John M. Bertko  curriculum
USA

Author

 
Date: Monday, March 18

Session: 09

Health Seminar


    Opening Plenary Session Health-Care Reform Using a Public-Private Partnership
 
 

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Summary

Social health insurance and private insurance both represent mechanisms which enable the burden of the direct cost of medical care for the individual to be spread, either over a period of time rather than having to be made at the time and point of delivery, and or among a group of protected people who share the risk of costs of medical care. On the other hand, health care issues cannot be addressed without some level of government involvement. This is the idea behind the need for health policy planning and implementation.

There is a considerable number of issues involved with this process; they are of different nature and present various technical and practical degrees of complexity. Nevertheless, all agree that funding is the chief issue. There are different ways of funding for health services: government financing through taxes, social insurance, private health insurance, and direct payment for services by patients. With the exception of the last, these systems all provide an element of insurance, i.e. risk pooling or risk sharing.

Actuaries have an important role to play in the process of policy-making and funding health services, regardless the specific techniques applied and the type of organization of health delivery.

This paper reviews recent experience in this field and makes some reflections about funding health services and the degree of the actuay's involvement in this process.

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Date: Tuesday, March 19

Session: 29

Health Seminar



Presentation

  Health Risk Adjustment
 

 


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 John Bertko (USA), F.S.A., M.A.A.A.

Curriculum
Vice President and Chief Actuary,
Humana Inc.,
130 Hermosa Ave.,
Oakland, CA 94618,
USA. 

(w): 510/654-8126

(f ):
510/654-8111

E-mail:
jbertko@humana.com

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Author