Medical Insurance Worldwide Term Paper

Rising medical costs is a worldwide problem today. Therefore, is not surprising, that there is on international aspiration to improve the state of the health of the population. These noble aspirations have an aim to improve situation in the medical insurance sphere and also helps in a fight against poverty. Another important question is appeared because the risk of “new” world pandemics, such as atypical pneumonia or swine flu, and the risk of the returning of “old” infectious diseases, such as a cholera, yellow fever and tuberculosis, the people in the United State, and other countries, needs to be protected.  However, in spite of everything, availability of health care services continues to remain limited for the majority of the population of the world.

Insurance as a socio-economic institute has an interesting history of development. It began in deep antiquity, during the origin of civilization and objective pre-conditions, which impelled people to enter into certain socio-economic relations, adopted later insurance, were preceded the origin of insurance and the formation of the first signs of the state system.

The dangerous phenomena of preconditions and unexpected events caused people irreparable property and physical losses. In other words, these phenomena and events caused harm, destroying material welfares that were created by people efforts and influenced on their personal improperly blessings. It is possible to formulate objective and subjective factors for insurance. We can see the next factors:

ü    “it is a presence of dangers, able to cause property or other financial harm, the offensive of which it is impossible to prevent (objective factor);

ü    it is appearance for the people of fear for safety and economy of material and personal non-material welfares (human factor);

ü    it is a necessity, and also desire and aspiration of people to fight accessible methods and methods with those dangers which cause for them the known fear and fear from the offensive of harmful consequences (combination of objective and subjective factors).” (Thomas, 2000)

In an aggregate, these factors became pre-conditions of creation of institute of insurance as a socio-economic method to fight against the consequences of the dangerous phenomena. Moreover, the indicated aggregate of factors is a historically generated model which in essence did not change by it and is presently instrumental in the origin of insurance relations. Thus, while it will exist subjective factors, I mean people under these words, it will exist insurance, because its main aim is to protect people and take care of their comfort and safety. In other words, insurance will accompany humanity as long as will exist idea about that, how to survive in difficult and dangerous situations and how to take care of own health and life.

In the next several paragraphs we will look through information connected with the health care situation in the world, because it is necessary to analyze what conditions are predominate over the health care system. The he scale of the problem testifies the statistic that 100 million people in a year, on different estimations, fall into poverty from a shortage accessible of medical insurance. It is hard to believe in these true facts. The question is goes not only about a human factor in this situation, because economic expenses and the level of financing, related to not enough developed systems of health care are also considerable. For example, to 2020 in the African countries with the greatest prevalence of AID or HIV lag in growth of rates of national income can make 20% that can really influence on situation. However, in spite of growing awareness of the importance of an improvement in the health care system, in practice, numerous complications continue to stay in the area of expansion of access to health protection. The key questions of policy of developing countries are related to the establishment of a minimum set of privileges of health care, which population must be well-to-do, with the choice of model or models of financing, and also with creation of necessary institutional infrastructure and the search of still human resources for the effective and productive providing of these services.

The volume of facilities, which are assigned to health care, and also a method of financing often determine the level of a country’s development. As a rule, the richer the country, the more facilities it outlays on health protection. Countries with a high level of profits on the average outlay about 10% from GDP to a health care. Countries with the middle level of profits 6%, while countries with the low level of profits outlay less than 5%. It is necessary to note that most countries with a low level of profits have an outlaid on health protection of less than 34 per capita, although this index is the minimum norm of charges, recommended by the Worldwide Organization of health Protection for vitally important medical aid. The question of more allocating resources is related to the previous information. In many developing countries a considerable part of present facilities is frequently selected by the specialized establishments in large cities. Hereupon, on priorities of primary health the majority of the population often selects the insufficient financing for their health.

It is widely known that available payment of services of health protection handicaps a group of the population with more low levels of profits. According to Siska (2009) it can even result in that patients will not apply for help, or will halt treatment, which can aggravate their state and result in the necessity of more difficult or expensive course of treatment. According to this information we see that if a result will be become by disability, then it also can result in the loss of potential profit.

In my opinion, inevitably, for many developing countries it is difficult to provide the necessary financing, as their possibilities for tax collection are limited, and international is help not always in a sufficient measure, and is aimed at satisfaction of primary needs of its recipients. When developing countries run into different calls, related to tax collection, labor-markets and infrastructure of medical service, they are predisposed to the use of combination from a few insurance models. Although international help can considerably increase assignations on health protection, the complex use of different possibilities of financing and institutional measures presents, nevertheless, complications for realization of integral and all-embracing policy. National systems of health care protections, financed due to tax facilities and giving universal access to the identical set of services, are sometimes considered socially just. But for the good functioning, they require sufficient and steady financial resources which rarely can be assured in countries with more low level of profits.

In the cases when the volume of providing can not be attained for lack of sufficient receipts from taxes, “it is necessary to consider the possibility of the use of additional strategies.” (Sorell, 1998).

The programs of health insurance are examined and Sorell (1998) proclaims “when a national scope is relatively wide, that does expedient subsidize the high-paying workers of less paid.” Nevertheless, a scope within the framework of insurance of health care remains in many countries small and avoiding payment of payments is a problem. It can be caused because of absence of necessary flexibility of the similar programs, required for satisfaction of concrete needs on a health of various groups of population care and taking into account their different possibilities for payment of insurance payments.

Intuition prompts, that for the groups of population with low profit one of the ways of scope expansion are the programs of social defence, financed due to payments, the state subsidizing can become. A question follows by it: how to expose the poor groups of population, which have on this right, and how after to register their information? This question becomes complicated, if to take into account often weak administrative possibilities of the states, and also predominance of employment of population in the sector of informal economy in the developing world.

Certainly, not all people who work in an informal sector are working the poor. Consequently, it is possible to use different approaches for expansion of insurance defence of groups of workers of the informal sector: those at which facilities must be for payment of insurance payments, and those which these facilities are not present at.

While voices sound in support individual payments on the categories of risk for those, whoever is included in the group of the poor, other possibilities include the charts of health insurance at primary level. Another approach is strengthening of administrative management of social security of health at the local level, sometimes combining the effort of different organizations in an association for more effective collection of payments and work with having a special purpose groups.

In many developing countries a tendency was set parallel to enter medical insurance for the workers of the formal sector and voluntarily health insurance at a primary level for those who are on a verge of formal economy. Although the programs of insurance at primary levels can begin to help to extend insurance on the whole, they are not deprived of risk.

As a rule, narrow-mindedness of the insurance pool subjects the programs of insurance at primary levels to the risk of cumulative cost of repetitive or catastrophic accidents insured. One of, the possible decisions, examined by special organizations and its partners consists of the creation of an organic connection between the programs of obligatory insurance and insurance at primary levels, allowing the participants of these programs to render mutual support and reinsure each other.

For developing countries, a double burden lies in the area of health protection. They are infectious diseases and all more frequent meetings noncontagious illnesses. Although part models of conduct can act in the frames of the area of health protection. Proceeding from above mentioned statement, we see that another key problem is a receipt of adequate access to pharmaceutical preparations.

Besides overcoming financial limitations which a developing country runs into, the first steps on diminishing of this double burden and grant of the best medical services require establishment of a basic component of medical privileges and drafting of a national list of medicines. However, different measures, accepted in this area, continue to be exposed to the risk from incessant migration in more developed countries of large numbers of medical workers from developing countries. And this problem can not be underestimated.

Returning to the worldwide medical insurance, I want to pay our attention to expatriates’ information. It means that “International Medical or Health Insurance plans are designed for expatriates or those working on overseas assignments from their home country. The plans offer comprehensive coverage, typically better than medical plans provided by local insurance companies.”(Schieber, 2006). It show us the importance of planning process and prove that “importantly, the plans are internationally mobile, meaning you can live anywhere and have freedom to choose where you go for treatment. The plans are normally renewable for life, and premiums will not vary, regardless of the change in your medical condition. International Medical Insurance plans are the most complete and a sure way to protect you and your family anywhere in the World.”(Schieber, 2006)

Worldwide medical insurance is directed on a specific category of the population and the plan of worldwide medical insurance has its own common points. It is important to understand that you choose a plan of insurance for yourself and the main components can help you to be more protected. For example, “When selecting a plan it is important to consider the following additional points: Chronic conditions are generally defined as medical conditions which you do not recover from but only manage and maintain, for example diabetes and asthma.” (Agency for Healthcare). We can’t stay without our attention such important moments because all components of our plan can greatly influence on our health in future. In addition to this information we can continue that “currently, about half of the international medical insurance plans in the market offer coverage for chronic conditions. It is important to understand that the on-going treatment and management of chronic conditions can be very expensive, as such plans offering this coverage are generally more expensive.” (Agency for Healthcare).

Geographic coverage also is an integral part of the insurance decision.  “There are basically two types of coverage. Worldwide including North America and Worldwide excluding North America.” (Himmelstein). You should choose the type of coverage and “if you choose Worldwide excluding North America then you can choose to visit any hospital, doctor or clinic anywhere in the World excluding North America. Conversely, if you choose to include the coverage in North America then you can go for treatment anywhere. Premiums that include coverage in North America are normally much higher. Most plans taken out are Worldwide excluding North America unless you are a US citizen. Plans that do not cover North America for elective treatment will normally still cover you for emergency or unscheduled treatment if you happen to be there while on business or vacation for a short period.” (Himmelstein).

Professional experts consider that by purchasing international medical insurance people can protect themselves from various dangers that they can be face in foreign countries. This variant can be useful for example while traveling: International medical insurance policies typically fall into two categories. According to U.S. Census Bureau we can define them in the next way:

1.   “Travel Medical Insurance – short term coverage for tourists, typically under one year. There are some policies that are renewable for up to three years, providing the traveler with flexibility in case the trip is extended or results in residency abroad. Most of these policies are limited to hospitalization and coverage for acute injuries and illnesses. They do not typically cover routine visits to doctors or preventive treatments such as vaccinations. Maximum coverage options typically range from $50,000 to $1,000,000 per trip.

2.   Long Term Medical Insurance – Permanent plans for expatriates, employees of multinationals, missionaries and other internationally mobile individuals. These plans are similar to your standard permanent policies back home, but are portable overseas. They typically cover doctor visits as well as hospitalization and medicine. Be careful to read the fine print, as some policies are limited to certain geographic zones and may not offer guaranteed lifetime renewability (important feature if you choose to live abroad indefinitely) and outpatient prescription medication coverage. Maximum coverage options typically range from $500,000 per annum or $1,000,000 to $5,000,000 per lifetime.”

It becomes understandable that both types of policies may contain various exclusions which the applicant should be aware of. Thrill seeking travelers should consider policies with hazardous sports and activity coverage.

In spite of the fact that medical service is well-developed in many countries, to find a local insurance company and insurance product which would allow without limitations to use services of any doctors and any medical establishments in the whole world, it is practically impossible. The policy of international medical insurance, covering any charges on a medical service and treatment regardless of time of stay on territory of this country, is certainly, always dearer than policies, offered by local insurance companies. However, much experience shows that more high price with usury is covered mass of advantages which such policy gives the insured person and in these situations you understand that you pay money for the real actions but not for the empty promises.

I think that only the individual policy of international medical insurance in every life situation will give you confidence in that all your charges on treatment in the case of illness or accident will be covered by insurance companies – always and everywhere.

Thus, taking into account all above mentioned it is possible to conclude that the product “International medical insurance” supposes organization and payment of Medicare on the wide spectrum of diseases and states, including long or requiring expensive treatment.

Oncologic diseases, hepatitis, tuberculosis, diabetes mellitus, professional illnesses, are included in this list. Thus, if some disease is exposed in the period of insurance, then during prolongation of agreement insurance defence continues to spread and on it and you will receive all necessary medical aid, because you was insured person and you have a right during your illness to be protected by your previous insurance agreement.

Ambulatory-policlinic treatment, stationary service, conduct of pregnancy and obstetrics, rehabilitation-reconstructive treatment join in the list of the covered types of Medicare, Medicare at HIV or in connection with diseases, caused HIV, transplantation of organs. It means that having the insurance document you can be calm about your health and be sure that you will be treating in a right way by the best physicians. In critical cases, urgent evacuation of the client is conducted in the country of residence. It takes place if necessary charges are paid on passage of the accompanying person. A separate medical stand, at any time accepting appeals, is specially created for this purpose.

During organization of Medicare abroad within the framework of the program “International medical insurance” services of professional translators are given.

Finally, based on all the above said, we could come to the conclusion that “International medical insurance” is a good variant for health problem solving. Your insurance agreement gives you a confidence that you will be treating in all situations and you pay money not for the empty promises but for the real medical aid. There are many debates over medical insurance worldwide but I think that only a person can make the right choice for own life and people should believe in real facts but not in the cloud-castles. I think it also will be good to add the next quotation for the end the words from the Obama-Biden plan. This plan has a big future and as were said at the official government internet source: www.barackobama.com it helps to find out the exit from the healthcare situation. “Make Health Insurance Work for People and Businesses – Not Just Insurance and Drug Companies.

ü  Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.

ü  Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.

ü  Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.

ü  Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.

ü  Make employer contributions fairer by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payrolls toward the costs of their employees’ health care.

ü  Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.

Ensure everyone who needs it will receive a tax credit for their premiums.” (barackobama.com)