Private And public Health Insurance System

Public health insurance:

Public health insurance is the government-run health insurable plan that is fully subsided as well as paid for the public fund (Cohen and Marshall, 2017). Public health insurance plan is provided by the government to the economically weak people, especially older people with unmet health needs and special groups in tb society.

Advantages:

• Public health insurance is more affordable as compared to the private health insurance plans which assist the people who reside in low income society to have proper financial support in terms of meeting their unmet health needs (Weerawansa and Samarasinghe, 2017).
• As the entire health insurance is subsidized by government, the entire public health care insurance is more transparent as well as fair which provides the equal facilities to public as compared to the private health insurance process
• Many of the public healthcare insurance plan do not require deductibles and co-pays

Disadvantages:

• As the public health insurance is government sponsored the health coverage is lower than that of the private health insurance system. Therefore, in terms of treating the critical diseases, poor people have to spend maximum amounts hospitals bills as well as doctors’ fees from their own pocket (Cohen and Marshall, 2017).
• This system is less flexible as compared to the private health insurance plan in selecting the providers
• Most of the providers are not agreed to accept the government sponsored health insurance plan due to its limitations
• As this is the government led health insurance program, it has several criteria while providing the health coverage to its users. People who receive this public health insurance, have to meet all government set criteria, before getting this health care benefits.

Example:

The UK represent largest government sponsored health carer system in which the health care is owned as well as regulated by the National healthcare agencies. In this country, British National Healthcare System is the social insurance plan which regulates the entire healthcare facilities and healthcare coverage to the countrymen.

Private health insurance::

Private health insurance plans are financed, regulated and covered by the private agencies, which can be the private insurance agencies and the employers of any organisation (Burwell, 2015). Generally private healthcare insurance can be two types such as employee sponsored health insurance plan and individual health insurance plan. In employee sponsored insurance, the employees are provided with health insurance as a benefit of their employment by the employers of the company in which the employees work. On the other hands, the individual health insurance plan needs to be purchased by the individual from the private health insurance agencies.

Advantages: .

• People having private health insurance plans having option to select physicians and hospitals by their own choice (Jamali (2017).
• Health coverage in the private insurance healthcare system is higher than in the public health insurance plans, as many potential investors, private agencies and international insurance organisations are associated with this insurance process to improve the overall financial coverage by this health insurance system
• As there are many private insurance agencies as well as organisational that provide the private health insurance coverage, service users can get wide ranges of options to choose suitable private health insurance agency in the market.

Disadvantages:

• Private health insurance is very expensive as compared to the public health insurance system. This is the reason why this insurance plans I restricted only in the middle nad mostly higher social class people in the community.
• As there is little r no government involvement in this health insurance system, the level of transparency as well as fairness is low in private health insurance. Evidence based studies have shown that financial coverage by the private insurance agencies is different to people belonging to different social class in spite of giving the same amount of premium.
• The premium is high in the private insurance process which makes it difficult for people belonging to low income social class to afford private health insurance facilities.

Example:

In the US, the overall healthcare system is maintained as well as regulated by the private health insurance agencies. People in the US, have two types of healthcare insurance plans, such as employee sponsored healthcare plan and individual health insurance plan. In the former plan, people are provided with the health insurance coverage by the employers of the company in which the individual is working, in case of the later, the healthcare plan is bought by citizens of US from private health insurance agencies. .

Contrast and compare of private and public health insurance:

Public health insurance is different from the private healthy insurance system in various aspects such as organisations involved in the two types of healthcare insurance system, finance and control of these two systems. According to Weerawansa and Samarasinghe (2017), in private health insurance process the organisations that are involved in private insurance agencies, corporate organisations. Thereafter, as the overall healthcare insurance process are controlled as well as regulated by t private health insurance agencies the private healthcare system has little or no involvement of state and national government rather it is dominated by the private organisational players. On the contrary, in the public health insurance system, government plays prime roles in controlling and regulating the entire process. As stated by Baker et al. (2018), as in the public health insurance the entre health coverage is provided by government the level of transparency is higher in thus healthcare insurance plans as compared to private health insurance system. For example, evidence-based report has shown that, in the US, there is huge disparity as well as bias in getting proper insurance coverage by country men. Even there is case if older people getting poor health coverage and lack of proper health facilities in spite of buying high premium health insurance in the US. While discussing the organisations involved in health insurance process of private and public system, it needs to be stated that, as compared to the public health insurance process in which the only controllers and player is government itself, the private insurance is led by two types of agencies, one is employers of corporate organisation and the other is

private insurance agencies who sell the insurance plan to the general public. In case of financial operation, the private health insurance system is led by the private organisations, potential investors and corporate organisations who maintain consistent cash flow to the system in term of operating the system in systematic manner, in this context Weerawansa and Samarasinghe (2017) mentioned that in the case public insurance system the financial operation is regulated by the government. Whole it comes to discuss the control of two types of insurance process, in case of private insurance process the overall operation is controlled and dominated by the insurance agencies. On the other hand, in public health insurance the overall operation is maintained as well as operated by the government itself.

Describing health insurance in two countries:

The US and UK represent the different health insurance system in which the former is largest private owned healthcare insurance system and the later has public health insurance system. As stated by Baker et al. (2018), in the UK, British National Health system is the sole authority that operate the entire health care process. On the contrary US has a health insurance system that is based on private health care insurance agencies, who are associated with o providing the healthcare benefits and coverage to citizen in return of high premium. As stated by Jamali (2017), in the US there are some public health insurance agencies that invest minimum amount to the health insurance system of the country such as Medicare Medicaid and large amount of the health insurance system is earned from the private agencies and the profits as well as non-profits insurance bodies. From the WHO report it is shown that, as compared to the UK in which people enjoys the free healthcare facilities due to having government sponsored health insurance, people in th US huge financial difficulties in coping with the higher premium of the health insurance plan. In addition to this the citizen in the US also face discrimination as well as bias in getting the health coverage as well as healthcare facilities in selected hospitals. From the WHO report it is seen that there are many older people in the US who have been reported to be devoid of proper healthcare facilities in spite of giving high rate of premium in each month. As compared to this malpractice in the US, the UK provides equal and fair healthcare benefits to all the citizens though government sponsored health insurance plan. In the US the private health insurance plan although have high premium rate it provide wide ranges of health care facilities and high healthcare coverage to the citizen as compared to the UK based public health insurance process in which the healthcare coverage is lower and the options for choosing healthcare professionals and hospitals is limited.

Describing health insurance in Saudi Arabia and comparing it with one country:

Healthcare system in Saudi Arab is Nationalized system, in which the healthcare facilities is strictly regulated, monitored ad provided by the government. Although in recent years there is of the private health insurance agencies in healthcare system, the overall their contribution in the healthcare system is negligible. The overall health insurance facilities in this country is provided by the government itself, which assures the country enjoys the fare and bias free healthcare facilities without any disparity in health coverage. As compared to the healthcare system in the US, in which healthcare benefits is voided through private organisation and private insurance agencies, in Saudi Arabia, national Health care insurance system overhaul as well as monitor the entire healthcare proposes (Sampson et al. 2016). As compered to the private health insurance system in the US, the government in Saudi Arabia, provide equal health benefits to all citizen through operating the nationalised health insurance process.

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Reference list:

Ahonen, E.Q., Fujishiro, K., Cunningham, T. And Flynn, M., 2018. Work as an inclusive part of population health inequities research and prevention. American journal of public health, 108(3), pp.306-311. Androniceanu, A. And Ohanyan, G., 2016. Comparative approach on education and healthcare in Romania and Bulgaria as beneficiaries of the IMF financial assistance. Administratie si Management Public, (26), p.25. Baker, P., Friel, S., Kay, A., Baum, F., Strazdins, L. And Mackean, T., 2018. What enables and constrains the inclusion of the social determinants of health inequities in government policy agendas? A narrative review. International journal of health policy and management, 7(2), p.101. Burwell, S.M., 2015. Setting value-based payment goals—HHS efforts to improve US health care. N Engl J Med, 372(10), pp.897-899. Cohen, B.E. and Marshall, S.G., 2017. Does public health advocacy seek to redress health inequities? A scoping review. Health & social care in the community, 25(2), pp.309-328. Goran, P., Gleason, S., and Ridic, O., 2012. Comparisons of Health Care Systems in the United States, Germany and Canada. Journal of the Academy of Medical Sciences of Bosnia nad Herzegoniva, 24(2), pp.112-120 Grant, Y., Haug, S. And Purcell, S., 2017. A Comparative Analysis of Infection Control Processes and Outcomes between the United States and Ireland. Inequality.org, (2019), Inequality and Health, [Online] Available at: [Accessed 23 May, 2018] Jamali, M.C., 2017. A Comparative Analysis upon Mobile Healthcare System and Services: A Case Study of Rural India. J Emerg Med Critical Care, 3(1), p.4. Kapur, N., Parand, A., Soukup, T., Reader, T. And Sevdalis, N., 2015. Aviation and healthcare: a comparative review with implications for patient safety. JRSM open, 7(1), p.2054270415616548. Karthikesalingam, A., Holt, P.J., Vidal-Diez, A., Ozdemir, B.A., Poloniecki, J.D., Hinchliffe, R.J. and Thompson, M.M., 2014. Mortality from ruptured abdominal aortic aneurysms: clinical lessons from a comparison of outcomes in England and the USA. The Lancet, 383(9921), pp.963-969. Keehan, S.P., Cuckler, G.A., Sisko, A.M., Madison, A.J., Smith, S.D., Stone, D.A., Poisal, J.A., Wolfe, C.J. and Lizonitz, J.M., 2015. National health expenditure projections, 2014–24: spending growth faster than recent trends. Health Affairs, 34(8), pp.1407-1417. Malik, M.M., Khan, M. And Abdallah, S., 2015. Aggregate capacity planning for elective surgeries: A bi-objective optimization approach to balance patients waiting with healthcare costs. Operations Research for Health Care, 7, pp.3-13. Luengo-Fernandez, R., Leal, J. And Gray, A., 2015. UK research spend in 2008 and 2012: comparing stroke, cancer, coronary heart disease and dementia. BMJ open, 5(4), p.e006648. Ogundele, M.O., 2017. A Study of Comparative Clinical and Socio-Economic Characteristics of School-Age Children Screened for ADHD: Implications for Development of ADHD Clinical Care Pathway. Psychology and Behavioral Sciences, 6(1), p.1. Ranade, W., 2016. Markets and health care: a comparative analysis. London: Routledge. Sampson, U.K., Kaplan, R.M., Cooper, R.S., Roux, A.V.D., Marks, J.S., Engelgau, M.M., Peprah, E., Mishoe, H., Boulware, L.E., Felix, K.L. and Califf, R.M., 2016. Reducing health inequities in the US: recommendations from the NHLBI’s Health Inequities Think Tank Meeting. Journal of the American College of Cardiology, 68(5), pp.517-524. Squires, D. And Anderson, C., 2015. US health care from a global perspective: spending, use of services, prices, and health in 13 countries. The Commonwealth Fund, 15, pp.1-16. Stiglitz, J.E. and Rosengard, J.K., 2015. Economics of the public sector: Fourth international student edition. WW Norton & Company. Villines, T.C., Ahmad, A., Petrini, M., Tang, W., Evans, A., Rush, T., Thompson, D., Oh, K. And Schwartzman, E., 2018. Comparative safety and effectiveness of dabigatran vs. Rivaroxaban and apixaban in patients with non-valvular atrial fibrillation: a retrospective study from a large healthcare system. European Heart Journal–Cardiovascular Pharmacotherapy, 5(2), pp.80-90. Wachs, P., Saurin, T.A., Righi, A.W. and Wears, R.L., 2016. Resilience skills as emergent phenomena: A study of emergency departments in Brazil and the United States. Applied ergonomics, 56, pp.227-237. Waterson, P., 2014. Health information technology and sociotechnical systems: A progress report on recent developments within the UK National Health Service (NHS). Applied ergonomics, 45(2), pp.150-161. Weerawansa, S. And Samarasinghe, S., 2017. Private or Public Inpatient Care? A Comparative Study on Key Factors Influencing the Patient Satisfaction in a Mixed Healthcare System. Www.aha.org 2018, Fast Facts on US Hospitals, 2018, Available at: https://www.aha.org/statistics/fast-facts-us-hospitals [Accessed on: 11 October 2018] Www.bbc.com 2018, Reality Check: Does UK spend half as much on health as US?, Available at: https://www.bbc.com/news/uk-42950587 [Accessed on: 06 October 2018] Www.cms.gov 2016, National Health Expenditures 2016 Highlights, Available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/nationalhealthexpenddata/downloads/highlights.pdf [Accessed on: 11 October 2018] Www.commonwealthfund.org 2014, Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally, Available at: https://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror-wall-2014-update-how-us-health-care-system?Redirect_source=/publications/fund-reports/2014/jun/mirror-mirror [Accessed on: 10 October 2018] Www.england.nhs.uk 2018, Community grants 2018, Available at: https://www.england.nhs.uk/participation/success/community-grants-2018/ [Accessed on: 07 October 2018] Www.legion.org 2015, Examining the Quality and Cost of VA Health Care, Available at: https://www.legion.org/legislative/testimony/225841/examining-quality-and-cost-va-health-care [Accessed on: 09 October 2018] Www.nhs.uk 2018, NHS: About Us, Available at: https://www.nhs.uk/about-us/ [Accessed on: 08 October 2018] Www.nice.org.uk 2018, NICE: About Us, Available at: https://www.nice.org.uk/about [Accessed on: 06 October 2018] Www.ons.gov.uk 2016, UK Health Accounts: 2016, Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2016 [Accessed on: 09 October 2018] Www.theguardian.com 2015, NHS hospital waiting times in England still failing to meet target, Available at: https://www.theguardian.com/society/2015/jan/16/nhs-hospital-waiting-times [Accessed on: 11 October 2018]