We are independent brokers of Health Insurance, Income Protection, Accident and Sickness, Life and Critical Illness policies.
We provide access to the whole of the Health Insurance market that will allow us to match your requirements to your budget.
It is also important to protect your health so that in turn you can protect your wealth.
Many people insure their pets, TV’s, Washing machines etc. but do not insure the one thing that is most important to realising their lifestyle and that is their salary. The Health Insurance Shop has specific expertise in Income Protection and Accident and Sickness insurance policies, where we deal with all of the major insurers and Friendly Societies to find the best policy for you. Whether that is day one cover, high monthly benefit or long deferment periods we will find the income protection or accident and sickness policy to give you the best value for money cover to meet your needs.
The Health Insurance Shop will also look at defining your family needs. We will assist you in finding the right Life and/or Critical Illness policy to meet the needs of your family in the event of death or critical illness. Would you prefer a lump sum or a monthly benefit? These are questions we can advise you on when you come to purchase a Life Insurance policy.
The service we bring to you is most important at point of claim, where we will be able to assist you in making your claim with your Health Insurance, Income Protection, Accident and Sickness, or Life and Critical Illness policies.
* When choosing an Income Protection policy the key things to consider are:
* Does it cover your own Occupation?
* When does it pay out?
* How long does it pay for?
* Is the premium fixed or reviewable?
* Are there any exclusions?
We have been at the fore front of selling Income Protection policies in the UK for a number of years and have access to policies to meet all requirements including that of professional sportsmen and security staff that are normally excluded from Income Protection policies.
We can also cover Income Protection, Health Insurance and Life Insurance for overseas workers and ex pats.
If it is personal insurance you want then "The Health Insurance Shop is your one stop shop"
Tuesday, April 7, 2009
About The Health Insurance Shop
Protecting Your Family
Labels: PROTECT FAMILY
Health insurance is important in the event that you, or any member of your family is ever sick or injured.
Having this coverage will protect you from financial hardships. State Farm® offers various types of health insurance, so that you can choose the product that best suits your personal situation.
Choose the plan that best fits your individual needs.
Individual Medical Coverage
This is primary medical insurance coverage that is designed for people who don't have this type of coverage through their employer or another group.
Prescription Drug (Part D) Plans
Medicare Part D is prescription drug coverage available to those enrolled/eligible for Medicare Part A and/or Part B.
Medicare Part C (Medicare Advantage) Coverage
Medicare Part C (otherwise known as Medicare Advantage) is a Medicare health plan available to those enrolled/eligible for Medicare Parts A and B.
Medicare Supplement Insurance
This is designed for the senior citizen who participates in Medicare, yet desires additional coverage to help with many of the expenses that Medicare does not pay.
Supplemental Medical Insurance*
This is Ideal for supplementing your primary health insurance coverage. It provides you with a pre-determined benefit amount for those extra, unbudgeted expenses that arise.
Unless you tell us otherwise or benefits are assigned according to state law, the benefit is paid directly to you.
You decide how the money is spent.
Benefits may be paid for necessary:
* Hospitalization
* Accidental Injury
* Outpatient Surgery
* Extended Care
* Intensive Care
*Supplemental Medical is the marketing name for our Hospital Income, Hospital Indemnity and Hospital Confinement Indemnity policy series 97024.
How to find and keep affordable health insurance
Labels: HOW TO FIND
The writers and editors at the Health Insurance Resource Center put the pieces of the medical insurance puzzle together for you in our Health Insurance 101 section, as well as shifting through the best information from across the Internet throughout our pages:
Finding individual health insurance for your family can be confusing. We provide several tools to help you make better choices.
* get health insurance quotes
* glossary of medical insurance terms
* information on high-risk insurance pools.
* Frequently-asked questions on health care
* Self-employed medical insurance
What can you do to provide low cost protection for your family's health? Here at the Health Insurance Resource Center, we strive to make you a better-informed consumer to aid you in your quest to secure and keep an adequate health plan for your family, regardless of your individual situation.
Lack of health insurance an epidemic – what should be done?
Nearly 16 percent of Americans – 47 million people – are uninsured. According to a story in USAToday, the people without health insurance aren't just the poor – they are all of us. Medical bills are the cause of more than half of all personal bankruptcies in the United States.
Urge Congress to act now – a call to action
Access to private medical insurance that is safe and affordable is easily the biggest domestic crisis facing us. Our advocacy page urges you to join us in urging Congress to support President Obama's call for health care reform. His plans are to ensure health plans do not discriminate on the basis of pre-existing conditions, expand access to the government's own insurance program, lower the cost on existing plans and give you the ability to keep your coverage if you switch jobs or become self-employed. Contact a member of the House of Representatives. Contact a US Senator. Contact the White House
Healthinsurance.org has long-held a well-deserved reputation for promoting health insurance reform, and with President Obama's election we are stepping up our efforts.
State Guides to health plans and health care quality
You'll also find information on the quality of health care in individual states from across the nation, spanning New Jersey to California. Each page also gives you the opportunity to receive quotes on protecting your family, getting pricing and details from competing companies. Many states are seeking ways to tackle the problem of access to affordable health insurance on their own, and we look to health care reform initiatives on our state pages. We also have links to the contact forms for your elected officials, so you can easily lend your support, or offer alternative ideas.
Affordable Health Insurance - Free Online Quotes
Labels: AFFORDABLE INSURANCETips for Finding Affordable Health Insurance
It can be a daunting task to find affordable health insurance especially if you are self employed or have a family that's not covered on your health plan at work. In addition to this, if you have a pre-existing condition, you are in real trouble because in most cases it will not be covered at all. One of the best ways to get affordable health insurance is with a group plan and this is normally done through an employer. That employer generally pays some or even all of the insurance cost for the employee but the employee may choose to add a spouse or a family member at an additional cost.
But, if you are self employed or lose a job, these affordable health insurance choices aren't offered to you, which can present a problem. However, you should be able to find something that is available for small business owners and self-employed people but it will be at a much higher cost. So, this makes it all the more important to shop around to help you find affordable health insurance. If you get quotes from several different companies, you'll be much more likely to find affordable heath insurance.
Top Health Insurance Carriers
When looking for a top health insurance carrier, you may consider looking into some big companies because they may give you the best rates. Often a larger company is capable of giving you a much better rate than smaller companies because they have more resources available to them to aid in offering better pricing. There are many large health insurance carriers to choose from in this day and age that can offer you the highest quality service at an affordable price. The key to finding one you like is to spend some time in research looking for the best carrier and then getting some quotes from them as well.
You may confuse best rate with best health insurance carrier but be advised that this is often not the case you and may not the quality of insurance you want with a cheaper coverage. In order to avoid any problems in this area, you should consider doing some research on the quality of coverage of the company you do decide to get your health insurance from. By taking the time to look into their payment history of claims, you can save yourself some time and hassle and know with certainty if you are choosing a top health insurance carrier after all.
Why You Should Compare Health Insurance Quotes
We are all looking for the best possible price we can get on the necessities of life, and health insurance is no different. This is why it's imperative to compare health insurance quotes to help you find the best one you possibly can. When you take the time to get several quotes, you are much more likely to get the best deal. These days it is extremely easy to do this with the aid of the Internet. You can easily log on these days and visit health insurance Websites and get several quotes at one time. This can allow us to compare prices and coverage. You need to be certain you look at the quality of coverage you will receive as well as the cost of the coverage. This will allow you to get the best of both.
It's very important for you to compare health insurance quotes to make certain you are getting the absolute best coverage possible. If you just commit to one health insurance company without shopping around, you could be making a huge financial mistake. Therefore, you should invest a few minutes to finding the best health insurance to meet your needs at the best price as well.
Online Health Insurance Resources
We have provided a number of online articles and resources to answer some of the most common question we receive about finding affordable health insurance coverage. Spending a little time researching before you choose a plan can make a big difference in the quality and price of the policy you end up purchasing.
I Introduction
Labels: INTRODUCTIONHealth Insurance, insurance designed to pay the costs associated with healthcare. Health insurance plans pay the bills from physicians, hospitals, and other providers of medical services. By doing so, health insurance protects people from financial hardship caused by large or unexpected medical bills.
People obtain health insurance from private organizations or from government agencies. All industrialized countries other than the United States have government-funded national health insurance systems that provide health insurance for virtually everyone. Countries with national health insurance generally consider access to healthcare to be a basic right of citizenship.
In the United States private organizations have traditionally provided the vast majority of health insurance coverage. The U.S. government operates some publicly funded health insurance programs but access is limited to specific groups, such as the poor and the elderly. Most Americans obtain private health insurance through their places of employment.
Americans pay the cost of health insurance in a variety of ways. Workers may pay for private health insurance by authorizing their employers to deduct a specified amount from their paychecks. Alternatively, individuals may work for employers who pay the direct costs of health insurance. People who do not receive health insurance through their jobs or through government programs can purchase private health insurance policies by paying premiums directly to an insurance company.
A Access to Health Insurance
Labels: ACCESS TO HEALTHIn 2007 the U.S. Census Bureau reported that as of 2006 about 47 million people in the United States (about 15.8 percent of the population) lacked health insurance coverage. Those without insurance are usually self-employed, work part-time, or work in low-wage jobs, so they lack access to low-cost, employer-sponsored group plans. Many of these workers cannot afford to purchase individual healthcare insurance, but they do not qualify for coverage under government programs for low-income Americans. For example, in the early 21st century almost half (47.5 percent) of full-time workers in low-wage jobs were uninsured. Nevertheless, even without insurance, these individuals may be able to receive emergency care without charge or at reduced rates in government-run hospitals.
Although millions of Americans lack health insurance because they cannot afford it, many others cannot buy health insurance because insurers consider them at especially high risk of needing expensive healthcare. Insurers assess the risks posed by applicants for insurance and then group applicants into similar classes of risk. Americans who are considered average or better-than-average risks can usually purchase insurance policies at a relatively affordable price. When an applicant presents too much risk, however, private companies consider it difficult or even impossible to offer insurance coverage to that person.
For example, some private companies will not offer coverage to an individual with a known predisposition to develop cancer because he or she presents a high risk of needing expensive treatment. Also, the few companies willing to insure such high-risk individuals will charge higher premiums to assume the risks. Increased premiums often make the insurance policy unaffordable to high-risk individuals. Even worse, occasionally no insurance company will offer a policy to a person who presents an exceptionally high risk of needing expensive medical care, such as a person infected with the virus that causes acquired immunodeficiency syndrome (AIDS).
Some insurance companies have introduced clauses to their policies that are designed to keep costs down by denying access to private insurance for anyone who already suffers from significant medical conditions. Introduction of preexisting condition clauses in insurance policies became especially widespread in the 1980s and early 1990s. Many workers found it virtually impossible to change jobs if any member of their families had a serious health problem because preexisting condition clauses in their new employer-sponsored plan would deny them access to insurance coverage. The Congress of the United States addressed this problem by introducing the Health Insurance Portability Act of 1996, which requires most employer-sponsored plans to accept transfers from other plans without imposing a preexisting condition clause.
Congress further addressed the issue of preexisting conditions in 2008 when it banned any form of discrimination based on an individual’s genetic makeup. The Genetic Information Nondiscrimination Act forbids health insurance companies from denying coverage or raising the cost of premiums to individuals whose genetic makeup predisposes them to disease or other condition requiring medical treatment. The new law also prohibits employers from using genetic information to make decisions about hiring, firing, or denying compensation to an employee. Employers who are found to have misused this information face fines up to $300,000. See also Gene; Genetics.
B Insurance Costs and Quality of Healthcare
Labels: QUALITY OF HEALTHThe costs of healthcare have increased dramatically for consumers and insurers, particularly since the 1980s. For example, in 1980 Americans spent $247.3 billion on healthcare. By 1999 that figure had more than quadrupled to $1.2 trillion, and it reached $2.3 trillion in 2007, according to one study.
One reason costs have risen is that Americans are living longer than ever before, and older people generally require more healthcare. In 1900 the average American had a life expectancy of about 50 years. In 2003 the average life expectancy was about 77.6 years. During the 20th century, the number of persons aged 65 or over increased 11 times. The elderly comprised only 1 in every 25 Americans in 1900, but represented 1 of every 8 Americans in 1994. By 2006 persons aged 65 or older represented 12.1 percent of the U.S. population. When older Americans join an insured group, the whole group’s healthcare risks—and costs—rise accordingly.
Advances in medical technology have also driven up the costs of healthcare and insurance. Medical procedures such as computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans, and arthroscopic surgery are commonplace today, but they did not exist until the 1970s. Although such new technology sometimes allows healthcare providers to introduce less-invasive and less-expensive treatments, more often it provides new but expensive ways to treat conditions that were previously untreatable.
Increased use of healthcare has also led to a growth in healthcare costs. Americans are more likely than ever to seek professional health services for medical problems. For example, in 1991 there were an estimated 669.7 million visits to doctors' offices, or 2.7 visits per person. In 1999 there were an estimated 757 million visits to doctors' offices, or 2.8 visits per person. Many Americans today seek medical care for treatment of sexual impotence, attention-deficit hyperactivity disorder, and other problems that previously were not always considered health problems. Just as increased demand pushes prices up in other industries, increased demand for healthcare leads to escalating medical costs.
Low Cost Health Insurance
Labels: LOW COST
Finding low cost health insurance is a priority for many Americans today. But it isn't always easy to find a plan that fits within your budget, especially if you have pre-existing health conditions. If you have a family and would like to get coverage for everyone, consider getting a group health plan from your employer or on your own. These are the most affordable and include HMOs, PPOs and POSs.
Affordable Health Insurance Options
With the PPO, or Preferred Provider Organization, and HMO, or Health Maintenance Organization, you are given a network of physicians to choose from. Only the HMO requires you to choose one of their doctors as your Primary Care Physician (PCP). Using one out of their network would result to you enduring the full cost of the expenses rendered. With the PPO you get more freedom to choose any doctor, but by using one out-of-network will raise the co-payments. The premiums are higher for the PPO, making the HMO the cheapest. The POS is a combo of the two.
Another option you can go with is an HDHP, or High Deductible Health Plan. This may not seem like a low cost option, but once you pay the annual high deductible, your benefits will kick in. Plus, your premiums are much lower than average from the start. After enrolling in this type plan you will qualify for an HSA, or Health Savings Account, which allows you to save up tax-free money for your medical expenses - even for alternative healing treatments/procedures, eye care and chiropractor therapies. The HSA also allows you withdraw the money you’ve accumulated for other purposes once you reach retirement age
Thursday, March 19, 2009
Manage your account online - anytime, anywhere
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Prefer to shop for insurance on your terms? It's easy to get a ballpark auto insurance estimate without even providing your name. Just answer a few simple questions and get all the information you need. Or, to quote over the phone, call 1-866-621-6900.
Discover an interactive auto insurance guide
Your own virtual insurance guide will talk you through some of the things you need to know about car insurance. Choose a guide that suits your style to make auto insurance easier to understand.
Not all insurers have agents. Here's why Allstate does.
When you have questions about insurance discounts and coverage, when you want a personalized quote, or if you need to make a claim, it's good to know you can talk person-to-person with a licensed insurance professional, your Allstate agent.
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Get money-saving tips from Allstate Agents, ways to save on your house and car, links to other special offers and more. Check back often for new updates.
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Quality motorcycle insurance protects more than your bike and the things you've added to it. It protects your freedom to take to the road and do what you dream about all winter. And with Allstate, it doesn't have to cost a lot
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t's real people talking about real issues in their own words. It's telling the Allstate story by highlighting what we're doing each day to reach out to our communities and to our customers. It's youtube.com/Allstate - where you can view short Allstate news and informational video clips
Insurance Quotes
How can you get multiple insurance quotes in just minutes, right from your own computer? InsuranceQuotes.com makes it easy! We've packed our website with valuable tips, articles and information designed to help you find the right insurance coverage at the best possible price. Once you understand all of your options, just complete our simple online form to get competitive insurance quotes from some of the nation's leading providers—instantly. Millions of users agree: when it comes to saving money on auto insurance, life insurance or homeowner insurance, InsuranceQuotes.com has you covered!
Top Insurance Tips
1. Importance of a Good Driving Record
2. Life Insurance Offered by Employer
3. Homeowners Insurance vs. Title Insurance
4. Know your Health before you Shop
5. Offer Only Coverage your Employees Plan to Use
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Monday, March 16, 2009
Australia
Main article: Health care in Australia
The public health system is called Medicare. It ensures free universal access to hospital treatment and subsidised out-of-hospital medical treatment. It is funded by a 1.5% tax levy.
The private health system is funded by a number of private health insurance organisations. The largest of these is Medibank Private, which is government-owned, but operates as a government business enterprise under the same regulatory regime as all other registered private health funds. The Coalition Howard government had announced that Medibank would be privatised if it won the 2007 election, however they were defeated by the Australian Labor Party under Kevin Rudd which had already pledged that it would remain in government ownership.
Some private health insurers are 'for profit' enterprises, and some are non-profit organizations such as HCF Health Insurance. Some have membership restricted to particular groups, but the majority have open membership.
Most aspects of private health insurance in Australia are regulated by the Private Health Insurance Act 2007.
The private health system in Australia operates on a "community rating" basis, whereby premiums do not vary solely because of a person's previous medical history, current state of health, or (generally speaking) their age (but see Lifetime Health Cover below). Balancing this are waiting periods, in particular for pre-existing conditions (usually referred to within the industry as PEA, which stands for "pre-existing ailment"). Funds are entitled to impose a waiting period of up to 12 months on benefits for any medical condition the signs and symptoms of which existed during the six months ending on the day the person first took out insurance. They are also entitled to impose a 12-month waiting period for benefits for treatment relating to an obstetric condition, and a 2-month waiting period for all other benefits when a person first takes out private insurance. Funds have the discretion to reduce or remove such waiting periods in individual cases. They are also free not to impose them to begin with, but this would place such a fund at risk of "adverse selection", attracting a disproportionate number of members from other funds, or from the pool of intending members who might otherwise have joined other funds. It would also attract people with existing medical conditions, who might not otherwise have taken out insurance at all because of the denial of benefits for 12 months due to the PEA Rule. The benefits paid out for these conditions would create pressure on premiums for all the fund's members, causing some to drop their membership, which would lead to further rises, and a vicious cycle would ensue.
There are a number of other matters about which funds are not permitted to discriminate between members in terms of premiums, benefits or membership - these include racial origin, religion, sex, sexual orientation, nature of employment, and leisure activities. Premiums for a fund's product that is sold in more than one state can vary from state to state, but not within the same state.
The Australian government has introduced a number of incentives to encourage adults to take out private hospital insurance. These include:
* Lifetime Health Cover: If a person has not taken out private hospital cover by the 1st July after their 30th birthday, then when (and if) they do so after this time, their premiums must include a loading of 2% per annum. Thus, a person taking out private cover for the first time at age 40 will pay a 20 per cent loading. The loading continues for 10 years. The loading applies only to premiums for hospital cover, not to ancillary (extras) cover.
* Medicare Levy Surcharge: People whose taxable income is greater than a specified amount (currently $70,000 for singles and $140,000 for couples) and who do not have an adequate level of private hospital cover must pay a 1% surcharge on top of the standard 1.5% Medicare Levy. The rationale is that if the people in this income group are forced to pay more money one way or another, most would choose to purchase hospital insurance with it, with the possibility of a benefit in the event that they need private hospital treatment - rather than pay it in the form of extra tax as well as having to meet their own private hospital costs.
o The Australian government announced in May 2008 that it proposes to increase the thresholds, to $100,000 for singles and $150,000 for families. These changes require legislative approval. A bill to change the law has been introduced but was not passed by the Senate.[22] A changed version was passed on 16 October 2008. There have been criticisms that the changes will cause many people to drop their private health insurance, causing a further burden on the public hospital system, and a rise in premiums for those who stay with the private system. Other commentators believe the effect will be minimal.[23]
* Private Health Insurance Rebate: The government subsidises the premiums for all private health insurance cover, including hospital and ancillary (extras), by 30%, 35% or 40%.
[edit] Canada
Main article: Health care in Canada
Most health insurance in Canada is administered by each province, under the Canada Health Act, which requires all people to have free access to basic health services. Collectively, the public provincial health insurance systems in Canada are frequently referred to as Medicare. Private health insurance is allowed, but the provincial governments allow it only for services that the public health plans do not cover; for example, semi-private or private rooms in hospitals and prescription drug plans. Canadians are free to use private insurance for elective medical services such as laser vision correction surgery, cosmetic surgery, and other non-basic medical procedures. Some 65% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers.[24] Private-sector services not paid for by the government account for nearly 30 percent of total health care spending.[25]
In 2005, the Supreme Court of Quebec ruled, in Chaoulli v. Quebec, that the province's prohibition on private insurance for health care already insured by the provincial plan could constitute an infringement of the right to life and security if there were long wait times for treatment as happened in this case. Certain other provinces have legislation which financially discourages but does not forbid private health insurance in areas covered by the public plans. The ruling has not changed the overall pattern of health insurance across Canada but has spurred on attempts to tackle the core issues of supply and demand and the impact of wait times.[26]
[edit] France
Main article: Health care in France
The French model of health insurance has been ranked by the World Health Organization as the best in the world, because it permits a high quality of care and nearly total patient freedom. The national system of health insurance was instituted in 1945, just after the end of the Second World War. It was a compromise between Gaullist and Communist representatives in the French parliament. The Conservative Gaullists were opposed to a state-run healthcare system, while the Communists were supportive of a complete nationalisation of health care along a British Beveridge model.
The resulting programme was profession-based : all people working were required to pay a portion of their income to a health insurance fund, which mutualised the risk of illness, and which reimbursed medical expenses at varying rates. Children and spouses of insured people were eligible for benefits, as well. Each fund was free to manage its own budget and reimburse medical expenses at the rate it saw fit.
The government has two responsibilities in this system.
* The first government responsibility is the fixing of the rate at which medical expenses should be negotiated, and it does this in two ways: The Ministry of Health directly negotiates prices of medicine with the manufacturers, based on the average price of sale observed in neighboring countries. A board of doctors and experts decides if the medicine provides a valuable enough medical benefit to be reimbursed (note that most medicine is reimbursed, including homeopathy). In parallel, the government fixes the reimbursment rate for medical services : this means that a doctor is free to charge the fee that he wishes for a consultation or an examination, but the social security system will only reimburse it at a pre-set rate. These tariffs are set annually through negotiation with doctors' representative organisations.
* The second government responsibility is oversight of the health-insurance funds, to ensure that they are correctly managing the sums they receive, and to ensure oversight of the public hospital network.
Today, this system is more-or-less intact. All citizens and legal foreign residents of France are covered by one of these mandatory programs, which continue to be funded by worker participation. However, since 1945, a number of major changes have been introduced. Firstly, the different health-care funds (there are five : General, Independent, Agricultural, Student, Public Servants) now all reimburse at the same rate. Secondly, since 2000, the government now provides health care to those who are not covered by a mandatory regime (those who have never worked and who are not students, meaning the very rich or the very poor). This regime, unlike the worker-financed ones, is financed via general taxation and reimburses at a higher rate than the profession-based system for those who cannot afford to make up the difference. Finally, to counter the rise in health-care costs, the government has installed two plans, (in 2004 and 2006), which require insured people to declare a referring doctor in order to be fully reimbursed for specalist visits, and which installed a mandatory co-pay of 1 € (about $1.45) for a doctor visit, 0,50 € (about 80 ¢) for each box of medicine prescribed, and a fee of 16-18 € (20-25 $) per day for hospital stays and for expensive procedures.
An important element of the French insurance system is solidarity : the more ill a person becomes, the less they pay. This means that for people with serious or chronic illnesses, the insurance system reimburses them 100 % of expenses, and waives their co-pay charges.
Finally, for fees that the mandatory system does not cover, there is a large range of private complementary insurance plans available. The market for these programs is very competitive, and often subsidised by the employer, which means that premiums are usually modest. 85% of French people benefit from complementary private health insurance.
[27][28]
[edit] Netherlands
Main article: Health care in the Netherlands
In 2006, a new system of health insurance came into force in the Netherlands. This new system avoids the two pitfalls of adverse selection and moral hazard associated with traditional forms of health insurance by using a combination of regulation and an insurance equalization pool. Moral hazard is avoided by mandating that insurance companies provide at least one policy which meets a government set minimum standard level of coverage, and all adult residents are obliged by law to purchase this coverage from an insurance company of their choice. All insurance companies receive funds from the equalization pool to help cover the cost of this government-mandated coverage. This pool is run by a regulator which collects salary-based contributions from employers, which make up about 50% of all health care funding, and funding from the government to cover people who cannot afford health care, which makes up an additional 5%.
The remaining 45% of health care funding comes from insurance premiums paid by the public, for which companies compete on price, though the variation between the various competing insurers is only about 5%. However, insurance companies are free to sell additional policies to provide coverage beyond the national minimum. These policies do not receive funding from the equalization pool, but cover additional treatments, such as dental procedures and physiotherapy, which are not paid for by the mandatory policy.
Funding from the equalization pool is distributed to insurance companies for each person they insure under the required policy. However, high-risk individuals get more from the pool, and low-income persons and children under 18 have their insurance paid for entirely. Because of this, insurance companies no longer find insuring high risk individuals an unappealing proposition, avoiding the potential problem of adverse selection.
Insurance companies are not allowed to have co-payments, caps, or deductibles, or to deny coverage to any person applying for a policy, or to charge anything other than their nationally set and published standard premiums. Therefore, every person buying insurance will pay the same price as everyone else buying the same policy, and every person will get at least the minimum level of coverage.
[edit] United Kingdom
Main article: National Health Service
The UK's National Health Service (NHS) is a publicly funded healthcare system that provides coverage to everyone normally resident in the UK. It is not strictly an insurance system because (a) there are no premiums collected, (b) costs are not charged at the patient level and (c) costs are not pre-paid from a pool. However, it does achieve the main aim of insurance which is to spread financial risk arising from ill-health. The costs of running the NHS (est. £104 billion in 2007-8)[29] are met directly from general taxation. The NHS provides the majority of health care in the UK, including primary care, in-patient care, long-term health care, ophthalmology and dentistry.
Private health care has continued parallel to the NHS, paid for largely by private insurance, but it is used by less than 8% of the population, and generally as a top-up to NHS services. There are many treatments that the private sector does not provide. For example, health insurance on pregnancy is generally not covered or covered with restricting clauses.[30] One of the major insurers, BUPA, excludes many forms of treatment and care that most people will need during their lifetime or specialist care most of which are freely available from the NHS. These include:-
ageing, menopause and puberty; AIDS/HIV; allergies or allergic disorders; birth control, conception, sexual problems and sex changes; chronic conditions; complications from excluded or restricted conditions/ treatment; convalescence, rehabilitation and general nursing care ; cosmetic, reconstructive or weight loss treatment; deafness; dental/oral treatment (such as fillings, gum disease, jaw shrinkage, etc); dialysis; drugs and dressings for out-patient or take-home use† ; experimental drugs and treatment; eyesight; HRT and bone densitometry; learning difficulties, behavioural and developmental problems; overseas treatment and repatriation; physical aids and devices; pre-existing or special conditions; pregnancy and childbirth; screening and preventive treatment; sleep problems and disorders; speech disorders; temporary relief of symptoms[31] († = except in exceptional circumstances)
BUPA's competitors include, among others, AXA, Aviva, Groupama Healthcare and Pru Health.
Recently the private sector has been used to increase NHS capacity despite a large proportion of the British public opposing such involvement.[32]. According to the World Health Organization, government funding covered 86% of overall health care expenditures in the UK as of 2004, with private expenditures covering the remaining 14%.[33]
[edit] United States
Main articles: Health insurance in the United States and Health care in the United States
The US market-based health care system relies heavily on private and not-for-profit health insurance, which is the primary source of coverage for most Americans. According to the United States Census Bureau, approximately 84% of Americans have health insurance; some 60% obtain it through an employer, while about 9% purchase it directly. Various government agencies provide coverage to about 27% of Americans (there is some overlap in these figures).[34]
Public programs provide the primary source of coverage for most seniors and for low-income children and families who meet certain eligibility requirements. The primary public programs are Medicare, a federal social insurance program for seniors and certain disabled individuals, Medicaid, funded jointly by the federal government and states but administered at the state level, which covers certain very low income children and their families, and SCHIP, also a federal-state partnership that serves certain children and families who do not qualify for Medicaid but who cannot afford private coverage. Other public programs include military health benefits provided through TRICARE and the Veterans Health Administration and benefits provided through the Indian Health Service. Some states have additional programs for low-income individuals.[35]
In 2006, there were 47 million people in the United States (16% of the population) who were without health insurance for at least part of that year.[34] About 37% of the uninsured live in households with an income over $50,000.[34]
In 2004, US health insurers directly employed almost 470,000 people at an average salary of $61,409.[36] (As of the fourth quarter of 2007, the total US labor force stood at 153.6 million, of whom 146.3 million were employed. Employment related to all forms of insurance totaled 2.3 million.[37] Mean annual earnings for full-time civilian workers as of June 2006 were $41,231; median earnings were $33,634.)[38] The insurance industry also represents a significant lobbying group in the US. For 2008 insurance was the 8th among industries in political contributions to members of Congress, giving $28,654,121, of which 51% was given to Democrats and 49% to Republicans, with the top recipient of insurance industry contributions being Senator John McCain (R-AZ).[39] The leading contributor from the insurance industry — as measured by total political contributions — was AFLAC, Inc., which contributed $907,150 in 2007.[40].
Comparison
The Commonwealth Fund, in its annual survey, "Mirror, Mirror on the Wall", compares the performance of the health care systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the U.S. Its 2007 study found that, although the U.S. system is the most expensive, it consistently under-performs compared to the other countries.[21] One difference between the U.S. and the other countries in the study is that the U.S. is the only country without universal health insurance coverage.
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Comparison
The Commonwealth Fund, in its annual survey, "Mirror, Mirror on the Wall", compares the performance of the health care systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the U.S. Its 2007 study found that, although the U.S. system is the most expensive, it consistently under-performs compared to the other countries.[21] One difference between the U.S. and the other countries in the study is that the U.S. is the only country without universal health insurance coverage.
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Moral hazard
Moral hazard occurs when an insurer and a consumer enter into a contract under symmetric information, but one party takes action, not taken into account in the contract, which changes the value of the insurance. A common example of moral hazard is third-party payment—when the parties involved in making a decision are not responsible for bearing costs arising from the decision. An example is where doctors and insured patients agree to extra tests which may or may not be necessary. Doctors benefit by avoiding possible malpractice suits, and patients benefit by gaining increased certainty of their medical condition. The cost of these extra tests is borne by the insurance company, which may have had little say in the decision. Co-payments, deductibles, and less generous insurance for services with more elastic demand attempt to combat moral hazard, as they hold the consumer responsible.
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