Social health protection in Cambodia: Challenges of policy design and implementation

The Government of Cambodia is implementing ambitious reform initiatives to improve the country's social health protection system. In January 2018, it was announced that the Health Equity Fund (HEF), which is fully subsidized by a joint government‐donor initiative for the reimbursement of user fees for the poor at public health facilities, is to be expanded to some segments of informal workers belonging to associations, as well as to commune and village chiefs. Since 2017, the National Social Security Fund (NSSF) has provided social health insurance for formal economy workers in enterprises with eight employees or more. In January 2018, it was expanded to civil servants and all employees regardless of the size of the enterprise. However, this article highlights that the new ambitious reforms are not accompanied by careful planning as regards funding, service delivery, human resources and institutional design. This article therefore aims to examine key policy issues and challenges for Cambodia's ambitious reform of its social health protection system in terms of resource generation, population coverage, strategic purchasing and governance.     

Health insurance literacy: A mixed methods study of college students

Objective: This study examines the health insurance literacy, or the ability to use health insurance effectively, of college students. Participants: A total of 455 students from a large, public university completed an online questionnaire in November 2016. Methods: A questionnaire examined students’ knowledge of commonly encountered health insurance terms and ability to apply that knowledge to determine cost-sharing in a clinical setting. Results: The majority of students were able to correctly identify the most commonly encountered terms, but could not identify terms related to plan types and options. Eighty-eight percent of students could not determine their cost-sharing for two presented scenarios. Approximately half of the students indicated they had been confused about their health insurance plan, with one-quarter of students stopping or delaying medical care due to confusion. Conclusions: Outreach and education for students should target specific deficits in knowledge such as those identified in this study.     

逆向选择条件下带奖惩金的两期保险契约模型及其Pareto改进性研究

为了更有效的规避影响保险市场交易效率的逆向选择问题，本文分投保人风险类型为两种和多种情形建立了带奖惩金的两期保险契约模型，首次提出可以用奖励金和惩罚金有效甄别投保人的风险类型。该模型根据投保人第一个保险期内的索赔情况在第二个保险期对其进行奖励或惩罚，高风险类型的投保人如果选择为低风险类型投保人设计的保险契约，则其在第二阶段受到惩罚的概率要远远大于得到奖励的概率，即风险越高的投保人越害怕惩罚金，因此所建模型满足斯彭斯-莫里斯分离条件。带奖惩金的两期保险契约模型中保险公司的期望利润仍然为0，并不会给投保人带来额外的经济负担，却能够实现对传统部分保险契约简单重复两次的严格帕累托改进。最后采用一个算例说明了该模型的有效性。     

产品服务供应链的“双重收益共享”合作机制

产品与服务融合缓解了"供需错位"矛盾，使得产品服务供应链探索成为"供给侧结构性改革"下供需结构性匹配的重要路径。本文刻画产品服务视角下供应链组织结构的本质特征，构建产品服务供应链合作模型，探讨合作机制下"帕累托改进"区间存在性，揭示合作机制对产品服务供应链效率的作用机理。核心研究发现：供应链多元化组织结构加剧收益分配冲突，并导致服务规模与供应链效率"倒挂"现象，而合作机制下"双重收益共享"合作模型能提升产品服务供应链效率。     

The limits of the decentred state: the case of policing insurance claims fraud

Existing research clearly shows that the public–private divide is continuously being challenged, recast and transformed. However, this article argues that a sharp distinction between public and private continues to operate as an important norm for professionals involved in the investigation of insurance claims fraud in Sweden. It shows how power within private insurance companies and the police authority is organized around the public–private divide, which is in turn mobilized to justify repression and to give investigations legitimacy. The article indicates that the formal public–private distinction is far more thoroughly maintained than is suggested by the existing literature. Rather than challenging the centrality of state power, private insurers and the police construct, maintain and have a stake in the reproduction of a state‐centric monopoly of crime control.     

农业保险的保障水平与财政补贴政策优化：一个文献综述 *

近年来，我国农业保险快速发展，在保费收入、保障范围和参保农户数量等指标上都取得了举世瞩目的成绩。与此同时，保障水平不高、农业保险“不解渴、不顶用”也一直是各方反映的焦点之一。本文结合了福利经济学和保险经济学中的相关理论，遵循“提高农业保险保障水平必须优化其财政补贴政策”的逻辑主线，对实施财政补贴政策是提升农业保险保障水平的前提条件、有效途径、有力举措和重要渠道进行了梳理和评析。最后，针对现有研究的不足，结合当前的时代背景，对该领域日后的研究重点进行了预测，并进一步探讨了其优化路径。     

国外巨灾保险体制对中国的启示

中国长期受到自然灾害的困扰,建立适合国情的巨灾保险体制已经成为必然。分析中国巨灾保险在供给和需求两方面均呈现不足状态的原因,借鉴国际上巨灾保险体制发展较好国家的经验,认为建立完善的巨灾保险体制需要从建立完备的法律体系、发展繁荣的巨灾保险市场和培养多层次的巨灾风险管理体系几个方面入手。从目前情况来看,应该从建立完善的法律体系、发展再保险市场、建立巨灾风险基金和发展政府巨灾债券几个方面着手,建设多层次的、适合中国国情的巨灾保险体制。     

The Impact of In-Home Services Utilization on the Institutionalization of Older People in Korea

As a result of aging populations, institutionalization of older people is creating an increasing financial burden in many countries. The purpose of the present study was to explore the impact of in-home service utilization on institutionalization. The subjects were newly certified as eligible for long-term care insurance between January and February 2009 in Korea. The follow-up period was 40 months, to April 2012. We used logistic regression models to identify factors influencing the transition to institutional service, adjusting for gender, age, living status, income level, activities of daily living, and chronic disease. The institutionalization rate was estimated to be 17.3% over 40 months. The interval from transitional living to institutionalization was 36 ± 8 months. Risk factors of transition to institutional services are being female, having advanced age, living with friends or cousins, getting dementia, and not using in-home services. We determined that institutionalization is mitigated by use of in-home services. Therefore, supplying appropriate in-home services to current nonusers would help to greatly reduce the rate of institutionalization of older people.     

Housing hardship and energy insecurity among native-born and immigrant low-income families with children in the United States

The costs for rent and utilities account for the largest share of living expenses, yet these two critical dimensions of material hardship have seldom been examined concurrently in population-based studies. This paper employs multivariate statistical analysis using American Community Survey data to demonstrate the relative risk ratio of low-income renter-occupied households with children experiencing ‘rent burden', ‘energy insecurity', or a ‘double burden’ as opposed to no burden. Findings suggest that low-income households are more likely to experience these economic hardships in general but that specific groups are disproportionately burdened in different ways. For instance, whereas immigrants are more likely to experience rental burden, they are less likely to experience energy insecurity and are also spared from the double burden. In contrast, native-born African Americans are more likely than all other groups to experience the double burden. These results may be driven by the housing stock available to certain groups due to racial residential segregation, decisions regarding the quality of housing low-income householders are able to afford, as well as home-country values, such as modest living and energy conservation practices, among immigrant families. This paper also points to important policy gaps in safety net benefits related to housing and energy targeting low-income households.     

新常态下推进"撤村建居"的探索与思考

"撤村建居"是一个庞大的系统工程,与国家、集体和个人利益息息相关,稍有不慎就会造成社会的不稳定因素.要以有利于经济社会全面发展、有利于加强社会事务管理、有利于提高人民生活水平为要求,统一规划,合理布局,加快农村社区建设,推进新型城镇化步伐.在实施过程中应注意妥善解决好以下问题:"撤村建居"过程中原村集体资产的处置,"撤村建居"后的换届,"撤村建居"后的公益事业及工作经费,"撤村建居"后的社区划分和管理,失地农民的社会保障,建设资金的来源等.