Health insurance

Health insurance is a type of insurance whereby the insurer pays the medical costs of the insured if the insured becomes sick due to covered causes, or due to accidents. The insurer may be a private organization or a government agency. Market-based health care systems such as that in the United States rely primarily on private health insurance.

History

The concept of health insurance was proposed in 1694 by Hugh the Elder Chamberlen from the Peter Chamberlen family. In the late 19th century, early health insurance was actually disability insurance, in the sense that it covered only the cost of emergency care for injuries that could lead to a disability[citation needed]. This payment model continued until the start of the 20th century in some jurisdictions (like California), where all laws regulating health insurance actually referred to disability insurance. Patients were expected to pay all other health care costs out of their own pockets, under what is known as the fee-for-service business model. During the middle to late 20th century, traditional disability insurance evolved into modern health insurance programs. Today, most comprehensive private health insurance programs cover the cost of routine, preventive, and emergency health care procedures, and also most prescription drugs, but this was not always the case.

Currents State

Individual and Family health insurance plans provide long-term protection and comprehensive medical coverage for you and your famaly:

• The number of people with health insurance coverage increased from 245.9 million in 2004 to 247.3 million in 2005.1.
• In 2005, 46.6 million people were without health insurance coverage, up from 45.3 million people in 2004 (Table 8).
• The percentage of people without health insurance coverage increased from 15.6 percent in 2004 to 15.9 percent in 2005.
• The historical record is marked by a 12-year period from 1987 to 1998 when the uninsured rate (12.9 percent in 1987) either increased or was not statistically different from one year to the next.2 After peaking at 16.3 percent in 1998, the rate fell for two years in a row to 14.2 percent in 2000. The rate then increased until 2003–2004, where it remained at 15.6 percent, before it increased to 15.9 percent in 2005.3
• The percentage of people covered by employment-based health insurance decreased between 2004 and 2005, from 59.8 percent to 59.5 percent.
• While the number of people covered by government health programs increased between 2004 and 2005, from 79.4 million to 80.2 million, the percentage of people covered by government health insurance remained at 27.3 percent. There was no statistical difference in the number or the percentage of people covered by Medicaid (38.1 million and 13.0 percent, respectively) between 2004 and 2005.
• The percentage and the number of children (people under 18 years old) without health insurance increased between 2004 and 2005, from 10.8 percent to 11.2 percent and from 7.9 million to 8.3 million, respectively. With an uninsured rate at 19.0 percent in 2005, children in poverty were more likely to be uninsured than all children.
• The uninsured rate and the number of uninsured remained statistically unchanged from 2004 to 2005 for non-Hispanic Whites (at 11.3 percent and 22.1 million) and for Blacks (at 19.6 percent and 7.2 million).
• The number of uninsured increased for Hispanics (from 13.5 million in 2004 to 14.1 million in 2005); their uninsured rate was not statistically different at 32.7 percent in 2005.

go to: Health Insurance 2005

Common complaints of private insurance

Some common complaints about private health insurance include:

• Insurance companies do not announce their health insurance premiums more than a year in advance. This means that, if one becomes ill, he or she may find that their premiums have greatly increased.
• If insurance companies try to charge different people different amounts based on their own personal health, people will feel they are unfairly treated.
• When a claim is made, particularly for a sizable amount, it may be deemed in the best interest of the insurance company to use paperwork and bureaucracy to attempt to avoid payment of the claim or, at a minimum, greatly delay it.
• Health insurance is often only widely available at a reasonable cost through an employer-sponsored group plan.
• Employers can write some or all of their employee health insurance premiums off of their taxable income whereas traditionally individuals have had to pay taxes on income used to fund health insurance.
• Experimental treatments are generally not covered. This practice is especially criticized by those who have already tried, and not benefited from, all “standard” medical treatments for their condition.
• The Health Maintenance Organization (HMO) type of health insurance plan has been criticized for excessive cost-cutting policies.
• As the health care recipient is not directly involved in payment of health care services and products, they are less likely to scrutinize or negotiate the costs of the health care received. The health care company has few popular and many unpopular ways of controlling this market force.
• Some health care providers end up with different sets of rates for the same procedure. One for people with insurance and another for those without.