Abstract for: Dynamic Analysis of Public Health Insurance Programmes

Effectiveness and continuity of public health insurance systems are facing significant threats from structural and demographic factors such as principle-agent problems and population aging. In this study, we construct a multi-sector broad-boundary system dynamics model: i) to explore the underlying causal structure surrounding public health insurance systems, and ii) to analyze the operational causality that leads to the development of structural problems for a variety of health insurance models with different characteristics. Our preliminary results show that against the rising healthcare costs, public programme benefits in single-payer insurance models show downward facing oscillations and the resulting austerity eras carry the danger of avoiding addressing necessary demand that would leave collateral damage on population health, lasting long after the first administration of the policy. Several policy options such as public revenue injections and labor immigration policies are tested to preserve the programme benefits in the long run. We will expand our model to include a private insurance sector and ultimately aim to comparatively analyze the performances of single-payer, multi-payer, and hybrid health insurance models.