Free medical care at public expense came a few years ago in Jamaica with the passage of an Act of Parliament. In the mean time and since then, wage and/or salary negotiations often involve provisions for Group Medical Insurance. Now the small operations with healthy staff sometimes simply agree to pay the medical costs of their staff. That was the situation on my very first job.
Now when medical insurance becomes compulsory, some employers will opt to self-insure, especially those with healthy staff. Now, that causes a problem because if the ones who need it the least do not participate, then the per person premium will increase. That might be why a government might make it compulsory for all companies with 50 staff or more which is the usual minimum number of persons an insurer will accept.
To get around that and to save on premiums, some employers are opting for what is know as "Excess of Loss" cover. That is, the employer pays up to an agreed amount per person and the insurer picks up the balance. In such cases, up to 99% of the time, the insurer pays nothing, so the premium is tiny and the employer has met the requirements of the law; his employees are covered under a group medical insurance policy.
The other one that may be done is to buy what is known as "Stop Loss" cover. Under this type of cover, the employer chooses a limit of the total payment for medical care per period of insurance and if the total payments exceed that the insurance company reimburses the employer the difference up to an agreed amount. Again, the employer has met the compulsory insurance requirements under the law.
Why would companies do that? Simple, it can work out to be cheaper. Remember that the law allows that the employees also contribute to the premium, so if the self-insurance scheme plus either "Excess of Loss" and/or "Stop Loss" cover results in less premium, it would be stupid not to go that route. Remember that the employees are paying part of the premium, including the self- insurance cover.
Since such things amount to "selection against the insurer", I expect to see your medical insurance companies to lobby the U.S. government to either curtail or not allow such covers.
I'm watching to see how things turn out.
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Comments: 18
I don't understand why options like that have not been considered here in the US.
Speaking of health insurance, I saw in the news today that Michele Bachmann, the far right wing Republican Presidential candidate has just announced that she is now a citizen of Switzerland.
The Swiss have universal medical care. Citizens are required to buy health care insurance.
Bachmann has repeatedly criticized the individual mandate included in Obama's reform plan. She has described health care reform as "the crown jewel of socialism," saying that it amounts to "gangster government."
Apparently she doesn't mind Swiss gangsters.
You can read more about it here if you are interested.
In the States, we still live in the FDR area as fr s insurance coverage is concerned At least in same aspects.
The health coverage was offered during the price control imposed by the government after the Depression during WWII.
Employers, most of which were government contractors, could not pay what the marked dictated during those times. So, in order to attract the best talent, they started to offer benefits, one of them being health care coverage. It was a way to attract and retain talent, offering indirect financial incentives.
How ever, the war ended, the price controls were dropped, but it was not so easy to drop the benefits in health care. So little by little the co payment creeped in and it turned into being just offered but bought by the insured party, mostly without company contribution.
At the beginning of the sixties, the UWA almost managed to convince Congress to pass legislation concerning the health care coverage. In the last minute, the auto industry,managed to reverse the original intend,promising that they will contribute to the workers plans...
Of course a lot of things have changed since then, and the health care turned to be a burden for the auto industry, and we ended up with what we have here now.
All countries having health care coverage for their citizens, have laws regulating this aspect.
Then again, in America we are free to make our own decisions, even when our decisions, impact others that may suffer because there is a small segment of the population, free to make stupid decisions...
Fired or not, the premium is compulsory and reaches some 450 dollars eq. monthly
This is a high problem : just Geneva faces 9,500 demands and there is only 1,500 homes available each year.
To High qualifications, high salaries and anyway expensive homes (40% of wages), taxes can easily reach 25-35% of the wages, Social security is anyway 16.5%.
So it is a complex formula but with qualifications you'll have much less of a problem. You will need to contact the Authorities before coming in then the others to set up your status nothing else.
Italy and UK have a very lousy public medical system and private clinics imply the means for it.
So it far more depend on the quality of the health care providers. But not of the insurances which accept the invoices as per agreement with hospital done in front.