Realization of the Right to Health Protection in Insurance Medicine: The First Experience of Covid-19
Keywords:
Right to Health, Coronavirus, Health Care System, Public Medicine, Private Medicine
Abstract
This article analyze the effectiveness of insurance medicine and the negative consequences of its work, which we could observe in the first period of the pandemic. The research methodology is based on general and special scientific methods, in particular: formal-legal, historical-legal, comparative analysis, and modeling. The procedure and issues to be considered are as follows: in the introduction, we will consider the concept of “the right to health care” and why it is important; in the first section, we will look at the general state of affairs, figures for different countries, and the first results of the fight against the pandemic; in the second section, we will touch on some of the problems of access to health care in the insurance system and its aggravation in connection with the pandemic; in the third, we will consider the impact of the pandemic on the health insurance system and how it could have been avoided some problems. The results of this study emphasize that the medical insurance system has extremely unsatisfactorily coped with the pandemic and its consequences, and therefore it is necessary at least to carry out a full-fledged official, and at best to develop an urgent comprehensive modernization program, taking into account the above positive experience of other developed countries.
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References
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Bodenheimer, T. & Pham, H. H. (2010). Primary Care: Current Problems and Proposed Solutions. Health Affairs, 29(5), 799–805. DOI: 10.1377/hlthaff.2010.0026.
Brown, E. R., Ojeda, V. D., Wyn, R. & Levan, R. (2000). Racial and ethnic disparities in access to health insurance and health care. UCLA Center for Health Policy Research and the Henry J. Kaiser Family Foundation. In http://healthpolicy.ucla.edu/publications/Documents/PDF/Racial%20and%20Ethnic%20Disparities%20in%20Access%20to%20Health%20Insurance%20and%20Health%20Care.pdf.
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Cohen, R.A., Terlizzi, E.P., Martinez, M.M. & Cha, A.E. (2020). Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January–June 2019. National Health Interview Survey Early Release Program. In https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202005-508.pdf.
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Douthit, N., Kiv, S., Dwolatzky, T. & Biswas, S. (2015). Exposing some important barriers to health care access in the rural USA. Public Health, 129(6), 611-20. DOI: 10.1016/j.puhe.2015.04.001.
FAIR Health, Inc. (2020). The Projected Economic Impact of the Covid-19 Pandemic on the US Healthcare System. In https://s3.amazonaws.com/media2.fairhealth.org/brief/asset/Covid-19%20-%20The%20Projected%20Economic%20Impact%20of%20the%20Covid-19%20Pandemic%20on%20the%20US%20Healthcare%20System.pdf.
Freeman, J. D., Kadiyala, S., Bell, J. B. & Martin, D. P. (2008). The Causal Effect of Health Insurance on Utilization and Outcomes in Adults: A Systematic Review of US Studies. Medical Care, 46(10), 1023-1032. DOI: 10.1097/MLR.0b013e318185c913.
Fullman, N., Yearwood, J., Abay, S.A. & Abbafati C. (2018). Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. GBD 2016 Healthcare Access and Quality Collaborators. DOI: 10.1016/S0140-6736(18)30994-2.
Giordano, C. (August 8, 2019). Treat NHS patients in private hospitals to cut waiting lists, government urged. Independent. In https://www.independent.co.uk/news/health/nhs-operation-waiting-list-private-hospitals-a9047661.html.
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Institute of Medicine (US). (2009). America’s Uninsured Crisis: Consequences for Health and Health Care. Washington (DC): National Academies Press. DOI: 10.17226/12511.
Kaiser Family Foundation. (2019). Health Insurance Coverage of the Total Population. In https://www.kff.org/other/state-indicator/total-population/?dataView=1¤tTimeframe=0&selectedDistributions=employer&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
Kliff, S. (June 16, 2020). Most Coronavirus Tests Cost About $100. Why Did One Cost $2,315? The New York Times. In https://www.nytimes.com/2020/06/16/upshot/coronavirus-test-cost-varies-widely.html.
Kurani, N., Pollitz, K., Cotliar, D., Shanosky, N. & Cox, C. (July 15, 2020). Covid-19 Test Prices and Payment Policy. Health System Tracker. In https://www.healthsystemtracker.org/brief/covid-19-test-prices-and-payment-policy/.
Lee, S. Y., Kim, C. W., Seo, N. K. & Lee, S. E. (2017). Analyzing the Historical Development and Transition of the Korean Health Care System. Osong public health and research perspectives, 8(4), 247–254. https://doi.org/10.24171/j.phrp.2017.8.4.03.
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Matsuda, S. (2019). Health Policy in Japan—Current Situation and Future Challenges. JMA Journal, 2(1), 1-10. DOI: 10.31662/jmaj.2018-0016.
McWilliams, J. M., Zaslavsky, A. M. & Meara, E. (2013). Impact of Medicare Coverage on Basic Clinical Services for Previously Uninsured Adults. JAMA, 290(6), 757-764. DOI:10.1001/jama.290.6.757.
Mehrotra, A., Chernew, M., Linetsky, D., Hatch, H. & Cutler, D. (2020). The Impact of the Covid-19 Pandemic on Outpatient Visits: A Rebound Emerges. In https://www.commonwealthfund.org/publications/2020/apr/impact-covid-19-outpatient-visits.
National Association of Community Health Centers and the Robert Graham Center. (2007). Access denied: a look at America’s medically disenfranchised. In https://www.graham-center.org/content/dam/rgc/documents/publications-reports/monographs-books/Access%20Denied.pdf.
U.S. Department of Labor (2020). News release: the employment situation—September 2020. Washington, DC: Bureau of Labor Statistics. In In https://www.bls.gov/news.release/pdf/empsit.pdf.
Nomura, H. & Nakayama, T. (2005). The Japanese healthcare system. BMJ (Clinical research ed.), 331(7518), 648–649. DOI:10.1136/bmj.331.7518.648.
Pimpertz, J. (May 30, 2017). Kein Spielraum für Wahlgeschenke: Wie die Demografie die privaten Haushalte belastet. In https://www.insm-oekonomenblog.de/16590-kein-spielraum-fuer-wahlgeschenke-wie-die-demografie-die-privaten-haushalte-belastet/.
Saad, L. (December 9, 2019). More Americans Delaying Medical Treatment Due to Cost. Gallup. In https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx.
Sawyer, B. & Cox, C. (December 7, 2018). How does health spending in the U.S. compare to other countries? Health System Tracker. In https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries.
Skinner, A. C. & Mayer, M. L. (2007). Effects of insurance status on children’s access to specialty care: a systematic review of the literature. BMC Health Services Research, 7, Article number: 194. DOI: 10.1186/1472-6963-7-194.
Starfield, B., Shi, L. & Macinko, J. (2005). Contribution of Primary Care to Health Systems and Health. The Milbank Quarterly, 83(3), 457-502. DOI: 10.1111/j.1468-0009.2005.00409.x.
Sung, S. & Park, H.A. (2019). Perceived cultural differences in healthcare for foreign patients visiting South Korea: tool development and measurement. BMC Health Serv Res 19, 197. DOI: 10.1186/s12913-019-3965-9.
Tolbert, J., Orgera, K. & Damico, A. (November 6, 2019). Key Facts about the Uninsured Population. KFF. In https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/.
U.S. Department of Health and Human Services Office of Inspector General. (2020). Hospital Experiences Responding to the Covid-19 Pandemic: Results of a National Pulse Survey March 23–27, 2020. In https://oig.hhs.gov/oei/reports/oei-06-20-00300.asp.
United Nations. (1966). International Covenant on Economic, Social and Cultural Rights. In https://www.ohchr.org/en/professionalinterest/pages/cescr.aspx.
Watkins, J., Wulaningsih, W., Zhou, C.D., Marshall, D.C., Sylianteng, G.D.C., Rosa, P.G.D., Miguel, V.A., Raine, R., King, L.P. & Maruthappu, M. (2017). Effects of health and social care spending constraints on mortality in England: a time trend analysis. BMJ Open, 7(11). In https://bmjopen.bmj.com/content/7/11/e017722.
Worldometers. (2020). Coronavirus Cases. In https://www.worldometers.info/coronavirus/.
Zuvekas, S.H. & Taliaferro, G.S. (2003). Pathways to Access: Health Insurance, the Health Care Delivery System, and Racial/Ethnic Disparities, 1996–1999. Health Affairs, 22(2), 139-153. DOI: 10.1377/hlthaff.22.2.139.
American Hospital Association. (2020). New AHA Report: Losses Deepen For Hospitals & Health Systems. In https://www.aha.org/press-releases/2020-06-30-new-aha-report-losses-deepen-hospitals-health-systems.
Ayanian, J. Z., Weissman, J. S., Schneider, E. C., Ginsburg, J. A. & Zaslavsky, A. M. (2009). Unmet health needs of uninsured adults in the United States. DOI: 10.1001/jama.284.16.2061.
Baicker, K., Taubman, S. L., Allen, H. L., Bernstein, M., Gruber, J. H., Newhouse, J. P., Schneider, E.C., Wright, B.J., Zaslavsky, A.M. & Finkelstein. (2013). The Oregon Experiment–Effects of Medicaid on Clinical Outcomes. The New England Journal of Medicine, 368(18), 1713-1722. DOI: 10.1056/NEJMsa1212321.
Banthin, J., Simpson, M., Buettgens, M., Blumberg, L. J. & Wang, R. (July 13, 2020). Changes in Health Insurance Coverage Due to the Covid-19 Recession. Urban Institute. In https://www.urban.org/research/publication/changes-health-insurance-coverage-due-covid-19-recession.
Becton, J. L. J., Cheng, L. & Nieman, L. Z. (2008). The effect of lack of insurance, poverty and pediatrician supply on immunization rates among children 19–35 months of age in the United States. The Journal of Evaluation in Clinical Practice, 14(2), 248-253. DOI: 10.1111/j.1365-2753.2007.00841.x.
Bodenheimer, T. & Pham, H. H. (2010). Primary Care: Current Problems and Proposed Solutions. Health Affairs, 29(5), 799–805. DOI: 10.1377/hlthaff.2010.0026.
Brown, E. R., Ojeda, V. D., Wyn, R. & Levan, R. (2000). Racial and ethnic disparities in access to health insurance and health care. UCLA Center for Health Policy Research and the Henry J. Kaiser Family Foundation. In http://healthpolicy.ucla.edu/publications/Documents/PDF/Racial%20and%20Ethnic%20Disparities%20in%20Access%20to%20Health%20Insurance%20and%20Health%20Care.pdf.
Buchmueller, T. C., Grumbach, K., Kronick, R. & Kahn, J. G. (2005). The Effect of Health Insurance on Medical Care Utilization and Implications for Insurance Expansion: A Review of the Literature. Medical Care Research and Review, 62(1), 3-30. DOI: 10.1177/1077558704271718.
Campbell, D. (July 8, 2019). NHS operations cancelled as consultants work to rule in pensions standoff. The Guardian. In https://www.theguardian.com/society/2019/jul/08/nhs-faces-existential-threat-as-senior-doctors-work-to-rule.
CBS Los Angeles. (2020). Lancaster Teen Who Died Of Possible Covid-19 Complications Lacked Insurance, Delaying Treatment. In https://losangeles.cbslocal.com/2020/03/27/coronavirus-lancaster-teen-insurance/.
Cho, Y., Chung, H., Joo, H., Park, H.J., Joh, H.-K. & Kim, J.W. (2020). Comparison of patient perceptions of primary care quality across healthcare facilities in Korea, A cross-sectional study. PLoS ONE, 15(3), e0230034. https://doi.org/10.1371/journal.pone.0230034.
Cohen, R.A., Terlizzi, E.P., Martinez, M.M. & Cha, A.E. (2020). Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January–June 2019. National Health Interview Survey Early Release Program. In https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202005-508.pdf.
Collins, S. R., Bhupal, H. K. & Doty, M.M. (2019). Health Insurance Coverage Eight Years after the ACA. Common wealth fund. In https://www.commonwealthfund.org/publications/issue-briefs/2019/feb/health-insurance-coverage-eight-years-after-aca.
Collins, S. R., Gunja, M. Z., Aboulafia, G. N., Czyzewicz, E., Kline, C. H., Rapoport, R. & Glancey, S. (June 23, 2020). An Early Look at the Potential Implications of the Covid-19 Pandemic for Health Insurance Coverage. Rama on healthcare. In https://ramaonhealthcare.com/an-early-look-at-the-potential-implications-of-the-covid-19-pandemic-for-health-insurance-coverage/.
Dorn, S. (July 13, 2020). The Covid-19 pandemic and resulting economic crash have caused the greatest health insurance losses in American history. Families USA. In https://familiesusa.org/resources/the-covid-19-pandemic-and-resulting-economic-crash-have-caused-the-greatest-health-insurance-losses-in-american-history/.
Douthit, N., Kiv, S., Dwolatzky, T. & Biswas, S. (2015). Exposing some important barriers to health care access in the rural USA. Public Health, 129(6), 611-20. DOI: 10.1016/j.puhe.2015.04.001.
FAIR Health, Inc. (2020). The Projected Economic Impact of the Covid-19 Pandemic on the US Healthcare System. In https://s3.amazonaws.com/media2.fairhealth.org/brief/asset/Covid-19%20-%20The%20Projected%20Economic%20Impact%20of%20the%20Covid-19%20Pandemic%20on%20the%20US%20Healthcare%20System.pdf.
Freeman, J. D., Kadiyala, S., Bell, J. B. & Martin, D. P. (2008). The Causal Effect of Health Insurance on Utilization and Outcomes in Adults: A Systematic Review of US Studies. Medical Care, 46(10), 1023-1032. DOI: 10.1097/MLR.0b013e318185c913.
Fullman, N., Yearwood, J., Abay, S.A. & Abbafati C. (2018). Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. GBD 2016 Healthcare Access and Quality Collaborators. DOI: 10.1016/S0140-6736(18)30994-2.
Giordano, C. (August 8, 2019). Treat NHS patients in private hospitals to cut waiting lists, government urged. Independent. In https://www.independent.co.uk/news/health/nhs-operation-waiting-list-private-hospitals-a9047661.html.
Goncharona, O. (June 24, 2019). The Right Korea: How Direct Government Financing Of Health Care Combines With Hard Competition in the Medical Services Market. Vademecum. In https://vademec.ru/article/nuzhnaya_koreya-_vademecum_podglyadel_u_dalnevostochnogo_soseda-_kak_pryamoe_gosfinansirovanie_zdrav/?fbclid=IwAR0zbOIqK3Lq9dp63TlX_Ibu-toaVUFppCWSqwWwC8ZpyipUk8qVb2ZtK94.
Harris, S., Sondel, J. & Schneider, G. S. (April 10, 2020). Cash-starved hospitals and doctor groups cut staff amid pandemic. The Washington Post. In https://www.washingtonpost.com/health/starved-for-cash-hospitals-and-doctor-groups-cut-staff-amid-pandemic/2020/04/09/d3593f54-79a7-11ea-a130-df573469f094_story.html.
Institute of Medicine (US). (2009). America’s Uninsured Crisis: Consequences for Health and Health Care. Washington (DC): National Academies Press. DOI: 10.17226/12511.
Kaiser Family Foundation. (2019). Health Insurance Coverage of the Total Population. In https://www.kff.org/other/state-indicator/total-population/?dataView=1¤tTimeframe=0&selectedDistributions=employer&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
Kliff, S. (June 16, 2020). Most Coronavirus Tests Cost About $100. Why Did One Cost $2,315? The New York Times. In https://www.nytimes.com/2020/06/16/upshot/coronavirus-test-cost-varies-widely.html.
Kurani, N., Pollitz, K., Cotliar, D., Shanosky, N. & Cox, C. (July 15, 2020). Covid-19 Test Prices and Payment Policy. Health System Tracker. In https://www.healthsystemtracker.org/brief/covid-19-test-prices-and-payment-policy/.
Lee, S. Y., Kim, C. W., Seo, N. K. & Lee, S. E. (2017). Analyzing the Historical Development and Transition of the Korean Health Care System. Osong public health and research perspectives, 8(4), 247–254. https://doi.org/10.24171/j.phrp.2017.8.4.03.
Majerol, M., Newkirk, V. & Garfield, R. (2015). The Uninsured: A Primer: key facts about health insurance and the uninsured in the era of health reform. Kaiser Family Foundation. In http://files.kff.org/attachment/primer-the-uninsured-a-primer-key-facts-about-health-insurance-and-the-uninsured-in-the-era-of-health-reform.
Matsuda, S. (2019). Health Policy in Japan—Current Situation and Future Challenges. JMA Journal, 2(1), 1-10. DOI: 10.31662/jmaj.2018-0016.
McWilliams, J. M., Zaslavsky, A. M. & Meara, E. (2013). Impact of Medicare Coverage on Basic Clinical Services for Previously Uninsured Adults. JAMA, 290(6), 757-764. DOI:10.1001/jama.290.6.757.
Mehrotra, A., Chernew, M., Linetsky, D., Hatch, H. & Cutler, D. (2020). The Impact of the Covid-19 Pandemic on Outpatient Visits: A Rebound Emerges. In https://www.commonwealthfund.org/publications/2020/apr/impact-covid-19-outpatient-visits.
National Association of Community Health Centers and the Robert Graham Center. (2007). Access denied: a look at America’s medically disenfranchised. In https://www.graham-center.org/content/dam/rgc/documents/publications-reports/monographs-books/Access%20Denied.pdf.
U.S. Department of Labor (2020). News release: the employment situation—September 2020. Washington, DC: Bureau of Labor Statistics. In In https://www.bls.gov/news.release/pdf/empsit.pdf.
Nomura, H. & Nakayama, T. (2005). The Japanese healthcare system. BMJ (Clinical research ed.), 331(7518), 648–649. DOI:10.1136/bmj.331.7518.648.
Pimpertz, J. (May 30, 2017). Kein Spielraum für Wahlgeschenke: Wie die Demografie die privaten Haushalte belastet. In https://www.insm-oekonomenblog.de/16590-kein-spielraum-fuer-wahlgeschenke-wie-die-demografie-die-privaten-haushalte-belastet/.
Saad, L. (December 9, 2019). More Americans Delaying Medical Treatment Due to Cost. Gallup. In https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx.
Sawyer, B. & Cox, C. (December 7, 2018). How does health spending in the U.S. compare to other countries? Health System Tracker. In https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries.
Skinner, A. C. & Mayer, M. L. (2007). Effects of insurance status on children’s access to specialty care: a systematic review of the literature. BMC Health Services Research, 7, Article number: 194. DOI: 10.1186/1472-6963-7-194.
Starfield, B., Shi, L. & Macinko, J. (2005). Contribution of Primary Care to Health Systems and Health. The Milbank Quarterly, 83(3), 457-502. DOI: 10.1111/j.1468-0009.2005.00409.x.
Sung, S. & Park, H.A. (2019). Perceived cultural differences in healthcare for foreign patients visiting South Korea: tool development and measurement. BMC Health Serv Res 19, 197. DOI: 10.1186/s12913-019-3965-9.
Tolbert, J., Orgera, K. & Damico, A. (November 6, 2019). Key Facts about the Uninsured Population. KFF. In https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/.
U.S. Department of Health and Human Services Office of Inspector General. (2020). Hospital Experiences Responding to the Covid-19 Pandemic: Results of a National Pulse Survey March 23–27, 2020. In https://oig.hhs.gov/oei/reports/oei-06-20-00300.asp.
United Nations. (1966). International Covenant on Economic, Social and Cultural Rights. In https://www.ohchr.org/en/professionalinterest/pages/cescr.aspx.
Watkins, J., Wulaningsih, W., Zhou, C.D., Marshall, D.C., Sylianteng, G.D.C., Rosa, P.G.D., Miguel, V.A., Raine, R., King, L.P. & Maruthappu, M. (2017). Effects of health and social care spending constraints on mortality in England: a time trend analysis. BMJ Open, 7(11). In https://bmjopen.bmj.com/content/7/11/e017722.
Worldometers. (2020). Coronavirus Cases. In https://www.worldometers.info/coronavirus/.
Zuvekas, S.H. & Taliaferro, G.S. (2003). Pathways to Access: Health Insurance, the Health Care Delivery System, and Racial/Ethnic Disparities, 1996–1999. Health Affairs, 22(2), 139-153. DOI: 10.1377/hlthaff.22.2.139.
Published
2020-11-19
How to Cite
Lutsyuk, P., Bolokan, I., Davydova, I., Chanysheva, A., & Yakymchuk, S. (2020). Realization of the Right to Health Protection in Insurance Medicine: The First Experience of Covid-19. Ius Humani. Law Journal, 9(2), 341-364. https://doi.org/https://doi.org/10.31207/ih.v9i2.259
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3. Authors can establish further clauses for non exclusive distribution, such as publication on a separate book or placing in an institutional data-base. Nevertheless, a note should be always added to explain that the paper was originally published in Ius Humani Law Journal.
4. We permit and encourage authors to share their work through Internet before and during the editorial process to receive further recommendations and wider references (we recommend you read the article The Effect of Open Access).
