Previously, health insurance was practically non-existent. Pension funds and provident funds were already in the consciousness of people as well as in the administration of institutions, whether private or public, for many decades. And yet, health is as important as one’s future retirement fund and present financial needs and is, in fact, closely related to both essential requirements for a healthy and productive working population. Hence, the rush to enact laws requiring all workers to acquire health insurance of some form has become a crucial issue.
For us to understand what health insurance is all about and its foundational principles, consider some pointers to guide you decide whether having health insurance is really essential or not:
1. Ideally, health insurance is not state-sponsored medicine
We hear activists declare that health insurance is a form of taxation or revenue- generating scheme of the state. Well, if some corrupt officials were to be given the hand, that would be true as news of government funds being carted away by top-level officials flood the news daily today.
However, as conceived and its ideal form, health insurance is a “plan whereby money is collected usually from the employer, the employee and the state and set aside as a fund out of which those who render services (health practitioners) to the insured population (the employees, that is) are paid.” It is not “state medicine” which is a technical phrase define by the American Medical Association as “a form of medical treatment provided, conducted, controlled or subsidized by the federal or any State (provincial) Government or municipality” and has certain exceptions.
2. The end beneficiary of health insurance is the insured
Again, this is the ideal case. At any time an employee or member of the fund requires medical attention, the fund is obligated to answer the immediate need without the insured having to pay anything above the premium already being collected. Of course, we hear of cases where hospitals or doctors turn away patients who could not put up a deposit or, perhaps, certain technical requirements such as a missing ID or other reasons; but these are exceptional cases. In general, the fund is meant to serve the beneficiary for the state sees the fund as a means to promote health.
3. The other beneficiary of the health insurance is the medical practitioner.
The health insurance may appear as if it puts the health service providers as the masters and not as the public servants that they are. We all have those people in every place – those who look at their work not as a way of alleviating suffering but aggravating it among those who sustain their livelihood. Yet, it is through the health insurance fund that health practice is enlivened and made more accessible to more people with the proper implementation of the program.
4. No monetary benefits.
The only benefit the insured gets from the fund is medical service, not cash benefits. In some cases, the insured may receive free medicine, diagnosis or medical surgery for free, depending on the coverage and the type of services that a particular state provides for it populace. However, in general, only medical service is given to the insured and not cash as it is often done in other insurance policies.
5. Preventive and curative medicine are given equal attention in health insurance.
This is one of the ideal principles in the program; but it is one that is easily forgotten or abused by practitioners and even by politicians who manage or control how the funds coming from the State should be used.
We know that medical practice has become a big moneymaking venture, especially among those who support the industry with pharmaceutical drugs, equipment and assorted medical supplies. The end-user in terms of medical care has to be knowledgeable enough to know what he or she needs for any particular health issue in order not to be taken advantage of by unlawful medical-service providers.
With these basic facts about health insurance, you can determine what you can expect to derive from having a health insurance. Ultimately, sustaining an active and healthy life will not depend on having the protection of a health insurance but having a healthful and wholesome lifestyle. Doctors and the medicine they use to cure people, ultimately, do not heal us. The body has the built-in immune system to do that. Medicines and other therapies and methods only enhance the immune system’s ability to bring back the body to its optimum condition.
Hence, a health insurance is more a temporary fall-back position than a real solution to having a reasonably healthful and fulfilling life. Leading a consciously active and healthful way of life is much better than depending on a supposedly a fail-safe crutch while living a carelessly unhealthful lifestyle.
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Harver Health Insurance Counter Fraud Group was established in July 2001 through the joint action of several large insurers. The objective today remains as it was then, which is to prevent and detect fraud within health care. The Group initially convened to consider matters of common concern and to exchange information and specified potential frauds within a mutually-accepted terms of reference.
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