Health Screening Law

• Abstract
• Purpose of health policy or idea
• Characteristics of this policy
• Political and economic background
• Purpose and process analysis
• Expected outcome
• References

Abstract

National health insurance provides coverage for health screening, but its effectiveness has been criticized. The new law on health screening aims to systematically improve the quality of health screening programs and increase the participation of the insured.

Purpose of health policy or idea

The new law on health screening aims to systematically improve the quality of health screening programs and increase the participation of the insured.

Main points

Main objectives

• To improve the quality of health screening programs
• To increase participation

Type of incentives

non-financial

Groups affected

consumers, providers of health screening programs

Innovationsgrad	traditionell		innovativ
Kontroversität	unumstritten		kontrovers
Strukturelle Wirkung	marginal		fundamental
Medienpräsenz	sehr gering		sehr hoch
Übertragbarkeit	sehr systemabhängig		systemneutral

Political and economic background

Purpose and process analysis

Current Process Stages

	Idee	Pilotprojekt	Strategiepapier	Gesetzgebung	Umsetzung	Evaluation	Veränderung/Richtungswechsel
Implemented in this survey?

Origins of health policy idea

Although national health insurance provides coverage for the health screening program, participation is not high (80% of industrial workers, and 30% for the self-employed). The health screening program used to be criticized for its low quality and the lack of quality control of participating providers.

To improve the quality of  the health screening program in a more systematic way, the new law on health screening contains the following elements:

• Establishment of a national committee for health screening in the Ministry of Health and Welfare: to develop and decide on major policy tools for guidelines, evaluation, and quality management associated with health screening programs
• Development of a health screening master plan every 5 years: for nation-wide planning and priority setting for target screening items, population, etc.
• Contracting and quality management with providers of health screening: criteria for contracting and contract termination, quality control, and dissemination of the results of quality evaluation
• Use of health screening data: for health promotion policy and community-based health promotion programs
• Research and development: economic evaluation of health screening, education and social marketing

There are currently two major types of screening covered by health insurance: 

1. Regular screening: for the insured over 40 years old, every 2 years
2. Cancer screening:

• stomach cancer: over 40 years old, every 2 years
• colon cancer: over 50 years old, every year
• liver cancer: high risk group (patients with liver disease, those with hepatitis B antigen positive) over 40 years old, every 6 months
• breast cancer: women above 40 years old, every 2 years
• cervical cancer: women above 30 years old, every 2 years

No government agency is responsible for quality control in screening, instead academic societies/associations are dealing with it to some extent. As a result, quality management in screening is of concern.  

The National Health Insurance Corporation (NHIC: single payer of social health insurance) informs the insured when they are eligible for screening. The insured can choose the provider (including private providers who have contracts with NHIC for health screenings).

Initiators of idea/main actors

• Regierung

Approach of idea

The approach of the idea is described as:
new:

Actors and positions

Regierung
Ministry of Health and Welfare	sehr unterstützend		stark dagegen

Influences in policy making and legislation

There has been little controversy over the new law on health screening among potential stakeholders.

Legislative outcome

success

Actors and influence

Regierung
Ministry of Health and Welfare	sehr groß		kein

Positions and Influences at a glance

Expected outcome

The new law on health screening is expected to have a positive effect on health screening and health promotion. But its successful implementation requires increased funding and policy support in health screening programs.

Contracting with the providers of health screening based on active quality control can contribute to the improvement of health screening programs. However, some university hospitals or high-quality hospitals do not participate in health screening programs because compensation from health insurance is low. To encourage the participation of high-quality hospitals, more funding for health screening may be necessary.

Government also needs to improve the quality of health screening provided by public health centers or public hospitals, by strengthening the capacity of medical staff and equipments in the public sector, because they can play an important role in health screening and health promotion programs in communities.

Impact of this policy

Qualität	kaum Einfluss		starker Einfluss
Gerechtigkeit	System weniger gerecht		System gerechter
Kosteneffizienz	sehr gering		sehr hoch

References

Author/s and/or contributors to this survey

Kwon, Soonman

Empfohlene Zitierweise für diesen Online-Artikel:

Kwon, Soonman. "Health Screening Law". Health Policy Monitor, April 2008. Available at http://www.hpm.org/survey/rok/a11/1