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Health insurance can offer protection against catastrophic medical
expenses and improve access to health care. There are, however,
imperfections in the insurance market that require intervention
such as asymmetry of information between the policy holder and the
insurance company, moral hazard that can occur on the side of the
insured or the provider of health services, risk selection that may
lead to cream skim a particular market, and others. To encourage
the effective development of Voluntary Private Health Insurance, it
will be necessary for policymakers to establish and enforce
regulatory standards that will attempt to correct inefficiencies
from market failures and that will achieve desired social
objectives. This book is intended to help countries that are
contemplating how to design and implement a legal framework for a
private health insurance market. First, it provides an overview of
private health insurance, the rationale for insurance regulation,
and the institutions involved in administering insurance laws. It
then reviews the key standards and protections that are often used
in regulating private health insurance. As part of the discussion
on regulatory standards, options for supervisors in certain areas
where policy and regulation approaches vary will be noted. To
illustrate international experience, examples of the regulation of
private health insurance from several low, middle, and high-income
countries will be drawn upon throughout the book.
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