What Is A Private Health Insurance Plan - The US health care system is often compared to other countries that have implemented universal health care, and the effectiveness (or lack thereof) of the system has long been a topic of debate in national and international forums.
A comparison of healthcare systems around the world shows the effectiveness (or lack thereof) of the American model.
What Is A Private Health Insurance Plan
Although most employers do not offer health insurance in Switzerland, it is common among multinational companies based there.
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Jeffrey Capone, Mercer's head of global business solutions in the United States, said, "The traditional market for employee benefits continues to grow with the consolidation of large health systems. With fewer options, employers and direct payers for health insurance have limited options in many parts of the United States. challenges health care providers during price negotiations with these health systems.”
Are other countries more effective in protecting the health of their citizens? We look at how five countries – Switzerland, France, Singapore, the UK and Australia – finance and regulate healthcare and where they stand in terms of price, quality and access to care.
Unlike many European countries (but similar to the US), Switzerland has left much of the health insurance sector to private enterprise. However, the government requires residents to purchase basic health insurance from private insurance. If a person is unable to obtain compulsory health insurance within three months, local authorities sign up to a higher premium plan.
When it comes to compulsory insurance, the Swiss government strictly regulates the market. For example, coverage requirements are set by law (and therefore the same for all providers). Benefits cover 80-90% of medical expenses, including most doctor visits, medical care, and prescription drugs. In addition, according to Swiss law, health insurance companies must accept all requests for compulsory health insurance, regardless of the applicant's age or health risk, without any conditions or waiting periods. Insurers also charge an annual minimum of 334 USD for adults. dollars (CHF 300), children under 18 must be offered at least a zero deductible. Finally, while insurers may make a profit on supplemental coverage, they are not allowed to make a profit on the sale of their primary health insurance.
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In addition to mandatory health insurance, insurers can offer additional plans for services not covered by basic health insurance, allowing for greater choice of doctors and better hospital accommodations. Due to the country's focus on individual health insurance, most employers do not offer health insurance to their workforce, but it is common among multinational companies with foreign employees based in Switzerland. Such employer-sponsored plans offer additional benefits to employees.
Regardless of the regulatory control of the Swiss government, premiums for basic health insurance may vary among insurers depending on deductibles, place of residence, and the degree of additional care selected.
However, it is alarming that the cost of healthcare in Switzerland continues to rise dramatically. According to a 2017 SantéSuisse report, the country's healthcare spending rose by 4.9 percent in 2016. According to an EY study, healthcare costs in Switzerland are expected to increase by 60 percent by 2030 due to factors such as advances in medical technology, the rise of chronic diseases and an aging population. EY notes that these factors have created an unsustainable health care system and many people cannot afford the coverage they need. The study urges insurers to work within their means and use technology to develop preventative and other tools to help people get and stay healthy. As the cost of health care continues to rise, so does the cost of health insurance. Since the introduction of basic health insurance in Switzerland in 1996, average insurance premiums have increased by 4.6% per year.
Like many European countries, the French healthcare system offers compulsory national health insurance, which allows French citizens and residents to cover 70-100% of hospital, doctor, long-term care and prescription drug costs. The national insurance system is financed mainly by payroll taxes (paid by both employers and employees), national income tax, and taxes on tobacco, alcohol, and pharmaceuticals.
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However, unlike its neighboring countries, France has a well-developed private insurance market that was created to supplement the national health system. In fact, 95 percent of the population has private health insurance in addition to the state health insurance. Private plans cover treatments not covered by national health insurance, such as dental, hearing and vision care, in addition to co-payments. Private and commercial insurers often offer this additional coverage. Non-commercial mutual insurers (called mutuelles) operate in France and mainly provide supplementary insurance to the national plan, which is not the main support of the system.
Thanks to the country's recent healthcare reforms, insurance companies and brokers are thriving in the French market. Five years ago, the French government passed the Employment Security Act, obliging all employers to provide their employees with private health insurance. This law increased supply and demand and led to a dramatic expansion of private health insurance in France. Despite this growth, the private health insurance market remains under the supervision of the French government, which plays an active role in maintaining an accessible, balanced and affordable public/private health system for all French residents.
Since the mandate in 2016, the French government has constantly revised the rules for the employer-sponsored health insurance market. Failure to comply with these regulations is a major risk to the country, with constant updates to regulations that reduce innovation in the market.
"Changes in private health insurance regulations have limited our ability to create products. However, we have been able to be more innovative to enable our corporate clients to implement their social strategies," said Juliet Kolb, benefits consultant and insurance broker at Verlingue in France. We have created a number of solutions. We have created digital tools for managers and HR, analysis of short and long-term disability data, preventive measures and many other services. We constantly need to change the range of services."
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Singapore's healthcare system is offered as a model for balancing universal basic healthcare with a competitive private insurance market. Universal health insurance in Singapore is provided through a mixed financing system based on three mandatory programs: MediSave, a national health savings program funded by private and employer contributions (8%-10.5%); MediShield Life, universal basic health insurance for major medical expenses funded by MediSave accounts; and MediFund, a government-funded safety net for low-income individuals who cannot cover out-of-pocket costs through MediSave.
Private health insurance in Singapore is available from various health insurance companies. In most cases, coverage is through Integrated Shield plans, which include a MediShield Life component and additional coverage from private insurers. These plans are approved by the government and can be paid for using MediSave. Patients can also purchase private insurance offered by commercial insurers, but private plans cannot be combined with MediShield Life or paid for using MediSave. However, because there are many insurance options available, a combination of MediShield Life, private health insurance and employer benefits can result in different levels of coverage.
We have created several solutions to complement regulatory requirements. We have created digital tools for managers and HR, analysis of short and long-term disability data, preventive measures and many other services. We often need to change the scope of our services.
The Singapore government has been very active in promoting affordable insurance premiums, reducing out-of-pocket costs, and reducing prescription drug prices through government subsidies. For example, in order to keep the price of medicines low, the Ministry of Health publishes a list of medicines that the government deems to be efficient and necessary. These drugs are given to patients at a discounted rate and can be purchased from the MediSave fund. There are drugs that are not listed, but they can be expensive. The government also enforces strict price transparency rules, including mandatory inclusion of all costs and fees in the total price to eliminate price gouging and fair price comparisons.
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Due to the government's strict control of the healthcare system, insurance companies and brokers in Singapore are limited in terms of prices, which can affect the company's bottom line. Singapore health insurance underwriting profits have been essentially negative since 2014, according to Statista. For example, the underwriting income of health insurers was negative SGD 44.2 million (US$ 33.4 million) and negative SGD 11.2 million (US$ 8.5 million). ) in 2018 and 2019 respectively. In 2020 alone, health insurance companies in Singapore gained S$17.9 million (US$13.5 million) in underwriting income, possibly due to the impact of COVID-19 on delays in scheduled and non-emergency services. Therefore, innovation and increased efficiency may be the only way to gain a competitive advantage.
The United Kingdom has the largest public health system
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