In the US, health insurance is voluntary and is carried out almost entirely by employers. Health insurance is the most common type of insurance on the job, but employers are not obliged to provide it. Not all American employees get such insurance. Yet in most major health insurance companies it is almost indispensable condition, and in 1990 it reached about 75% of the US population.
There are many types of health insurance. The most common is the so-called compensation insurance or insurance “fees.” In this form of insurance the employer pays the insurance company a premium for each employee, to provide an appropriate policy. Then the insurance company pays the checks provided a hospital or other medical facility or physician. Thus, paid services are included in the insurance plan. Usually, the insurance company covers 80% of medical expenses for the rest to pay the insured himself.
There is an alternative - the insurance of the so-called managed services. The number of Americans is covered with this type of insurance, which has increasing rapid (more than 31 million people in 1991). In this case, the insurance company contracts with physicians, other health professionals, as well as with institutions, including hospitals, to provide all the services, which are provided by this type of insurance. Usually, hospitals receive a fixed amount that is paid in advance for each insured person.
The differences between these two types of insurance are very important. At insurance “fees’ thee is paid the cost of services that are actually provided to patients. When insuring “managed services”, hospitals receive only a fixed amount based on each insured patient regardless of the volume of services provided. Thus, in the first case, health care professionals interested in attracting customers and providing them with a variety of services, while in the second - they are likely to abandon the use of additional procedures to patients, at least, is unlikely to be assigned to more than necessary.
Currently, the US government also pays more than 40% of health spending within the major programs – “Medicaid” and “Medicare”. According to the program “Medicare” the insurance for all Americans over age 65 and those, who are approaching this age and who have serious health disorders. Program “Medicare” is partly funded by a tax levied on all employees - both salaried workers and to employers. In general, this tax is about 15% of the income of employed Americans. In addition, “Medicare” financed from general income tax revenues. Program “Medicaid” provides coverage of poor Americans, mostly women and children from poor families. The program also paid stay in a nursing home, who requires constant care and cannot live without daily assistance.
Program «Medicaid» is financed by the federal government and the governments of the states. The federal government pays for about half of all program costs “Medicaid” from general tax revenues. The rest is paid by the government in each state.
However, there are many Americans who are not covered by any kind of insurance. Many of them work, but employers do not …