Progress and Excellence Research

Progress and Excellence Research

The Impact of Supplementary Health Insurance on Productivity and Household Healthcare Cost Management within the Framework of the Health Economics System

Document Type : Original Article

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Abstract
Humans have always sought to reduce risks arising from unforeseen events. Since health is of critical importance, its various dimensions must be accurately understood by experts in the field so that appropriate methods can be used to manage the risks associated with illness. One such method is the coverage of healthcare costs through supplementary health insurance, which, by adopting intelligent and strategic measures, can partially address the limitations and shortcomings of basic health insurance. As supplementary health insurance is a solution for covering risks arising from unexpected events and diseases, stakeholders in this sector must identify influencing factors on policyholders’ willingness to pay and design appropriate plans to inform the public. The aim of this article is to examine the impact of supplementary health insurance on two key components: household healthcare cost management and access to health services, with emphasis on its role in Iran’s health economics system. Using a case study approach focused on Atiyeh-Sazan Hafez Insurance Company, this research analyzes the performance of this type of insurance in reducing household financial burden, facilitating access to higher-quality services, and its macro-level implications for the health system, as well as the synergy between supplementary and basic insurance schemes. The findings indicate that supplementary health insurance, by adjusting direct and indirect health costs, leads to increased predictability of expenses and reduces the risk of catastrophic health expenditures. Furthermore, by expanding the network of private service providers and covering more specialized services, it improves access and satisfaction with healthcare services. Accordingly, the government can focus more on prevention in the health sector and enhance productivity within the health economics system.
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