The Basic Elements of Health Insurance Essay

Published: 2021-07-19 15:20:05
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Category: Healthcare Financing

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For health insurance to be effective, different aspects must be put into consideration. Universal coverage is a basic element of health insurance. Health insurance should cover majority of citizens in a particular country. In addition, health insurance should be continuous. Continuity allows early detection of a disease and uninterrupted treatment.
Moreover, health insurance should be affordable to low income families and individuals (Gunnar, 2006).Affordability includes incentives, inflation controls and cost to offer cost-effective services.
As a result, health insurance can be accessible to low-income individuals and families. Health insurance should promote health and well-being of those it covers. It should include mental health and preventive services. These elements can be summarized as: efficiency, effectiveness, patient-centered services, timeliness and equity (Quadagno, 2005).
There are several associated with the use of employment based coverage. Quadagno states (2005) that research has made it evident that it is always cheap for a worker to get a health insurance through his employer than doing it himself. It is because the employer can negotiate prices with issuers because he represents many workers.
This also becomes easy for the insurance company because it spends less per person as compared to insuring an individual. It is an advantage to the issuer in that the financial risks are spread over a group of people. In addition, the program ensures delivery of quality healthcare services. As a result, innovativeness is a key element in this program.
Employer based health insurance has drawbacks too. First, all citizens cannot have access to it because employers offer coverage to their employees only. In addition, if an employee decides to quit his job or resign he losses his coverage. In addition, the choices of healthcare plans are limited because the company intents to minimize the costs. Employer based insurance lacks universal coverage. As a result, the program lacks portability and benefits are not transferable (Quadagno, 2005).
There are basic elements which need to be incorporated in health insurance programs to ensure the poor and uninsured have access to insurance health. These elements should ensure services have the following characteristics: affordable, cost-shared, accessible, extended scope of benefits and financed.
The best way that has been known to provide health care to the poor and non insured is through provision of affordable premiums. Statistics show that nine out of ten of the uninsured families and individuals are classified as poor or low-income group (Gunnar, 2006).The premiums offered are expensive and this group of persons cannot afford to pay. Provision of affordable premiums can accommodate the poor and low-income persons (Quadagno, 2005).
Poor families and individuals are at high risk of being uninsured. In addition, this group of uninsured persons is in moderate or low income families. Cost sharing is essential in provision of health insurance to the poor and uninsured. The employers can contribute towards the payment of premiums for their employees. As a result, the poor can afford insurance premiums through cost sharing (Gunnar, 2006).
Stakeholders involved should review the existing health insurance programs to identify and address the gaps in accessibility of services. Insurance companies lack health insurance for children and the elderly (Gunnar, 2006). However, some insurance companies have revised eligibility of individuals to be covered to provide inclusive services.
Every citizen in a particular country should access health insurance. Services offered should be universal to ensure coverage of all citizens in a particular country. In addition, the scope of benefits should be reviewed to ensure all members of family are covered (Gunnar, 2006).
Gunnar, W. P. (2006). Fundamental Law That Shapes the United States Health Care System: Is Universal Health Care Realistic within the Established Paradigm, The Annals Health L., 15 (2), 151.
Quadagno, J. (2005). One nation, uninsured: Why the US has no national health insurance 5(3), 23-30.
The Basic Elements of Health Insurance

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