International Portability of Health-Cost Coverage : Concepts and Experience
Social insurance and other arrangements for funding health-care benefits often establish long-term relationships, effectively providing insurance against lasting changes in an individual's health status, engaging in burden-smoothing over the l...
| Main Authors: | , |
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| Format: | Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2017
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/144321468177841767/International-portability-of-health-cost-coverage-concepts-and-experience http://hdl.handle.net/10986/27341 |
| Summary: | Social insurance and other arrangements
for funding health-care benefits often establish long-term
relationships, effectively providing insurance against
lasting changes in an individual's health status,
engaging in burden-smoothing over the life cycle, and
entailing additional elements of redistribution.
International portability regarding this type of cover is,
therefore, difficult to establish, but at the same time
rather important both for the individuals affected and for
the health funds involved in any instance of an
international change in work place or residence. In this
paper, full portability of health-cost cover is taken to
mean that mobile individuals can, at a minimum, find
comparable continuation of coverage under a different system
and that this does not impose external costs or benefits on
other members of the systems in the source and destination
countries. Both of these aspects needs to be addressed in a
meaningful portability framework for health systems, as
lacking or incomplete portability may not only lead to
significant losses in coverage for an individual who
considers becoming mobile which may impede mobility that is
otherwise likely to be beneficial. It may also lead to
financial losses, or windfall gains, for sources of
health-cost funding which can ultimately lead to a
detrimental process of risk segmentation across national
health systems. Against this background, even the most
advanced sets of existing portability rules, such as those
agreed upon multilaterally at the EU-level or laid down in
bilateral agreements on social protection, appear to be
untargeted, inconsistent and therefore potentially harmful,
either for migrants or for health funds operated at both
ends of the migration process, and hence for other
individuals who are covered there. |
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