Willingness to Pay for Antiretroviral Drugs Covered by Medical Insurance among People Living with HIV in 18 Chinese Cities

Objective Antiretroviral drugs covered by medical insurance have been gradually used by people living with human immunodeficiency virus(PLWH)in recent years in China.This study aimed to analyze their willingness to pay(WTP)for antiretroviral drugs.Methods A mixed-methods study design involving a cross-sectional survey and in-depth interviews was conducted.A cross-sectional survey was performed to collect data on the general characteristics,economic status,antiretroviral therapy(ART)status,and WTP of PLWH in 18 Chinese cities from August 2022 to February 2023.Multivariate logistic regression was used to analyze the factors associated with WTP.Representatives of PLWH were interviewed via in-depth interviews,and the data were thematically analyzed.Results Among the 941 PLWH,271(28.80%)were willing to pay for antiretroviral drugs covered by medical insurance.For basic medical insurance for urban and rural residents,PLWH with the following characteristics were more willing to pay:an educational level of senior high school or technical secondary school,having an undergraduate degree or higher,frequently working away from their hometowns,and homosexual transmission.Off-farm workers and recipients of government medical aid were more unwilling to pay.For basic medical insurance for urban employees,PLWH with the following characteristics were more willing to pay:frequently working away from their hometowns;homosexual transmission;personal annual income≥100,000 CNY;and adverse events of antiretroviral drugs.The main reasons for PLWH’s WTP for antiretroviral drugs covered by medical insurance were that the drugs had fewer adverse events and were easier to administer.The main reasons for PLWH’s unwillingness to pay were financial difficulties and privacy concerns.Conclusion Nearly one-third of PLWH are willing to pay for antiretroviral drugs covered by medical insurance.In the future,PLWH with a high WTP can be guided to use these drugs.

The Extreme Machine Learning Actuarial Intelligent Agricultural Insurance Based Automated Underwriting Model

The paper presents an innovative approach towards agricultural insurance underwriting and risk pricing through the development of an Extreme Machine Learning (ELM) Actuarial Intelligent Model. This model integrates diverse datasets, including climate change scenarios, crop types, farm sizes, and various risk factors, to automate underwriting decisions and estimate loss reserves in agricultural insurance. The study conducts extensive exploratory data analysis, model building, feature engineering, and validation to demonstrate the effectiveness of the proposed approach. Additionally, the paper discusses the application of robust tests, stress tests, and scenario tests to assess the model’s resilience and adaptability to changing market conditions. Overall, the research contributes to advancing actuarial science in agricultural insurance by leveraging advanced machine learning techniques for enhanced risk management and decision-making.

Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

China Continues to Be World’s Second Largest Insurance Market

Allianz Group recently released the Allianz Global Insurance Report,predicting that China will consolidate its position as the world’s second largest insurance market in the next decade.The report analyzes the business performance of the global insurance market in 2023 and forecasts the development direction and trends of the global insurance industry in the next decade.2023:A year of significant growth According to the report,in 2023,the global insurance industry grew by an impressive 7.5%,which is the fastest rate since the pre-Global Financial Crisis(GFC)era.

Telematics as a Transformative Agent for the Zimbabwean Auto Insurance Ecosystem

Zimbabwe has witnessed the evolution of Information Communication Technology (ICT). The vehicle population soared to above 1.2 million hence rendering the Transport and Insurance domains complex. Therefore, there is a need to look at ways that can augment conventional Vehicular Management Information Systems (VMIS) in transforming business processes through Telematics. This paper aims to contextualise the role that telematics can play in transforming the Insurance Ecosystem in Zimbabwe. The main objective was to investigate the integration of Usage-Based Insurance (UBI) with vehicle tracking solutions provided by technology companies like Econet Wireless in Zimbabwe, aiming to align customer billing with individual risk profiles and enhance the synergy between technology and insurance service providers in the motor insurance ecosystem. A triangulation through structured interviews, questionnaires, and literature review, supported by Information Systems Analysis and Design techniques was conducted. The study adopted a case study approach, qualitatively analyzing the complexities of the Telematics insurance ecosystem in Zimbabwe, informed by the TOGAF framework. A case-study approach was applied to derive themes whilst applying within and cross-case analysis. Data was collected using questionnaires, and interviews. The findings of the research clearly show the importance of Telematics in modern-day insurance and the positive relationship between technology and insurance business performance. The study, therefore revealed how UBI can incentivize positive driver behavior, potentially reducing insurance premiums for safe drivers and lowering the incidence of claims against insurance companies. Future work can be done on studying the role of Telematics in combating highway crime and corruption.

Transcending Labor Relations:A Study on the Mechanisms for Protecting Social Insurance Rights and Interests of Workers in New Business Forms——An Empirical Analysis Based on Judicial Cases

Abstract:With the rise of new business forms,the traditional industrial-era model of binding social insurance to labor relations is facing unprecedented challenges.In the context of these new busi-ness forms,whether the protection of workers’social insurance rights and interests can be“decoupled from labor relations”has become a hotly debated topic in academia,with“the ability to establish labor relations”emerging as a key variable influencing government depart-ments’policy choices on classified social insurance coverage.Based on this,the paper constructs a theoretical model of the correlation be-tween social insurance and labor relations to analyze cases concern-ing the protection of social insurance rights and interests of workers in new business forms.It examines the advantages and disadvantages of binding social insurance to labor relations and suggests promoting so-cial insurance policy innovation by transcending labor relations.The paper advocates abandoning the path dependency that starts with la-bor relations and clarifying the theoretical basis that workers’access to social insurance rights should be based on labor rather than em-ployment.To adapt to the profit model of new business forms,it pro-poses establishing a rule of“proportional responsibility for commis-sions,”where the social insurance contribution base is determined by the proportion and amount of corporate commissions.By reasonably setting rates,it will protect the healthy development of new business forms in a balanced manner.In this way,enterprises can share social insurance responsibilities according to unified rules without worrying about being classified as having a labor relationship,which helps fully protect workers’social insurance rights and interests and promotes fair competition and healthy development among enterprises.

An Analysis and Prediction of Health Insurance Costs Using Machine Learning-Based Regressor Techniques

One of the most significant annual expenses that a person has is their health insurance coverage. Health insurance accounts for one-third of GDP, and everyone needs medical treatment to varying degrees. Changes in medicine, pharmaceutical trends, and political factors are only a few of the many factors that cause annual fluctuations in healthcare costs. This paper describes how a system may analyse a person’s medical history to display their insurance plans and make predictions about their health insurance premiums. The performance of four ML models—XGBoost, Lasso, KNN, and Ridge—is evaluated using R2-score and RMSE. The analysis of medical health insurance cost prediction using Lasso regression, Ridge regression, and K-Nearest Neighbours (KNN), and XGBoost (XGB) highlights notable differences in performance. KNN has the lowest R2-score of 55.21 and an RMSE of 4431.1, indicating limited predictive ability. Ridge Regression improves on this by an R2-score of 78.38 but has a higher RMSE of 4652.06. Lasso Regression slightly edges out Ridge with an R2-score of 79.78, yet it suffers from an advanced RMSE of 5671.6. In contrast, XGBoost excels with the highest R2-score of 86.81 and the lowermost RMSE of 4450.4, demonstrating superior predictive accuracy and making it the most effective model for this task. The best method for accurately predicting health insurance premiums was XGBoost Regression. The findings beneficial for policymakers, insurers, and healthcare providers as they can use this information to allocate resources more efficiently and enhance cost-effectiveness in the healthcare industry.

Optimal Insurance with Background Risk under the Ambiguity and Belief Heterogeneity Structure

In this paper, we discuss the optimal insurance in the presence of background risk while the insured is ambiguity averse and there exists belief heterogeneity between the insured and the insurer. We give the optimal insurance contract when maxing the insured’s expected utility of his/her remaining wealth under the smooth ambiguity model and the heterogeneous belief form satisfying the MHR condition. We calculate the insurance premium by using generalized Wang’s premium and also introduce a series of stochastic orders proposed by [1] to describe the relationships among the insurable risk, background risk and ambiguity parameter. We obtain the deductible insurance is the optimal insurance while they meet specific dependence structures.

A Market Model of Risk Transfer and Insurance

We introduce a model of a market where risk-averse consumers pay a fee to transfer their future losses to one or more firms.The future loss of each consumer is stochastic with a unique,known mean and variance.The law of large numbers allows the firms to know with certainty the expected aggregate loss of the consumers to whom they sell.The model could describe the behavior of agents in the market for property insurance where an insurance company sells a single type of policy to a specific group of consumers based upon the expected losses of those consumers and their willingness to pay for coverage.The model demonstrates how a single firm can choose the optimal segment of the market to which they sell a policy and how that choice might change when the distribution of consumers and their risk aversion changes.The model also demonstrates how two firms might engage in a cooperative strategy and share the market.The model shows how a firm entering the market will find it more advantageous to target a segment of the market with consumers that have a lower expected loss.

Analysis of Drug Medical Insurance Access Pricing Based on the Perspective of Binary Equilibrium

Objective To study the influencing factors in the process of national medical insurance negotiation and drug pricing from the dualistic equilibrium perspective,and to provide reference for the harmonious management of drug pricing in China.Methods Through the literature analysis and policy review,the pricing subject,pricing basis and price control system in the pricing process of medical-accessed medicines were analyzed from the perspective of binary equilibrium and harmonious management.Results and Conclusion It is found that four balances in the drug pricing process,two balances in pricing basis and three balances in price control system need to be considered,respectively.Drug pricing is the key content of national medical insurance access,which is also the hotspot of the policy in the pharmaceutical fields in recent years.Drug pricing not only reflects the value of drugs,but also reflects a lot of top-level designs of binary equilibriums in medical insurance policy.While the rational design of drug pricing requires the joint efforts of the government,pharmaceutical companies and relevant experts to comprehensively consider many equilibriums,so as to improve the relevant systems.

Research on the Establishment of a Long-Term Care System for the Elderly with Alzheimer’s Disease Under the Background of Long-Term Care Insurance: A Literature Review

With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.

TEN FEATURES OF CHINA'S LAW ON INSURANCE

The Law on Insurance is becomingeffective as the monopoly position ofChina’s insurance and insurance marketis being shifted to an opening one.The lawassimilates the experience and legal contentof advanced international legislation,but itcan also meet the needs of China’s insurancesystem reform and provide legal protectionfor insurance supervision and sound

Network analysis of Iranian’s health insurance ecosystem before and after the introduction of Universal Health Insurance law

Introduction The policy-making process in health reform is challenging due to the complexity of organizations,overlapping roles,and diversity of responsibilities.The present study aims to investigate and analyze the network of actors in the Iran health insurance ecosystem regarding the laws before and after the adoption of the Universal Health Insurance(UHI).Methods The present study was done by sequential exploratory mixed method research,consisting of two distinct phases.During the qualitative phase,the actors and issues pertaining to the laws of the Iranian health insurance ecosystem from 1971 to 2021 were identified through a systematic search of the laws and regulations section of the Research Center of the Islamic Legislative Assembly website.Qualitative data was analyzed in three steps using directed content analysis.During the quantitative phase,in order to draw the communication network of the actors in Iran’s health insurance ecosystem,the data related to the nodes and links of the networks was collected.The communication networks were drawn using Gephi software and the micro-and macro-indicators of network were calculated and analyzed.Results There were 245 laws and 510 articles identified in the field of health insurance in Iran from 1971 to 2021.Most of the legal comments were on financial matters and credit allocation,and the payment of premiums.The number of actors before and after the enactment of the UHI Law was 33 and 137,respectively.The Ministry of Health and Medical Education and the Iran Health Insurance Organization were found the two main actors in the network before and after the approval of this law.Conclusions Adopting a UHI Law and delegating various legal missions and tasks,often with support to the health insurance organization,have facilitated the achievement of the law objectives.However,it has created a poor governance system and a network of actors with low coherence.Based on the results of the study,it is suggested to reduce actor roles and separate them for better governance and to prevent corruption in health insurance ecosystem.Introducing knowledge and technology brokers can be effective in strengthening governance and filling the structural gaps between actors.

Compulsory Liability Insurance for Marine Drilling Platforms Pollution under Chinese Law

Compulsory liability insurance has widely existed in the field of marine insurance. However, marine drilling platforms have always been excluded from this system in China. In view of the special legal nature of oil pollution compulsory liability insurance for marine drilling platforms, this paper analyzes a number of issues related to oil pollution compulsory liability insurance, elaborates on the necessity for China to implement the system and makes some suggestions about the implementation of that.

How does the Civil Code Process the Civil and Commercial Relations According to the Insurance Law

The relationship between the civil law and commercial law is a long-standing issue of controversy in the area of private law, and it is also an issue of unavoidably legislative selection during the codification the civil code in almost every country. Since the founding of the People Republic of China, China has carried out the codification of civil code for four times, and since the part^s eighteen plenary session officially proposed the ＇codification of civil code＇, the issue of the civil and conmaercial relation draws the attention again, either unification or division of civil and commercial law directly affects the system and content of the civil code, and affects how to process the relationship between the civil law and commercial law during the codification of the civil code as well. The codification of the civil code should not only consider the legislative tradition of the civil and commercial legislation and the current legal system, but also pursue characteristics of the commercial law, in a system of combining civil and commercial law, through adding commercial law into the general principle of civil law; the existing commercial law should be separately retained.

Assessing the feasibility and appropriateness of introducing a national health insurance scheme in Malawi

Background:In May 2015 the Malawian Ministry of Health(MOH)contacted the German Development Cooperation to seek technical assistance from the P4H Network for Social Health Protection for an“Assessment of the appropriateness and feasibility of National Health Insurance in Malawi”against two alternative options:continuing with a tax(and donor)-funded National Health Service,and introducing a purchaser-provider split without a revenue collection function.Methods:A health financing benchmarking matrix was agreed with MOH,with six domains corresponding to six objectives:revenue mobilisation,technical efficiency,equity,financial risk protection,policy coordination,and health outcomes.The assessment comprised key informant interviews with Malawian stakeholders,a review of the relevant literature and datasets,rapid assessments of the Malawi Revenue Authority(MRA)and the Unified Beneficiary Registry(UBR),and projections of the National Health Insurance Scheme’s(NHIS)revenue collection costs and benefits.Results:A key finding was that introducing NHIS in Malawi would increase revenues for health,but these would come predominantly from the formal sector and would be unlikely to cover the health sector funding gap.The performance of existing poverty identification and targeting mechanisms was not commensurate with the requirements of a NHIS.Incentives to enrol in NHI are insufficient to reach scale unless service fees be introduced,which would negatively affect equity and financial risk protection.The assessment identified the Purchaser Scenario as the most favourable reform model.Conclusions:As ever more countries look towards implementing National Health Insurance,the proposed assessment framework can provide an orientation for evidence-based policy making in the area of health financing.

Multistage Stochastic Programming Model for the Portfolio Problem of a Property-Liability Insurance Company

The current portfolio model for property-liability insurance company is only single period that can not meet the practical demands of portfolio management, and the purpose of this paper is to develop a multiperiod model for its portfolio problem. The model is a multistage stochastic programming which considers transaction costs, cash flow between time periods, and the matching of asset and liability; it does not depend on the assumption for normality of return distribution. Additionally, an investment constraint is added. The numerical example manifests that the multiperiod model can more effectively assist the property-liability insurer to determine the optimal composition of insurance and investment portfolio and outperforms the single period one.

Obstacles and Countermeasures for Policyoriented Agricultural Insurance Development in the Context of Agricultural Modernization

Agricultural insurance is a key impetus for agricultural modernization. How- ever, there are some problems on the aspect, including deficiency of law supports and top system design, less recognition on insurance of farmers and low effective demands of agricultural insurance market, huge agricultural risks and insufficient supply from agricultural insurance market, and shortage of reinsurance support and disaster risk desertification, hardly to deal with heavy disasters. Therefore, some countermeasures were proposed, including to formulate agricultural insurance laws and establish specific agricultural insurance management institutions, to reinforce promotion and improve premium subsidy system in order to increase market de- mands, to increase tax preference and operating costs, improve insurance services and enhance effective supply in market and to construct a risk diversification system of agricultural heavy disaster.

GAMES ANALYSIS OF INSURANCE PRICING UNDER CONSIDERING MORAL HAZARD

This paper first gives an explanation of moral hazard in the insurance field,and then offers a game theory model about insurance pricing according to the non zero sum game analysis between the insurer and the insured when moral hazard exists.On the basis of the game analysis,this paper also presents a lowest pricing formula and studies the cost of moral hazard simultaneously.