Jürgen, a legal resident of Germany, has recently suffered a stroke and must utilize his country’s healthcare system. Since he is a legal resident of Germany, he will have access to insurance through various not-for-profit health insurance funds called “sickness funds” (Blümel and Busse 2014). Through the Statutory Health Insurance (SHI) scheme, these not-for-profit organizations all must guarantee issue. This means that Jürgen will have access to an insurance program regardless of his medical background; he will also have the opportunity to choose between different available plans. These plans are available to Jürgen regardless of his age and geographic location in Germany. These plans are also available to Jürgen regardless of his income. …show more content…
In Germany, the health insurance system includes both public-sector and private-sector insurance companies. The public-sector insurance groups are part of the SHI system and include more than a hundred sickness funds (Blümel and Busse 63). For sickness funds, individuals and their employer split the mandatory contributions, individuals contributing 8.2 percent of their income and employers paying another 7.3 percent (Blümel and Busse 64). These monthly contributions are capped at €630 (or 804 US dollars), which encompasses both employee and employer contributions. These required contributions apply to pensioners and their pension funds, respectively (Blümel and Busse 64). In this way, people pay depending on their income, not based on their health status. If Jürgen is low-income, he would pay less money per month than if he were high-income. Anyone covered under SHI also can rest assured that coverage is extended to dependents as well, which includes children and unemployed spouses. Through general taxes, the federal government of Germany funds certain SHI perks such as free coverage for children. (Blümel and Busse 64). Since SHI sickness funds are all nonprofit, depending on whether revenues are too low or high, individuals may be charged an additional premium or paid an annual bonus. In 2014, none of the sickness funds had to charge extra premiums, and around twenty even paid bonuses upwards of €263 (or …show more content…
Most of the population, about 86 percent, receive coverage through nonprofit sickness funds within the statutory health insurance (SHI) scheme, while about 11 percent are covered through substitutive private health insurance (PHI). The remainder of the population are covered via special programs (Blümel and Busse 63).
Due to guaranteed issue in Germany, Jürgen, or any citizen, will not be denied healthcare coverage because of a particular illness. In addition, no citizen will be denied coverage because of a pre-existing condition either. The same standard applies to all citizens, regardless of age or wealth. In fact, although the German government does not directly finance or provide health care, it watches the country’s nonprofits and for-profits very closely to make sure that they do not increase any patient’s insurance rates or stop providing coverage as the patients grow older or sicker
A simple comparison to the US system is difficult considering the multitude of insurance plans with variable premiums and the wide array of coverage depending on company size and other factors. Different from the French system, American employers do not buy insurance based on a percentage system and the money does not flow into a few National Health insurance funds, rather...
In comparison, Germany spent slightly more than 11% of GDP (2011) towards healthcare funding. Universal health insurance is available to everybody with an option to purchase private insurance coverage (The U.S. Health Care System: An International Perspective, 2014). Approximately 90% of the population uses the national system in which premiums are income based. The system uses 240 private insurers for a non-profit, competitive system. Insurance costs are significantly less than the U.S. due to cost negotiations for medical facilities, appointments, and prescription medications (Sick Around the World, 2008).
In the 1800’s, the Netherlands, Sweden, and Belgium, among others, began to establish “socialized insurance policies” and medical care, which are still in effect today, while at the same time, the United States began to furthe...
The concept of Health Insurance and managed health care the inventions of the twentieth century that were started as prepaid health care. The early insurance concept was merely a way for people to pay medical bills not a way of protecting individual financial assets as the case is today. Overall the health care industry has endured significant changes since its inception.
Health insurance is currently an important issue in the United States. Everyday more and more Americans become uninsured due to job loss and an increase in premiums. These Americans add to the ever growing population of 45.7 million people who are currently uninsured (Bialik). Moreover only 27% of those uninsured are under the age of 65 (NCHC). This is staggering considering most of those who are uninsured have, or soon will, suffer from some sort of illness or injury. As a result they will not be able to afford proper treatment. Insurance premiums can range in cost from fifty dollars per month, to fifteen hundred dollars per month (Kreidler). An individual’s premium is determined by factors they choose as well as other factors looked at by their provider. The cost of health insurance in America varies depending on the controllable factors, like particular insurance policies, and uncontrollable factors, like age.
Out of all the industrialized countries in the world, the United States is the only one that doesn’t have a universal health care plan (Yamin 1157). The current health care system in the United States relies on employer-sponsored insurance programs or purchase of individual insurance plans. Employer-sponsored coverage has dropped from roughly 80 percent in 1982 to a little over 60 percent in 2006 (Kinney 809). The government does provide...
The increase in the number of unemployed due to economic crises continue to increase the number of uninsured and reduce people’s ability to access the healthcare insurance and services. Many are unable to cater for their health needs and thus may die immaturely due to the effect of severe illnesses.
Insuring health is a big commodity, and it is not the easiest task to choose the right plan. One must have an understanding insurance terms and what insuring health costs. One must know who can help with financial coverage and how the relationship works between the insurer and member. Finally, one must have assurance that the protection will last into old age.
From the hospital perspective mandating the health insurance will reduce the problem of Free riders into the Hospital and if a person who is insured visits the hospital for the treatment the cost of his medical treatment will not be totally absorbed by the hospital if the person is unable to pay for the treatment and the amount will be shared between the hospital and the insurance company.
The three main types of health insurance in the United States are voluntary, social and welfare. These types on insurance a person possess sometimes determine the ability to seek care and how that care is given. Insurance types such as voluntary and social insurance can be very expensive and will make participants consider how important it is for them to see the doctor, while welfare medicine participants have trouble finding a doctor due to the limit number of physicians who are provider or are refusing to take on new patients. Some of the types of voluntary insurance are Blue Cross and Blue Shield (BCBS), private and commercial insurance, and health maintenance organizations. Voluntary insurance is not only limited to health care from physicians, but can also include dental, long-term, and life insurance. One of the most popular voluntary insurance companies is BCBS. Sometime people have trouble paying for insurance especially if is as it related to an on the job injury or because they have reached retirement age and can no longer work.
When someone gets sick or injured they expect to receive medical care, whether it be as a public or private practice. We tend to think that most everyone has some type of health insurance to cover the expensive costs of medical care but in reality there are many who cannot afford such. The universal challenge has been how to get medical coverage for everyone around the world, but is this ideal too radical? Each country has its own pros-and-cons with health care plans. The United States, among others, have just recently reformed our own. There are many types of medical coverage around the world that still face the endless rising costs, as well as the lack of accessibility to public and/or private health care. Here, we will look at other countries to see how the medical coverage models they have adopted have helped improve their own health care and how these same models could potentially improve our own.
“47 million U.S. residents have no health insurance, and the numbers keep growing. America’s workers struggle to pay higher premiums, deductibles and co-payments. Working families are experiencing increases in the costs of health insurance, more out-of-pocket costs for doctor visits and skyrocketing prices for prescriptions, forcing many to delay getting needed medical care or words“(2012). The video Sick Around America introduced many issues with the United States health care system. The biggest problems in the United States is medical underwriting, if you lose your job that provides health insurance, you lose the health insurance.
The National Health Service (NHS) provides preventive medicine, primary care, and hospital services, and UK residents can use NHS health care for essentially nothing except for some co-payments for prescriptions and dental care. Alternatively, the national programs in the US are Medicare, Medicaid, and programs that cover military veterans and federal government employees. A large proportion of people have private insurance through their employer. While some private insurers in the US have imposed CEA rules, cost per QALY is a mandated decision-making tool concerning coverage and reimbursement in the
Health insurance facilitates entry into the health care system. Uninsured people are less likely to receive medical care and more likely to have poor health. Many Americans are foregoing medical care because they cannot afford it, or are struggling to pay their medical bills. “Adults in the US are more likely to go without health care due to cost” (Schoen, Osborn, Squires, Doty, & Pierson, 2010) Many of the currently uninsured or underinsured are forced accept inferior plans with large out-of-pocket costs, or are not be able to afford coverage offered by private health insurers. This lack of adequate coverage makes it difficult for people to get the health care they need and can have a particularly serious impact on a person's health and stability.
In terms of access, everyone is required to buy and maintain health care within the first 3 months of living within the country. If one cannot afford insurance, the government subsidizes for low-income families. This is extremely important to make sure everyone has health care. Access again is obtained based on what canton on...