Health insurance is a collective act of people pooling their risk, in this case the risk of incurring medical expenses.This form of insurance can be obtained by consumers from either public sector insurance programs or private sector insurance companies.
It may be purchased on a group basis, for example by a firm to provide coverage and benefits to its employees, or by an individual. Either the covered groups or individuals pay premiums or taxes to protect themselves from unforeseen health care expenses.
A routine finance structure like a monthly premium or an annual tax can be developed by estimation of the overall risk of health care expenses, thus ensuring that money is available for payment of health care benefits as per the specifications underlined in the agreement.
The concept of health insurance was proposed in 1694 by Hugh the Elder Chamberlin.During the 1920s; hospitals started offering services to individuals on a pre-paid basis, leading to the evolution of the Blue Cross organizations.
In the United States of America the combination of public-private health care system is the most expensive in the world. Health care per person costs more than any other nation. A major portion of gross domestic product (GDP) is spent on health care in America compared to any other United Nations member state. The U.S. is a wealthy, industrialized nation, but is the only one that does not have a universal health care system, according to the Institute of Medicine of the National Academy of Sciences.
For several decades in the history of the United States, many Presidents have tried to introduce health care reform with no success. When President Clinton tried to implement a health care reform in 1993, it was met with a lot opposition. During his election campaign in 2008, President Obama made health care reform a major aspect of his agenda
2010 Health Care Reform and New Bill Summary
He successfully got his health care reform bill passed on March 23, 2010. There is a big controversy according to major news agencies and the general public surrounding President Barack Obama’s health care reforms that passed through Congress recently after going through many proposed amendments on March 23, 2010.
The biggest pro of this reform is considered to be the access to health care for several uninsured Americans. The Bill also insists that health insurance companies do not neglect individuals with pre-existing conditions.
It appears that the debate over health care reform in the United States questions the rights to health care, access to providers and benefits, fairness, and quality purchased by the high amount of money spent on health insurance. The recent reform Bill that passed is possibly costing the American people an astounding 1 trillion dollars. On the other hand it is supposed to cut the deficit by billions of dollars, by hiking taxes and cuts in Medicare programs.
During 2010, adults and children previously denied coverage due to pre-existing conditions will be able to access healthcare. High-risk pools are supposed to be set up for these individuals to gain access to coverage. There’s no concrete information about how, where or how someone can access these pools. The pool is supposed to be subsidized but the legislation isn’t clear on where you can apply for the subsidy.
There are no Lifetime maximums in 2010. In addition, insurance companies cannot drop a person if he falls ill. Annual limits are done away with as well, helping those that suffer catastrophic illnesses. Children up to 26 can stay on their parents’ plan. Small businesses offering insurance to their employees can get a 35% tax credit from premiums paid. New plans written during this time have to offer preventative care with no co-pays or deductibles. Retirees aged 55-64 are offered access to a re-insurance program, and Medicare D participants receive a $250 credit.
In the year 2011, the Bill proposes that Medicare must provide plans with preventative care with no co-pays or deductibles, Medicare D recipients receive 50% off drugs falling in a “donut hole”, and health insurance companies will have to justify any premium increases or risk being taken out of a state’s insurance exchange pool.
In 2014, an IRS penalty of $750 per individual or 2% of income – whichever is greater – kicks in for those that choose not to purchase health insurance. No one can be denied access to insurance for pre-existing conditions, and annual caps on benefits are banned altogether. In addition, the temporary high risk pools are now done away with as states will have to have exchanges put in place.
The bill will put American families and small businesses in charge of their health care instead of insurance companies. Reforms will make health care affordable, insurers more accountable and expand coverage to all Americans. It promises to stabilize family and Federal budget and the economy.
The biggest cons are the uncertainty surrounding the bill regarding the cost and issues of the bill infringing on the constitutional rights. The proposed bill is very expensive and makes it a requirement for Americans to purchase insurance, failing which, they will be fined. The bill has been received well by many people, but on the other hand a lot of Americans are opposing it very vehemently.
There are some questions for the administration and answers are being awaited by the American people.
As a result of this bill, India stands to benefit too. Generic drug manufacturers will stand to gain because demand for their drugs will increase and the patenting laws have changed resulting in advantages for the generic drug makers. Another benefit is for the Indian IT industry. Indian IT outsourcing firms that have the Healthcare verticals can expect to see significant number of outsourcing deals worth several hundreds of millions of dollars.
One of the bill’s immediate benefits is that it ends health discrimination for children with pre existing conditions. On 29th March 2010, the Secretary of Health and Human services Kathleen Sibelius said that she will issue regulations to insurers clarifying the law which says children cannot be denied access to their parents’ plan, and that the plan cannot exclude coverage to their pre existing conditions. Democrats claimed that coverage would not be denied to any child with a pre existing condition. President Obama claimed during this year, insurance companies will be banned forever from denying coverage to children with pre existing conditions, but insurance companies see the rule in a different light.
The bill claims, “Insurers may not impose any pre existing condition exclusion” for children under 19 as of September 23 2010. Insurance companies take it to mean that if they choose to cover a child with such conditions, they have to cover the condition and its costs but they don’t actually have to give new coverage for any child with pre existing conditions till 2014. Sebelius said that insurers are just looking for loopholes in the plan.
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