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Presidential hopefuls in the Democratic primary in recent weeks have found themselves facing a new litmus test: Do they want to get rid of private health insurance?
Dental And Vision Coverage In European Health Insurance Policies
Sen. Kamala Harris (D-CA) faces this question in a straightforward way and gives a straightforward answer. “Let’s get rid of these things,” she said of the private protection.
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Sen. Cory Booker (D-NJ) faces a question in a slightly more confusing way. and gave a slightly more confusing answer indicating support for keeping parts of the health care system private.
An international perspective is useful here. When you look out in the rest of the world – among the dozens of countries that operate universal health care systems – you will find that every universal health plan is dependent on private insurance in some form or another.
Gerard Anderson, a professor at Johns Hopkins University who studies international health systems, said: “Basically Every country with universal health coverage also has private insurance.” “I don’t think there is a model in the world that allows you to go without it.”
Other developed countries routinely use private insurance to fill gaps in public plans or to get patients to the doctor a little earlier. Citizens apply for private coverage alongside their public plans.
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“Each country has defined its own role in private insurance,” said Robin Osborne, vice president of the nonprofit Commonwealth Fund. said the study of the international health system. “In almost every system There are usually no conflicts. because there is an obligation on the basic universal health coverage.”
How other countries Using private health insurance can tell you a lot about which countries prioritize their health care system. And how do they think access to treatment should be organized?
When you look out at neighboring countries You’ll see them take personal health insurance in three different ways.
First, there are some countries that require all citizens to register for health coverage provided by private insurers. These insurers typically compete in a marketplace with strict rules about what to cover and how much different medical expenses are.
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The Netherlands and Israel are good examples of this type of system. in both countries Citizens must purchase coverage from a personal plan. quite a coincidence The Netherlands and Israel each have four prominent health plans in their private markets.
In each case, the insurer must cover the same set of benefits and cannot charge higher premiums to the patient. but can compete in other dimensions
“They compete for other interests. that they offer and the price of premiums as well,” Osborne said. “Although in general People won’t change their insurance much. They tend to stick to their plans for a long time. Even if they have the option to change every year.”
Most of the benefits of these systems are about choice: in Israel and the Netherlands. Patients have several options for where they want to seek health coverage.
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Secondly, there are some countries where private insurance complements state insurance. It’s common for Canadians and Europeans to purchase supplemental insurance that covers things the public plan won’t provide.
Sometimes it comes in the form of supplemental insurance to pay for benefits that are not covered. In Canada, for example, two-thirds of the population uses private plans to cover eye, dental and prescription drug benefits. which is not included in the public plan Thirty-nine percent of Danish citizens have private coverage for non-covered benefits, including physical therapy.
In other places This will take the form of supplemental insurance to cover the cost-sharing included in the public plan. If you look at France, you’ll see that 95 percent of the population has private insurance. (or subsidized by the state) to cover compensation and deductions
Third, there are some countries where private insurance complements state insurance. in these places Residents purchase personal coverage for better and faster access to benefits.
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Osborne pointed to the UK as a good example of this type of coverage. Around 11 per cent of the UK population purchases supplemental coverage that gives them quicker access to a specialist doctor or selection process.
“The UK is deeply committed to solidarity and equity in its health system. But at the same time, they are comfortable with this private insurance role,” she said. “I think it works like a safety valve. People use it for elective surgery, such as a hip replacement. which may have to queue for a long time.”
It accepts supplemental coverage to the point where 47 percent of the country’s residents have private coverage alongside a public plan. The government encourages citizens to purchase private plans. It offers tax savings for those who enroll — and lower lifetime premiums for those enrolling before age 30.
Many countries combine different types of private insurance. For example, in the Netherlands The individual plan offers a basic set of benefits — and 84 percent of Dutch people purchase add-on plans to cover more benefits. Denmark has a strong market for complementary and complementary coverage, as do New Zealand and Australia.
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The debate we’re having about universal health coverage in the United States right now often centers on the health care plan proposed by Sen. Bernie Sanders (I-VT). His plan — which you can read more about here. — Overlook government-run health insurance that covers a wide range of benefits including vision, dental and prescription drugs. Their plan has no patient cost-sharing — meaning you don’t have to pay contributions when you see a doctor. And you don’t have a deductible before you get the benefit.
The Sanders plan allows for additional personal insurance. which is a category that covers what the public system cannot do. But since public insurance plans pretty much cover everything. So it’s hard to see how this plan will play out.
Here’s the thing: none of our friend countries have built a healthcare system like this: Canada, France, England, Australia, and the Netherlands. Both use health care systems that have gaps in their coverage.
Not one of our neighboring countries has found a way to provide all-benefit healthcare at no cost to the patient — the price is simply prohibitive. Most provide free or low-cost access to primary medical services. while asking patients to contribute parts that the government cannot afford.
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Individual health insurance will play. The answers to those questions often reflect the health system’s core values.
For example, Canada The country prohibits insurance supplementing any benefits that cover the public sector, such as doctor visits and hospital stays. Private carriers cannot cover it.
This reflects the Canadian system’s commitment to equality and fairness. As one scholar told journalist T.R. Reid, “Canadians don’t mind waiting in line. As long as rich Canadians and poor Canadians have to wait the same amount of time.”
This differs greatly from the Australian system. The government explicitly encourages citizens to enroll in private protection with discounts on taxes and penalties. There, officials think they can ease the burden on the public system by building a strong private system in parallel.
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It is true that Australians like their healthcare system more than Canadians like theirs. But it is also true that wealthier Australians are more likely to enroll in private insurance than low-income Australians. This introduces an element of inequality that does not exist in Canada. The health system you want will change the values you hold.
“I think there are some fundamental policy issues faced by countries,” Anderson said. “Should private insurance allow you to skip the queue? Should you be allowed to have a private room? This is a huge policy debate in other countries.”
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