Non-governmental or private, health insurance in some countries – the main way to cover the cost of treatment. In other countries, it adds a level of free medical care, which is guaranteed by the state. To understand the processes that occur in medical insurance in Russia, it is useful to get acquainted with the principles on which to base this type of insurance, and how it operates in the West and us. Information about health insurance is limited. Most available data on the U.S., where private treatment costs are covered in various ways by private organizations (health insurance), and the state. In both of these sources of funding in the late 90s accounted for more than 70% of the total health care spending is equal to 440 billion dollars, including the share of private insurance companies – over 30% of that amount. It should take into account that the state social program Medicare pays for most of the medical expenses of persons aged 65 years and older, as well as those with incomes below the official "poverty line budget» (poverty level budget).
Approximately 145 million Americans under age 65 in these years, participated in medical insurance in one or more insurance companies or other institutions. Among the latter are well-known organizations such as the "Blue Cross", "Blue Shield", "health maintenance organization" (IPF), which appeared in different years and meet the needs of his time. The first of these specialized institutions were established during the Great Depression, when many patients are simply unable to pay for medical bills. Two other organizations have emerged in the 70s when the country is clearly there has been a "desire for a healthy lifestyle." By the end of the 90s the number of such health care organizations had reached 600. Organizations differ in the methods of service, responsibility to clients and many other features. However, they all more or less based on insurance principles. Learn more about horoskop kostenlos!
In insurance companies, health insurance is often practiced with other types of insurance (life insurance, property, etc.), since it is less profitable than other types. Insurance companies tend to act as intermediaries, limited coverage of the costs of its customers. They themselves do not engage in any organization, no provision of health services, giving the insured the right to choose their own doctor and hospital, but with some restrictions. Large firms create their own insurance system (Self-Funded Plans) for group health insurance for their employees. Often, as an insurer in favor of the employee performs an entrepreneur who pays for up to 80% of the cost of the insurance contract.
Conditions of health insurance – an important criterion when choosing a job. Unlike insurance companies, specialized organizations do provide treatment in their clinics or other means, and the customer does not enter into financial relationships with the clinic or doctor. Introduced the first specialized organization under the statute have been and remain non-profit. All proceeds from the investment of free reserves formed from insurance payments, the entire act in favor of members of these organizations. In other words, the profit is taken into account when determining the rates of insurance. Note that the organization created in recent years, usually involve getting some income from their activities. In this respect they are similar to insurance companies. "Blue Cross" and "Blue Shield" – a collection of local organizations focused on care for the population of individual states and regions. "Blue Cross" shall pay the required treatment in hospitals, which have signed the relevant treaties. In turn, the "Blue Shield" provides treatment from doctors outside the system. Both organizations monitor the quality of care.
Health maintenance organization develop themselves and pay the full healing process. Customer shall pay in advance a fixed amount for medical care within a certain time, regardless of the actual (expected) cost of treatment. The activities regulated by the state IPF. It is appropriate to trace the differences between organizations and the health insurance organizations (CO) – more precisely, between the opportunities offered by the insured involved in these kinds of medical care. In CO – free choice of doctor or hospital by the insured, in IPF – the customer agrees to receive medical care from a physician, who provides or recommends the organization, and it is also responsible for the quality of treatment. We now turn to the private health insurance in Western Europe. Consider its scale and certain features of individual countries. As you can see, the proportion of insured persons in the general population (insurance coverage) and the amount of contributions per insured vary considerably across countries. Differences in health insurance coverage due to several reasons, which is probably not the last to include the adequacy and quality of public health insurance. With regard to the size of contributions, distinguished high differentiation (maximum contributions – in Germany, the minimum – in Denmark and England), apparently due to differences in sets of medical services. Health care benefits stipulated in the contract.