devon, PL4 8AA, UK.
Isr J Health Policy Res. 2017 Jul 13;6(1):40. doi: 10.1186/s13584-017-0163-2.
As coverage is expanded in health systems that rely on consumers to choose health insurance plans that best meet their needs, interest in whether consumers possess sufficient understanding of health insurance to make good coverage decisions is growing. The recent IJHPR article by Green and colleagues-examining understanding of supplementary health insurance (SHI) among Israeli consumers-provides an important and timely answer to the above question. Indeed, their study addresses similar problems to the ones identified in the US health care market, with two notable findings. First, they show that overall-regardless of demographic variables-there are low levels of knowledge about SHI, which the literature has come to refer to more broadly as "health insurance literacy." Second, they find a significant disparity in health insurance literacy between different SES groups, where Jews were significantly more knowledgeable about SHI compared to their Arab counterparts.The authors' findings are consistent with a growing body of literature from the U.S. and elsewhere, including our own, presenting evidence that consumers struggle with understanding and using health insurance. Studies in the U.S. have also found that difficulties are generally more acute for populations considered the most vulnerable and consequently most in need of adequate and affordable health insurance coverage.The authors' findings call attention to the need to tailor communication strategies aimed at mitigating health insurance literacy and, ultimately, access and outcomes disparities among vulnerable populations in Israel and elsewhere. It also raises the importance of creating insurance choice environments in health systems relying on consumers to make coverage decisions that facilitate the decision process by using "choice architecture" to, among other things, simplify plan information and highlight meaningful differences between coverage options.
在依赖消费者选择最符合其需求的医疗保险计划的卫生系统中，随着覆盖范围的扩大，人们越来越关注消费者是否具备足够的医疗保险知识以做出良好的覆盖范围决策。格林及其同事最近发表在《国际卫生政策与管理杂志》上的文章，研究了以色列消费者对补充医疗保险（SHI）的理解，为上述问题提供了重要且及时的答案。事实上，他们的研究解决了美国医疗保健市场中发现的类似问题，有两个值得注意的发现。首先，他们表明，总体而言——无论人口统计学变量如何——对补充医疗保险的知识水平较低，文献中更广泛地将其称为“医疗保险素养”。其次，他们发现不同社会经济地位群体之间在医疗保险素养方面存在显著差异，与阿拉伯人相比，犹太人对补充医疗保险的了解明显更多。作者的研究结果与美国和其他地方（包括我们自己的研究）越来越多的文献一致，这些文献表明消费者在理解和使用医疗保险方面存在困难。美国的研究还发现，对于被认为最脆弱、因此最需要充足且负担得起的医疗保险覆盖的人群来说，困难通常更为严重。作者的研究结果提醒人们，需要调整沟通策略，以减轻医疗保险素养问题，并最终缩小以色列和其他地方弱势群体在医保获取和结果方面的差距。这也凸显了在依赖消费者做出覆盖范围决策的卫生系统中创建保险选择环境的重要性，通过使用“选择架构”等方式简化计划信息并突出覆盖选项之间的显著差异，从而促进决策过程。
