Health expenses and financing: The effects of the COVID-19 pandemic.

From 2013 to 2019, expenditure growth rates have increased sharply in almost all European countries. This increase followed a period of stabilization, or in many cases a negative trend in health expenditure ratios across the European Union, resulting from the economic crisis that began in 2008. Expenditure in 2020 in all European states was significantly affected by the COVID-19 disease pandemic. The level of health expenditure and how it changes over time depends on a wide range of factors, including the organizational structure of the health system. Examination of these data reveals wide fluctuations in the levels, with increase of expenditures, especially in the financing of countries to deal with the pandemic. The European Union has financed its member-states through special programmes, in order to cope with the increased demands. This article attempts to analyze the health costs before the COVID-19 period and the ways in which they have been affected during the pandemic. In addition, the impact of the spread of the pandemic on the supply chain of medical supplies and medical equipment, and its expenditure, at the national and the European Union level, is presented.Copyright © Athens Medical Society

Changing Funerals and Their Effects on Bereavement Grief in Japan.

Bereavement is an extremely personal feeling, but Japanese society tends to disapprove of displays of negative personal emotion or weakness. For ages, mourning rituals like funerals provided an exception where social permission was given to sharing grief and seeking support. However, the form and significance of Japanese funerals have changed rapidly over the past generation, and especially since the advent of COVID-19 restrictions on assembly and travel. This paper overviews the trajectory of changes and continuities in mourning rituals in Japan, looking at their psychological and social impacts. It goes on to summarize recent Japanese research showing that appropriate funerals are not merely of psychological and social benefit, but may have an important role in reducing or supporting grief that might otherwise require medical and social work intervention.

People's perspectives about COVID-19 vaccination certificate: Findings from a representative Italian sample.

In Italy, like in other countries, issues still exist regarding how to reach high vaccine coverage and several countries have considered policies to increase vaccine uptake. In the present study, we focused on people who have a favorable attitude towards vaccination. In March-April 2021, we asked a representative sample of Italian participants (N = 1,530) to assess to what extent they would support the adoption of a COVID-19 vaccination certificate, excluding unvaccinated people from participating in public and cultural events. Furthermore, as the vaccination coverage increases, severe forms of COVID-19 requiring hospitalization more likely involve unvaccinated individuals, who might be perceived as those who don't contribute to ending the pandemic and who constitute a significant health cost for society. We then asked participants to assess to what extent they would favor the idea of requiring people who refuse the vaccine to pay for their own medical expenses in case of hospitalization. We hypothesized that support for the adoption of the vaccination certificate would be predicted by the COVID-19 vaccination status (received, booked, high-, medium-, low-willingness to be vaccinated, or refused) and by the same factors that are known to affect the willingness to get vaccinated. These factors were also tested in a model aimed at investigating if a vaccinated person would favor a measure requiring the unvaccinated individuals to pay for medical expenses. Results confirmed that the support towards the vaccination certificate policy was strongly predicted by the vaccination status and by factors known to affect the willingness to get vaccinated. Interestingly (and surprisingly), a similar pattern was observed for the support of the policy about medical expenses. In conclusion, support for a COVID-19 vaccination certificate was high among the Italian population in the early phases of the vaccination rollout. The findings are discussed considering potential policies to tackle the pandemic.

Financial Security: Protecting the Health of Consumers

Medical expenses and health insurance are important dimensions of policy and research debates in protecting the health of consumers. This chapter provides an overview of the large and growing body of literature exploring the determinants of medical expenses and health insurance in protecting the health of consumers in the context of financial security. This chapter highlights analyses of two distinct sets of evidence: (a) studies of medical expenses and health insurance;and (b) studies of job loss and financial insecurity, particularly the inability to pay medical bills resulting from the Covid-19 pandemic. As discussed in this chapter, implementing health policies and regulations plays a critical role in protecting the health of consumers. Thus, the chapter addresses recent U.S. legislation such as the Affordable Care Act (ACA) and the No Surprises Act, which could protect consumers both medically and financially. Reviewing an extensive body of literature on these issues, the chapter concludes with implications for both policy and practice, as well as for future research avenues. © 2022 Walter de Gruyter GmbH, Berlin/Boston.

Effects of various medical expense characteristics on the occurrence of household debt burden

Medical expenses can aggravate the debt burden of households and in severe cases also lead to household bankruptcy. Using longitudinal data, this study identified various characteristics of medical expenses that could lead to household debt burden. In particular, we investigated whether household debt burden varied according to the beneficiary of medical expenses based on mental accounting. Data of 5007 households (number of observations = 34,071) from 2010 (13th wave) to 2018 (21st wave) surveys of the Korean Labor Panel were analysed using descriptive statistics and a random effect logistic regression model. Descriptive statistics showed that 8.3% of households began to feel debt burden during the survey period. The results of the random effects model revealed that the size of medical expense and debt impacted the probability of debt burden. Although medical expense support for parents or children living separately did not affect the household debt burden significantly, medical expense support for the spouse's parents increased the debt burden probability. The results showed that the household conducted mental accounting and it was driven by the subject with whom the household had a relationship. These results imply the necessity of expanding the medical insurance coverage to reduce the burden of medical expenses, and policies to supplement the gap or decrease in income caused by the occurrence of a medical event.

Impact of Air Pollution on Residents' Medical Expenses: A Study Based on the Survey Data of 122 Cities in China.

Background: With the development of the social economy, air pollution has resulted in increased social costs. Medical costs and health issues due to air pollution are important aspects of environmental governance in various countries. Methods: This study uses daily air pollution monitoring data from 122 cities in China to empirically investigate the impact of air pollution on residents' medical expenses using the Heckman two-stage and instrumental variable methods, matching data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) survey. Results: The study found that poor air quality, measured by the air quality index (AQI), significantly increased the probability of chronic lung disease, heart disease, and self-rated poor health. Additionally, the AQI (with an effect of 4.51%) significantly impacted health-seeking behavior and medical expenses. The medical expenditure effects of mild, moderate, severe, and serious pollution days were 3.27, 7.21, 8.62, and 42.66%, respectively. Conclusion: In the long run, residents' health in areas with a higher air pollution index, indicating poor air quality, is negatively impacted. The more extreme the pollution, the higher the probability of residents' medical treatment and the subsequent increase in medical expenses. Group and regional heterogeneity also play a role in the impact of air pollution on medical expenses. Compared with the existing literature, this study is based on individuals aged 15 years and above and produces reliable research conclusions.