Mindmasterclass dot Com: Health and Medical Blog

Whether you are self-employed, have one or two jobs or retired, you need a good health insurance plan for yourself and your family. It is important to get good health insurance coverage against unexpected medical expenses in order to avoid to be buried in debt. However, a plan that is good for someone else may not be the right one for you. In industrialized countries like the US, where the health insurance companies constantly change their policy, it is necessary that you have adequate information before choosing a health insurance plan. This article explains the different types of health insurance, their advantages and disadvantages so that can choose wisely if you shop for health insurance.

Individual health insurance

Individual health insurance is a form of individual contract between you and an insurance company to guarantee the repayment of all or almost all medical expenses. This may includes hospitalization, medications, dental care, seeing a specialist, and certain therapies (radiotherapy, chemotherapy, etc.). This service may be provided by a government-sponsored social insurance program (mostly for individuals with low income), or from private insurance companies.

What is the history behind health insurance?

Some hundred years ago, before the appearance of health insurance, all patients used to pay their health care costs. Around 1694, Hugh the elder Chamberlen (1630-1720) introduced health insurance. At that time, the idea was not widely known and welcomed by the public. Around the end of the 19th century, health insurance took an expansion, and other forms insurance such as accidental or disability insurance started being available in certain states in the United States.

Franklin Health Insurance Company of Massachusetts was the first company to provide accident insurance in the United States. However, it covered only injuries caused by railroad and steamboat. As the insurance industry grows, in 1866, there were approximately sixty companies offering accidental insurance in the United States. Today, there are more insurance companies than we can count.

Although there are numerous insurance companies, health insurance plans are grouped into three main categories:

Fee-for-service – also known as indemnity plans is a type of insurance plan where you, patient, have to pay all medical expenses out of your own pockets, and then request a reimbursement from your insurance company. These types of plans have their advantages and disadvantages.

Advantages: they offer more flexibility in choosing your own doctor. You can decide the time to see your health care provider, and what type of treatment you want; as long as you remain in the limit that your insurer will pay

Disadvantages: in indemnity plans, most doctors require upfront payment, so you have to submit claim forms to the insurance company to receive a reimbursement. That requires paper work, and sometimes many phone calls. Fee-for-service plans offer limit benefits; they do not cover annual physical exam and educational programs.

HMOs (Health Maintenance Organizations) – Health maintenance organizations (HMOs) are managed care plans that offer health care coverage to their members through hospitals, doctors, and other health care providers that are in their network. That is, having their service, you are limited to members of their network.

Advantages: unlike Fee-for-service plans, you do not have to pay up front; although some of them require a copayment. You do not need to submit forms after forms to receive reimbursement. In addition, HMOs usually charge a lower cost.

Disadvantages: you can use only health care providers who are associated with the organization. Most HMOs (Health Maintenance Organizations) tend to refuse to approve certain treatments. Although some HMOs accept their members to see physician or specialists who are not in their network, they often charge you additional costs.

(PPOs) participating provider organization, also known as Preferred Provider Organizations – is a form of managed care organization of physicians , hospitals, clinics and other health care providers that sign a contract with an insurer to provide health services to its member at reduced rates . Usually, PPOs cost more than traditional HMOs, but offer more options to their members.

Advantages: Preferred Provider Organizations provide more flexibility to their members; they have a bigger network of doctors and hospitals. You can take service from health care providers that are not part of their networks (certain charges often apply). You pay Lower copayments for care from primary care physicians. In addition, you do not need a referral to see a specialist.

Disadvantages: PPOs cost more than traditional HMOs. You will more likely to make co-payments (usually from $10 to $30) when you visit a health specialist.

Do some health insurance companies offer better service to their members than others?

Yes. Some insurers offer better service to their members.

The family doctor has traditionally been a reliable figure that parents and children alike could trust for good judgment and to oversee their family’s healthcare.  Most people just assume that the education and training that doctors undergo assures them that they use the best of their judgment and that the health practices and drugs administered to patients are the unquestioned latest and correct advice.

Unfortunately, this belief in the family doctor is in many ways a misperception.  In many instances doctor’s judgment has been compromised by the overwhelming one-sided education they are being given by the giant pharmaceutical conglomerates.  The result is unnecessary medication use, poor outcomes and sometimes dangerous results for patients all to satisfy the drug company’s insatiable need to make a buck and keep their stock price up.

From the day your doctor enters medical school his view of the world of medicine is shaped in large part by pharmaceutical companies.  Most major teaching hospitals and university medical programs are heavily subsidized by pharmaceutical companies.  Tens of millions in grants are given each year for research studies and scholarships to keep medical schools filled.  The medical textbooks given to the students and much of the literature and reading material is provided free of charge to medical students and are written by or paid for by drug companies.  Is it any wonder then that the first course of treatment for many ailments has been to take a pharmaceutical product?

The first rule of medicine is supposed to be ‘first do no harm’.  But in many cases this is not being followed.  Instead of medical students being trained on healthy non-pharmaceutical ways to treat common ailments, they are instead taught that drugs are the ‘first line’ of treatment.  This not only exposes patient to unnecessary possible side effects from the medications but also causes them and their health insurance company to spend money needlessly.

Of course the pharmaceutical companies prefer this as it means more money for them.  Courses in medical school that encourage alternative therapy or even such staples as good diet and exercise are discouraged and instead a ‘treat the symptom not the cause’ ethos has prevailed in large part due to the insidious influence of drug companies.  How does this happen?

Nearly every major professor at well known medical schools is given grant money from drug companies.  If a professor or academic publishes a paper that is critical of the pharmaceutical practices then they simply are ‘looked over’ and skipped when it comes time for their grants to be renewed.  Those who ‘tow the line’ are rewarded with trips to conferences and lavish grants to study yet another new drug.

These professors then get to publish their work in medical journals which are…you guessed it…paid for by the pharmaceutical company.  The university likes professors that publish as it is good PR for the university.  Published articles are also one of the mandatory linchpins in many universities determinations of professors gaining tenure and pay raises.  A vicious cycle then emerges where you have drug companies using this system to promote those professors and researchers that ‘favor’ using pharmaceuticals and those that disagree are simply dropped…first from the grants…then from the publishing…and eventually from the university.

By the time a young med school student graduates and enters his internship at a hospital he has been taught that for most ailments he is likely to see, drugs are the first and best way to treat them.  It only gets worse from there.  Make sure you stop by www.sedatednation.com and see how a young doctor is even further ‘influenced’ by drug companies once they enter private practice.

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As we already know, there was some health insurance debate lately. After President Obama make some changes for government’s role in health care reform, many health insurance companies are on the opposite side and even one of the giant health insurance company plans to launch a Web site on health care reform in the next few weeks, offering videos, links to information, and invitations to customers to share their thoughts.

Try to search in internet and you can found so much news and article about debate on public health insurance. The Debate over Health Care Reform and Public Health Insurance is seriously becoming interesting news to watch.
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Take time to consider the points presented above. What you learn may help you overcome your hesitation to take action.