Sick <b>health insurance</b> scheme leaves patients helpless – The Punch

Minister of Health, Professor Onyebuchi Chukwu

Minister of Health, Professor Onyebuchi Chukwu

The crave for profitability by operators of the National Health Insurance Scheme is breeding bad ethics and eroding quality health care delivery for subscribers, NIKE POPOOLA writes

DISGRUNTLED ENROLEES

Mrs. Aderonke Korede works in a telecommunications firm that registered its employees with a Health Maintenance Organisation under the National Health Insurance Scheme.

She expected her health plan with the HMO to allow her to deliver her baby through Caesarean section. However, when the delivery time came, the HMO refused to bear the responsibility, claiming that her health plan did not cover such a procedure.

After unsuccessfully persuading the HMO to live up to its responsibility, her husband agreed to pay the hospital bill when his wife’s health showed signs of deterioration. The Koredes felt the HMO’s refusal to pick the bill had defeated the essence of having a health insurance in place.

Aderonke’s husband, Babatunde, says, “The experience was really traumatic. I could not stand the attitude of the HMO and risk the lives of my wife and our unborn baby; so, I had to go back to the money we were saving to roof the small house we are building in Ikorodu to fund the operation.

“Almost a year after, we’ve not been able to raise enough money to roof the house because of other contending issues. The development has left us at the mercy of our troublesome landlord and my wife is even sceptical of going to the hospital even for services covered by her health insurance package with the HMO.”

Different complaints emerge daily from both the enrolees, who are registered with the HMOs, and the hospitals, which are designated as health care providers under the NHIS.

On the other hand, the HMOs are also complaining about the treatment that the hospitals are meting out to them, especially when it comes to money matters. The relationship between the HMOs and the hospitals can best be described as that between a cat and a mouse, because they are always suspicious of each other.

The strained relationship between the HMOs and the hospitals has left the enrolees at the receiving end of terrible services.

Yet, amid the challenges militating against the ability of the scheme to provide quality health care services, little is being done to address the issues by the regulator of the scheme.

Unlike the financial services sector, where the regulators take strict and decisive actions, players in the health insurance sector in the country have continued to do things their own way.

The NHIS ensures the pooling of funds from different sectors of the economy, with many people contributing money but only a few of them expected to fall ill at a particular time. The essence is to guarantee free health care for the contributors whenever the need arises.

While the importance of a virile health insurance scheme cannot be over emphasized, experts are of the view that majority of those on the NHIS enjoy cover only for minor ailments.

When there is a need for surgery or an expensive treatment, the HMOs always require the hospitals to take permission from them. If not, they end up not paying for the enrolee’s treatment.

In most cases, enrolees have to pay from their pockets for such treatment. In times of emergencies, the hospitals may either have the challenge of reaching the HMO; or the HMO simply refuses to pay.

An enrolee, who works in an oil company, Mr. Tunde Atolagbe, will rather pay for his treatment than to depend solely on his health insurance plan because he lacks confidence in the cheap services being rendered by the hospitals in their bid to make profits.

“I use a particular hospital alongside my colleagues in the office through our HMO, but you find that the types of drugs that they are giving you may be different from when you are paying from your pocket,” he says.

Mr. Adeolu Oyeniran works in an oil company. He says he stopped getting free treatment in his hospital last November.

“Whenever I go to the hospital, they say they cannot treat me because the HMO has stopped service to my organisation. I am sure my employer has not been paying the HMO and this money is removed from my salary,” he laments.

HMOs VERSUS HOSPITALS

Common complaints by the hospitals against the HMOs include default in paying capitation (the amount payable per head irrespective of whether the person draws from pool of funds or not for a certain period of time); paying ridiculously low capitation; and delay in payment, even when the HMOs have collected their premium from the enrolees.

The hospitals are in a dilemma because they stand to be disengaged if they make official reports of HMOs indebtedness to them.

This hostile condition of doing business is forcing the hospitals to render very cheap services that may leave the patients worse off.

According to the result of a health insurance survey conducted by the Lagos Chamber of Commerce and Industry, majority of the enrolees are absolutely displeased with not receiving commensurate treatment for the premiums paid compared to when they visit their family or personal hospitals where they pay on the go.

The Director, Research and Advocacy, LCCI, Mr. Vincent Nwani, says the survey found out that many enrolees were actually opting out of being treated by HMO-registered hospitals, preferring to patronise their personal doctors for better treatment.

The average enrolee, according to the survey, thinks that he is fully covered by the scheme irrespective of the nature of the ailment.

Nwani says the hospitals are complaining that the capitation fees being paid to them are very small; adding that the present monthly capitation that the HMOs pay per person to the hospitals is between N500 and N750, but adds that some enrolees make regular visits to the hospitals even for minor complaints.

Those with serious diseases and infections want perfect treatment with the N500 or N750 paid by their HMOs monthly, he says.

The LCCI investigation shows that complaints are not limited to the hospitals. The HMOs too are not happy, because they say that sometimes when their corporate clients go to the hospitals for inspection, they get bad reception.

Some hospitals, Nwani says, accumulate bills for up to three months before sending them, and at the end of the day, they complain of delayed payment.

He also observes that the HMOs do not really explain in details to their clients the plans they registered for. This, he says, makes patients with the most basic plan to go to the hospital demanding major surgeries to be performed on them, or comparing their level of treatment to others with more comprehensive plans.

Recently, one of the hospitals being owed a large sum, in a mail to one of the HMOs, narrated how several attempts made to recover the money had proved abortive, and how the employees of the HMO had been lackadaisical to its plight despite sending monthly bills.

In response, the HMO made it clear that it was doing the health care provider a favour by having it on its register, and expressed frustration that its gesture was not appreciated!

Presently, about 5.5 million Nigerians are registered under the NHIS. Seventy-five per cent of these are Federal Government employees who are mandatorily insured, while the remaining are private sector employees.

The health insurance scheme, whose implementation began about 16 years ago with the signing into law of the NHIS Act, 1999, has continued to grow at a very slow pace.

Under the scheme, 77 HMOs are licensed and they are working with about 7,000 health care providers. The health care providers are hospitals that should be well equipped, but because most of them render services on credit, it has been extremely difficult for them to meet set standards.

At the commencement of the scheme, the minimum required capital base for each HMO was N30m. It was later reviewed to N100m, and it is now N400m.

RISING FRAUDULENT ACTIVITIES

Instead of prioritising quality health care delivery, fraudulent activities are prevalent among professionals in the health insurance scheme. For instance, Nwani says the results of investigations carried out by the LCCI WERE really displeasing.

He says, “One of the HMOs we visited during the fieldwork informed us that it had been receiving unrealistic bills from the hospitals. A mystery shopping was carried out by the HMO by sending one of its members of staff as a patient to one of the suspected hospitals that normally sent exorbitant bills. The disguised patient was treated for a very minor ailment and was given drugs.

“The staff kept the drugs, waiting for the hospital to send the bill. When the bill was received, it was discovered that the hospital had inflated it and added some drugs that were not given to him. The HMO took the drugs and the bill to the hospital as a proof that it had been sending unrealistic bills,” he notes.

Narrating another case, Nwani says, “One of the registered hospitals sent a bill to a HMO that a client was treated for dog bite. When the HMO called the parents of the boy to sympathise with them, it was discovered that the boy was never bitten by a dog. The hospital cooked up the case in order to extort the HMO.”

BETWEEN HMOS AND ENROLEES

The Managing Director, Healthcare International, Mr. Tosin Awosika, says HMOs actually have structures in place to ensure quality health care delivery to the enrolees.

“Before we accredit hospitals, we would have inspected them to ascertain what they can do and what they cannot do. On a regular basis, we do quality assurance visits to check what they are doing and how they are treating the clients. We have a feedback system; if there is an issue, we expect the clients to get back to us,” he says.

According to him, HMOs have the right to delist hospitals that are not doing well and transfer the patients to other hospitals for better care. With these measures in place, Awosika says the hospitals will ensure efficiency because they will not want to be delisted.

Many enrolees also erroneously believe that once they pay a certain premium, they will enjoy full treatment for any ailment throughout the year, but are shocked that their health plans sometimes operate like the mobile phone that goes off ones its credit has been exhausted.

The President, Actors Guild of Nigeria, Ibinabo Fiberesima, says, “Some of my members, after the first and second visits to the hospital, do receive text messages from the hospital that they have exhausted their plan.”

The Managing Director, MetroHealth, HMO Limited, Mr. Kola Awokoya, stresses the need to build the health insurance scheme on trust. “The responsibility of enlightening the enrolee on the coverage of his health plan lies with the HMO and the employers,” he explains.

It has been found out that the quality structures put in place by the HMOs are not working perfectly. A survey conducted by The PUNCH, using questionnaires to collect information from enrolees of different HMOs, showed that most of them subscribed to the cheapest plans, which do not provide treatment for the illnesses killing majority of Nigerians presently.

It was discovered that none of the enrolees had ever been called by their HMOs to either enquire about their welfare or ask if they were satisfied with their health plans.

Despite the fact that their employers subscribed to health insurance on their behalf, 30 per cent of respondents preferred to go to their family doctors than visit the hospitals recommended by their HMOs.

Mr. Gbenga Ilemobayo enrolled his family of five with a HMO and paid a premium price for choosing a band ‘B’ hospital and subscribing to the ‘Gold’ plan, but when one of his sons required an urgent surgery for a medical condition called hernia, the hospital could not obtain authorisation from the HMO to carry on with the procedure for more than 16 hours. The HMO’s customer care lines rang for hours without anybody picking up the calls.

Ilemobayo explains, “Due to the severity of the boy’s condition, the senior doctor at the hospital told me that the operation had to be done immediately and I had to approach my brother to lend me some money, which I could deposit.

“It was a difficult period for my family because I had just paid the school fees of my three children, who are all in private schools. Their mother has been out of job for about three years and my income leaves no room for any serious savings.”

MULTIPLE COMPLAINTS

The immediate President, Nigerian Medical Association, Dr. Osahon Enabulele, accuses some of the HMOs of not paying their capitation to the health providers, adding that the issue was raised during the Presidential Summit on Universal Health Coverage held in Abuja in March this year.

“At the last presidential summit on universal health coverage, the same allegation was made. It is very criminal for any HMO to withhold the capitation of the provider because that invariably will not motivate the provider to provide the needed quality services,” he says.

As a result of default, he says that the HMOs are short changing the insurance scheme and the health care system, which will invariably impact on the patients, who may get poor services resulting from lack of motivation.

Enabulele says a lot of disgruntled doctors have reported their HMOs to the NHIS, adding that the NHIS leadership has asked the doctors to provide information to establish that some of the HMOs are actually owing the providers their due capitation.

“It is criminal for any HMO to withhold capitation to the provider and the NMA frowns seriously on that, and we charge the leadership of the NHIS scheme to fish out such HMOs and appropriately discipline them so that the scheme does not die a natural death as a result of the poor assimilation of the providers of care due to the antics and acts of some of the HMOs,” he says.

The NMA boss notes that if a HMO is having grievances against an employer who refuses to pay his premium, such complaints should be tendered before the governing board of the NHIS.

Enabulele explains that it is not in the power of the HMOs to deny anyone of the services that they have promised to provide if the customer has paid the agreed premium.

“The HMOs have to pay their own capitation to the subscribers; once a portal has been allocated to a provider for health care facility, it is under obligation. For anybody to be allocated to a provider, it is assumed that the person has paid up his premium and subscribed to the care,” he says.

The Healthcare Providers Association of Nigeria is the umbrella body of the hospitals registered under the NHIS.

The National President, HCPAN, Dr. Adenike Olaniba, says the major frictions between the HMOs and the providers are low capitation, abysmally low tariff, indebtedness to the providers by the HMOs, slashing of hospitals’ bills and non-payment of capitation, among others.

Olaniba, who is also a consultant public health physician, observes that many private providers’ clinics are closing down as they cannot cope with the financial burden imposed on them by health insurance.

She explains that in February 2012, a joint consultative meeting was held in the premises of Healthcare International HMO between the Health and Managed Care Association of Nigeria (the umbrella body of the HMOs) and HCPAN.

Some of the items on the agenda of the meeting, she says, were the implementation of the new NHIS capitation, HMOs’ indebtedness to the providers, slashing of bills, care of the chronically ill and standardised contractual agreement between the HMOs and care providers.

“In order to fast track the review of capitation and tariff, the HCPAN forwarded the report of its tariff and pricing committee to the forum for consideration. No feedback has been received from the HMCAN on this document,” she adds.

If the issues are positively addressed, Olaniba says the relationship between the two stakeholders will improve tremendously.

Copyright PUNCH.
All rights reserved. This material, and other digital content on this website, may not be reproduced, published, broadcast, rewritten or redistributed in whole or in part without prior express written permission from PUNCH.

Contact: editor@punchng.com

More:
Sick <b>health insurance</b> scheme leaves patients helpless – The Punch

Sick <b>health insurance</b> scheme leaves patients helpless (1)

Minister of Health, Professor Onyebuchi Chukwu

Minister of Health, Professor Onyebuchi Chukwu

The crave for profitability by operators of the National Health Insurance Scheme is breeding bad ethics and eroding quality health care delivery for subscribers, NIKE POPOOLA writes

DISGRUNTLED ENROLEES

Mrs. Aderonke Korede works in a telecommunications firm that registered its employees with a Health Maintenance Organisation under the National Health Insurance Scheme.

She expected her health plan with the HMO to allow her to deliver her baby through Caesarean section. However, when the delivery time came, the HMO refused to bear the responsibility, claiming that her health plan did not cover such a procedure.

After unsuccessfully persuading the HMO to live up to its responsibility, her husband agreed to pay the hospital bill when his wife’s health showed signs of deterioration. The Koredes felt the HMO’s refusal to pick the bill had defeated the essence of having a health insurance in place.

Aderonke’s husband, Babatunde, says, “The experience was really traumatic. I could not stand the attitude of the HMO and risk the lives of my wife and our unborn baby; so, I had to go back to the money we were saving to roof the small house we are building in Ikorodu to fund the operation.

“Almost a year after, we’ve not been able to raise enough money to roof the house because of other contending issues. The development has left us at the mercy of our troublesome landlord and my wife is even sceptical of going to the hospital even for services covered by her health insurance package with the HMO.”

Different complaints emerge daily from both the enrolees, who are registered with the HMOs, and the hospitals, which are designated as health care providers under the NHIS.

On the other hand, the HMOs are also complaining about the treatment that the hospitals are meting out to them, especially when it comes to money matters. The relationship between the HMOs and the hospitals can best be described as that between a cat and a mouse, because they are always suspicious of each other.

The strained relationship between the HMOs and the hospitals has left the enrolees at the receiving end of terrible services.

Yet, amid the challenges militating against the ability of the scheme to provide quality health care services, little is being done to address the issues by the regulator of the scheme.

Unlike the financial services sector, where the regulators take strict and decisive actions, players in the health insurance sector in the country have continued to do things their own way.

The NHIS ensures the pooling of funds from different sectors of the economy, with many people contributing money but only a few of them expected to fall ill at a particular time. The essence is to guarantee free health care for the contributors whenever the need arises.

While the importance of a virile health insurance scheme cannot be over emphasized, experts are of the view that majority of those on the NHIS enjoy cover only for minor ailments.

When there is a need for surgery or an expensive treatment, the HMOs always require the hospitals to take permission from them. If not, they end up not paying for the enrolee’s treatment.

In most cases, enrolees have to pay from their pockets for such treatment. In times of emergencies, the hospitals may either have the challenge of reaching the HMO; or the HMO simply refuses to pay.

An enrolee, who works in an oil company, Mr. Tunde Atolagbe, will rather pay for his treatment than to depend solely on his health insurance plan because he lacks confidence in the cheap services being rendered by the hospitals in their bid to make profits.

“I use a particular hospital alongside my colleagues in the office through our HMO, but you find that the types of drugs that they are giving you may be different from when you are paying from your pocket,” he says.

Mr. Adeolu Oyeniran works in an oil company. He says he stopped getting free treatment in his hospital last November.

“Whenever I go to the hospital, they say they cannot treat me because the HMO has stopped service to my organisation. I am sure my employer has not been paying the HMO and this money is removed from my salary,” he laments.

HMOs VERSUS HOSPITALS

Common complaints by the hospitals against the HMOs include default in paying capitation (the amount payable per head irrespective of whether the person draws from pool of funds or not for a certain period of time); paying ridiculously low capitation; and delay in payment, even when the HMOs have collected their premium from the enrolees.

The hospitals are in a dilemma because they stand to be disengaged if they make official reports of HMOs indebtedness to them.

This hostile condition of doing business is forcing the hospitals to render very cheap services that may leave the patients worse off.

According to the result of a health insurance survey conducted by the Lagos Chamber of Commerce and Industry, majority of the enrolees are absolutely displeased with not receiving commensurate treatment for the premiums paid compared to when they visit their family or personal hospitals where they pay on the go.

The Director, Research and Advocacy, LCCI, Mr. Vincent Nwani, says the survey found out that many enrolees were actually opting out of being treated by HMO-registered hospitals, preferring to patronise their personal doctors for better treatment.

The average enrolee, according to the survey, thinks that he is fully covered by the scheme irrespective of the nature of the ailment.

Nwani says the hospitals are complaining that the capitation fees being paid to them are very small; adding that the present monthly capitation that the HMOs pay per person to the hospitals is between N500 and N750, but adds that some enrolees make regular visits to the hospitals even for minor complaints.

Those with serious diseases and infections want perfect treatment with the N500 or N750 paid by their HMOs monthly, he says.

The LCCI investigation shows that complaints are not limited to the hospitals. The HMOs too are not happy, because they say that sometimes when their corporate clients go to the hospitals for inspection, they get bad reception.

Some hospitals, Nwani says, accumulate bills for up to three months before sending them, and at the end of the day, they complain of delayed payment.

He also observes that the HMOs do not really explain in details to their clients the plans they registered for. This, he says, makes patients with the most basic plan to go to the hospital demanding major surgeries to be performed on them, or comparing their level of treatment to others with more comprehensive plans.

Recently, one of the hospitals being owed a large sum, in a mail to one of the HMOs, narrated how several attempts made to recover the money had proved abortive, and how the employees of the HMO had been lackadaisical to its plight despite sending monthly bills.

In response, the HMO made it clear that it was doing the health care provider a favour by having it on its register, and expressed frustration that its gesture was not appreciated!

Presently, about 5.5 million Nigerians are registered under the NHIS. Seventy-five per cent of these are Federal Government employees who are mandatorily insured, while the remaining are private sector employees.

The health insurance scheme, whose implementation began about 16 years ago with the signing into law of the NHIS Act, 1999, has continued to grow at a very slow pace.

Under the scheme, 77 HMOs are licensed and they are working with about 7,000 health care providers. The health care providers are hospitals that should be well equipped, but because most of them render services on credit, it has been extremely difficult for them to meet set standards.

At the commencement of the scheme, the minimum required capital base for each HMO was N30m. It was later reviewed to N100m, and it is now N400m.

RISING FRAUDULENT ACTIVITIES

Instead of prioritising quality health care delivery, fraudulent activities are prevalent among professionals in the health insurance scheme. For instance, Nwani says the results of investigations carried out by the LCCI WERE really displeasing.

He says, “One of the HMOs we visited during the fieldwork informed us that it had been receiving unrealistic bills from the hospitals. A mystery shopping was carried out by the HMO by sending one of its members of staff as a patient to one of the suspected hospitals that normally sent exorbitant bills. The disguised patient was treated for a very minor ailment and was given drugs.

“The staff kept the drugs, waiting for the hospital to send the bill. When the bill was received, it was discovered that the hospital had inflated it and added some drugs that were not given to him. The HMO took the drugs and the bill to the hospital as a proof that it had been sending unrealistic bills,” he notes.

Narrating another case, Nwani says, “One of the registered hospitals sent a bill to a HMO that a client was treated for dog bite. When the HMO called the parents of the boy to sympathise with them, it was discovered that the boy was never bitten by a dog. The hospital cooked up the case in order to extort the HMO.”

BETWEEN HMOS AND ENROLEES

The Managing Director, Healthcare International, Mr. Tosin Awosika, says HMOs actually have structures in place to ensure quality health care delivery to the enrolees.

“Before we accredit hospitals, we would have inspected them to ascertain what they can do and what they cannot do. On a regular basis, we do quality assurance visits to check what they are doing and how they are treating the clients. We have a feedback system; if there is an issue, we expect the clients to get back to us,” he says.

According to him, HMOs have the right to delist hospitals that are not doing well and transfer the patients to other hospitals for better care. With these measures in place, Awosika says the hospitals will ensure efficiency because they will not want to be delisted.

Many enrolees also erroneously believe that once they pay a certain premium, they will enjoy full treatment for any ailment throughout the year, but are shocked that their health plans sometimes operate like the mobile phone that goes off ones its credit has been exhausted.

The President, Actors Guild of Nigeria, Ibinabo Fiberesima, says, “Some of my members, after the first and second visits to the hospital, do receive text messages from the hospital that they have exhausted their plan.”

The Managing Director, MetroHealth, HMO Limited, Mr. Kola Awokoya, stresses the need to build the health insurance scheme on trust. “The responsibility of enlightening the enrolee on the coverage of his health plan lies with the HMO and the employers,” he explains.

It has been found out that the quality structures put in place by the HMOs are not working perfectly. A survey conducted by The PUNCH, using questionnaires to collect information from enrolees of different HMOs, showed that most of them subscribed to the cheapest plans, which do not provide treatment for the illnesses killing majority of Nigerians presently.

It was discovered that none of the enrolees had ever been called by their HMOs to either enquire about their welfare or ask if they were satisfied with their health plans.

Despite the fact that their employers subscribed to health insurance on their behalf, 30 per cent of respondents preferred to go to their family doctors than visit the hospitals recommended by their HMOs.

Mr. Gbenga Ilemobayo enrolled his family of five with a HMO and paid a premium price for choosing a band ‘B’ hospital and subscribing to the ‘Gold’ plan, but when one of his sons required an urgent surgery for a medical condition called hernia, the hospital could not obtain authorisation from the HMO to carry on with the procedure for more than 16 hours. The HMO’s customer care lines rang for hours without anybody picking up the calls.

Ilemobayo explains, “Due to the severity of the boy’s condition, the senior doctor at the hospital told me that the operation had to be done immediately and I had to approach my brother to lend me some money, which I could deposit.

“It was a difficult period for my family because I had just paid the school fees of my three children, who are all in private schools. Their mother has been out of job for about three years and my income leaves no room for any serious savings.”

MULTIPLE COMPLAINTS

The immediate President, Nigerian Medical Association, Dr. Osahon Enabulele, accuses some of the HMOs of not paying their capitation to the health providers, adding that the issue was raised during the Presidential Summit on Universal Health Coverage held in Abuja in March this year.

“At the last presidential summit on universal health coverage, the same allegation was made. It is very criminal for any HMO to withhold the capitation of the provider because that invariably will not motivate the provider to provide the needed quality services,” he says.

As a result of default, he says that the HMOs are short changing the insurance scheme and the health care system, which will invariably impact on the patients, who may get poor services resulting from lack of motivation.

Enabulele says a lot of disgruntled doctors have reported their HMOs to the NHIS, adding that the NHIS leadership has asked the doctors to provide information to establish that some of the HMOs are actually owing the providers their due capitation.

“It is criminal for any HMO to withhold capitation to the provider and the NMA frowns seriously on that, and we charge the leadership of the NHIS scheme to fish out such HMOs and appropriately discipline them so that the scheme does not die a natural death as a result of the poor assimilation of the providers of care due to the antics and acts of some of the HMOs,” he says.

The NMA boss notes that if a HMO is having grievances against an employer who refuses to pay his premium, such complaints should be tendered before the governing board of the NHIS.

Enabulele explains that it is not in the power of the HMOs to deny anyone of the services that they have promised to provide if the customer has paid the agreed premium.

“The HMOs have to pay their own capitation to the subscribers; once a portal has been allocated to a provider for health care facility, it is under obligation. For anybody to be allocated to a provider, it is assumed that the person has paid up his premium and subscribed to the care,” he says.

The Healthcare Providers Association of Nigeria is the umbrella body of the hospitals registered under the NHIS.

The National President, HCPAN, Dr. Adenike Olaniba, says the major frictions between the HMOs and the providers are low capitation, abysmally low tariff, indebtedness to the providers by the HMOs, slashing of hospitals’ bills and non-payment of capitation, among others.

Olaniba, who is also a consultant public health physician, observes that many private providers’ clinics are closing down as they cannot cope with the financial burden imposed on them by health insurance.

She explains that in February 2012, a joint consultative meeting was held in the premises of Healthcare International HMO between the Health and Managed Care Association of Nigeria (the umbrella body of the HMOs) and HCPAN.

Some of the items on the agenda of the meeting, she says, were the implementation of the new NHIS capitation, HMOs’ indebtedness to the providers, slashing of bills, care of the chronically ill and standardised contractual agreement between the HMOs and care providers.

“In order to fast track the review of capitation and tariff, the HCPAN forwarded the report of its tariff and pricing committee to the forum for consideration. No feedback has been received from the HMCAN on this document,” she adds.

If the issues are positively addressed, Olaniba says the relationship between the two stakeholders will improve tremendously.

Copyright PUNCH.
All rights reserved. This material, and other digital content on this website, may not be reproduced, published, broadcast, rewritten or redistributed in whole or in part without prior express written permission from PUNCH.

Contact: editor@punchng.com

See more here:
Sick <b>health insurance</b> scheme leaves patients helpless (1)

Why I Joined Samaritan Ministries <b>International</b> – Granny Miller

My husband and I are both self-employed.
Neither of us has had any type of health insurance for about 8 years.

Fact is we don’t need health insurance.
Fact is we don’t want health insurance.

We seldom get sick.
When we do need medical care we pay as we go and pay in cash.
Because “Cash is King”, we pick our own doctors, and our doctor does what he/she thinks is best for us without any 3rd party interference.
Doctors love cash and always do a steep discount for fast on-the-spot payment.

Believe it or not in the last 8 years we have saved over $110,000 by not having so called health insurance. That’s enough to buy a house or pay for two heart attacks in cash.

We spend about $450 – $550 a year in total for health care.
That’s all doctors, drugs and 3 times a year dental check ups and teeth cleaning. My husband’s Lyme disease only costs us $280.

Interestingly enough, by not buying into the big insurance fear mongering we’ve become more self-reliant.
We are now more responsible and much more proactive about our own health.
Ditching corporate health insurance was a smart move for us.

But this year we face Obamacare income tax penalties.
Well I’m not about to pay one dollar more to the IRS due a corrupted Supreme Court.

Samaritan Ministries

Samaritan Ministries Logo

So in June I joined Samaritan Ministries International. It was the smartest thing I’ve done in a long time.
Only I wish I’d done it sooner.
Samaritan Ministries is health care for people of faith. Samaritan is exempt from Obamacare.

It costs me $180 a month as a single person. Now that my husband has recently stopped smoking he’ll be joining me at Samaritan. The total cost for two people is $360 per month.
The cost for a family of any size has never exceeded $405 a month. The cost for a single parent family is $250.

There are requirements to join Samaritan.
Members must be professing Christians who attend church regularly. They must agree to abstain from sinful practices such as drug and alcohol abuse and sexual immorality. The use of tobacco is forbidden. Members must be accountable to their pastor or other church leader for the medical needs they submit.

For me it’s been a privilege to be able to help share in another person’s health care bills and pray for them.

I also feel good that not a penny of my hard earned money goes to pay for abortions, questionable psychiatric drugs and idiot treatments that go against my beliefs and common sense.

Evil Corporate Insurance Fat Cats and Washington, D.C. Morons and Control Freaks stay out of my doctor’s direct care for me.
If you don’t know about Samaritan Ministries International maybe it’s time to find out more about them.
Watch the video below to learn more. You’ll be glad you did.

Continued here:
Why I Joined Samaritan Ministries <b>International</b> – Granny Miller

Expansion of Mental <b>Health Care</b> Hits Obstacles – <b>International</b> <b>…</b>

TimesMentalHealth

Click Here to Read  Expansion of Mental Health Care Hits Obstacles By Abby Goodnough in The New York Times on August 28, 2014.

Terri Hall talks about her struggles with depression, and the care she has been receiving since she signed up for health insurance. Video Credit By Abby Goodnough on Publish Date August 28, 2014.

Explore posts in the same categories: Audio/Video, General News

This entry was posted on Thursday, August 28th, 2014 at 9:22 am and is filed under Audio/Video, General News. You can subscribe via RSS 2.0 feed to this post’s comments. You can comment below, or link to this permanent URL from your own site. Your comments will be moderated but will appear as soon as humanly possible.

Read more here:
Expansion of Mental <b>Health Care</b> Hits Obstacles – <b>International</b> <b>…</b>

Invest In Your Future With These Personal Finance Tips

by on Monday, August 25th, 2014 | Comments Off

TIP! If you often wonder where your money goes, try writing down your daily expenditures for a month to gain a true picture of where you are overspending. However, if you document it somewhere you are never going to look, it will do you no good.

Do you wish to handle money better in the future starting now? Anyone can change their spending habits and manage their personal finances, it just takes some knowledge. The article below will give you some basic information to make sure that you are financially responsible.

International News

TIP! To maintain a good credit score, use more than one credit card. Remember, however, not to go overboard; do not have more than four credit cards.

Stay tuned to world news so you are aware of possible global market movements. It’s problematic to ignore international news in favor of U.S. news if you’re trying to trade currencies. Knowing about international news will help improve your strategy for the market.

TIP! If your debt has been turned over to a collection agency, keep in mind that if the debt is not collected, it will eventually expire. Ask a financial expert to find out when the debt you owe will elapse and do not make a payment to a collection agenct if they are working to collect an old debt.

Try to eat in the restaurants that are frequented by the local people in order to eat economically when you visit foreign countries. Your hotel restaurant, and any other restaurants in tourist areas, are likely to be way overpriced, so do some research and find out where the locals eat. You can find quaint restaurants with lower prices and great tasting local cuisine.

TIP! Find a checking account that is free. You can try banks in your area or even a credit union.

Make solid plans for keeping your personal finances orderly for your future. Having a solid plan is an effective motivational tool, as it helps you to keep a reward in sight, which is more satisfying than pointless spending.

TIP! Don’t take out large amounts of student loan debt unless you expect to be in a financial situation to pay it back. You could wind up in serious debt if you pick a costly private school when you don’t even know what career path you want to take.

Be prepared by having the correct health insurance policy at hand. Everyone, at some point in life, will get sick. For this reason, it is vital to have good health insurance. You may find hospital bills in the amount of $20,000, or even more. You will have a big issue if you cannot carry health insurance.

TIP! Don’t waste money on lottery tickets. Put the money in your savings account instead.

If your spouse has a great credit score, use this to your advantage. If you have a bad credit rating, you should try your best to rebuild your rating by using any credit cards that you own regularly and paying them off in full each month. Once both of you have good credit scores, you can jointly apply for loans that evenly share your debt.

TIP! Having an account for rainy days is a wise way to prepare for emergencies. Depending on your situation, you may choose to save in order to get out of debt or for a future expense.

Having a garage sale is a great way to make some spending money and also rid the house of clutter. Also, talk to neighbors to find out some of the items that they would like to sell. You can be as entrepreneurial as you want during a garage or yard sale.

TIP! You should use a flexible spending account to your advantage. Using the flexible spending account to pay down medical bills or daycare can actually help you save money in the long run.

When obtaining student loans, make sure that you will be able to pay them back when all is said and done. Choosing a costly private college without having declared a major is a good way to land yourself in perpetual debt.

TIP! If you pay attention to your cash, you will have well controlled properties. Monitor your income as well as your spending, and also analyze how your property performs from an investment standpoint each month.

Some people spend $20 to $30 each week in lottery drawings hoping to ‘win it big.’ Instead, invest that same amount of money in a savings account. This will ensure that you do not lose any money and will improve your financial situation by increasing your savings.

Credit Card

TIP! It may take a little more effort and distance, but you can save a great deal of money over time by using only the ATMs of your bank, credit union, or thrift. Many financial institutions impose fees for using ATMs of non associated banks.

If you’re not yet 21 years of age and are looking for a credit card, you should know that things have changed recently. It used to be easy for college-age students to get a credit card. Today, you must have verifiable income or a co-signer to qualify. Before you apply for an account, learn its specific restrictions.

TIP! If you do not like the hassle of balancing your checkbook manually, you can easily do all the work online. These programs can track your income and expenses, as well as creating a budget plan for you with minimal effort.

The way you look at your finances should be changed at this point. Now that you have read all of this, you will have what it takes to have a better financial future. All you can do now is have lots of determination to succeed in your goal. Don’t allow anything to interfere with your efforts.

View article:
Invest In Your Future With These Personal Finance Tips

International law firms in India offering legal services to ensure professionalism

Martand Law firm India provide marvelous services to determine all legal issues. A law firm is a business unit formed by a group of lawyers who advise the clients about the legal rights and responsibilities. Martand Law firm with the dedicated team provides excellent services to the clients. Our experts have the ability to anticipate and resolve all kinds of legal issues. Our dedicated team put maximum effort to understand your expectations and requirements and provide marvelous services to fulfill all your needs.         

The Legal solution offered by Martand Law Firm to the clients

  • Business immigration
  • Corporate Law
  • Civil litigation Act
  • Construction defects
  • Criminal Act
  • Child welfare and adoptions
  • Collection Act
  • Elder Act
  • EEOC Act
  • Estate or trust Administration Rule
  • Estate Planning
  • Guardianship and probate
  • Legal Drafting
  • Legal Research
  • International law firm 

We have a dedicated team of experienced attorneys, who are able to resolve any legal issue. Our services are for all kinds of industries either larger or smaller. We support you in all activities and assignments including providing help in protecting your strategic and commercial interests. Expert lawyers respond with great patience and always provide the exact solution for any of your queries. Our services help you to manage your organization and formulate financial strategy. We help you to claim your insurance for life insurance, motor vehicle accidents, business loss, health insurance and many more. If any kind of loss occurs in your business insurance policy helps you to overcome that loss. Our lawyers are highly experienced in solving marriage cases. The matrimonial lawyers can effectively sort out any issue related to marriage and divorced law of different religions. We provide excellent legal advisory services to establish your business. Our services cover all aspects of trade and commerce from registration of your company to agreements need to make related to the sale. Any form of criminal background is the biggest impediment for finding a job. Our criminal lawyers have wide knowledge in solving the criminal cases. We assist people to come out of situations like paying fines, imprisonment, and such others.

Martand Law Firm has a team of well skilled and experienced lawyers who treasure the value of diligence and knowledge as well as creativity and innovation in addressing their client’s needs. Our experts offer excellent legal advices that meets the clients needs and expectations.

Visit link:
International law firms in India offering legal services to ensure professionalism

The Complete Guide to Travel Insurance for the Over 65s UK

With people now living longer, healthier and more active lives, there’s little to stop retired people from living out their dreams by retiring abroad, or taking that round the world cruise. Finding the right travel insurance can be a challenge for the over 65s, however, as much of the insurance industry shies away from cover for this age group.

The good news, however, is that some companies welcome older policy holders, and some cater especially to the senior market. You can find the right travel insurance for your retirement dreams – you just need to understand what you’re looking for.

What type of travel insurance policy do you need?

If your holiday is for less than 30 days, and you’re only planning to go once or twice a year, then a single

Trip policy is probably the most cost effective for you. If you’re planning on taking more than 2 trips a year, a multi-trip travel insurance policy is more likely to fit the bill. Annual policies are also available which will cover you for an unlimited number of trips per year – but most restrict each individual journey to 30 days or less. If you’re going away for more than 30 days, you should look for long stay travel insurance.

If you’re going to retire abroad, look for an expatriate travel policy which will address your unique needs as you settle into your new life.

Websites such as Traveler Friendly Insurance offer a range of Patriot Travel Medical Insurance plans and policies to cater to any length of trip or combination of trips.

What to look for in your travel insurance policy?

All travel insurance policies for the over 65s will include the standard kind of cover you’ve had on every other holiday earlier in life – but you should pay particular attention to the level of travel health insurance cover available. Emergency repatriation cover is essential; should something happen, the costs of getting you back safely to the UK can be astronomical.

Ensure that you are covered for any pre-existing conditions. This may push the price up, but it will be worth it for your peace of mind. Don’t be tempted to lie about your standard of health, as this will invalidate your policy if the worst should happen.

Look for a policy with a 24 hour helpline, to ensure that you don’t need to panic if anything goes wrong.

Do you need cover for loss of medication, or for mobility aids?

Don’t be tempted to skimp on cover

If you’re travelling within Europe, the free EHIC card will entitle you to free or reduced cost health treatment in most European countries, but it does not cover repatriation costs, and should not replace proper travel health insurance. Although travel insurance for the over 65s can be expensive, it’s simply a must-have if you’re to enjoy your retirement travels. The costs of dealing with an illness, accident or emergency without it would be huge. There’s not only the financial cost to consider – a repatriation from the US, for instance, can cost around £60,000 – but the stress and anxiety too. So don’t skimp on your travel insurance cover – but do go ahead and enjoy the trip of a lifetime.

Contact Info:

855-765-6555

Info@TravelerFriendlyInsurance.com

http:/ / www.travelerfriendlyinsurance.com

More:
The Complete Guide to Travel Insurance for the Over 65s UK

Transcending Obamacare: A Patient-Centered <b>Plan</b> for Near <b>…</b>

 

TRANSCENDING OBAMACARE

A Patient-Centered Plan for Near-Universal Coverage and

Permanent Fiscal Solvency

August 2014


Avik Roy, Senior Fellow, Manhattan Institute

 

EXECUTIVE SUMMARY

In 2010, President Obama signed into law the Patient Protection and Affordable Care Act, also known as the “Affordable Care Act,” the “ACA,” or “Obamacare.” The ACA will reduce the number of Americans without health insurance— an important goal—but it will do so by increasing the cost of U.S. health coverage. Increasing the cost of health coverage, in turn, will worsen two of the nation’s most important policy problems.

The first of those problems is the increasing unaffordability of private health insurance, a problem that is straining the budgets of middle-income Americans, and hampering social mobility. The second problem is the nation’s grave long-term fiscal instability, a problem primarily driven by government spending on health insurance and health care.

Indeed, the ACA will especially drive up the cost of private health insurance that individuals purchase directly. The law will dramatically expand Medicaid, a program with the poorest health outcomes of any health insurance system in the industrialized world. And the ACA, despite spending over $2 trillion over the next decade, will leave 23 million lawful U.S. residents without health insurance, according to estimates from the Congressional Budget Office (CBO).

In other words, the U.S. health care system remains in need of substantial reform, in ways that address the ACA’s deficiencies as well as the system’s preexisting flaws.

The ACA’s supporters wrongly contend that the health law requires only minor tinkering in order to succeed. But the ACA’s critics, in seeking to repeal Obamacare, would not necessarily address the underlying problems that predate the ACA. Furthermore, while it is possible to “repeal and replace” the ACA with a better health care system, it is desirable to develop policy proposals that do not require the disruption implied by repeal in order to put U.S. health spending on a sustainable path.

With these considerations in mind, the proposal contained herein—dubbed the Universal Exchange Plan (“the Plan”)—seeks to substantially repair both sets of health-policy problems: those caused by the ACA and those that predate it. It is the latter set of problems that have denied affordable, high-quality health care to millions of Americans, while presenting the government with crushing health care bills.

The Universal Exchange Plan’s reforms are perfectly compatible with the “repeal and replace” approach, but they do not require the full and formal repeal of the ACA in order to be enacted.

The Universal Exchange Plan would introduce major changes to the broad set of federal health care entitlements: Obamacare, Medicare, and Medicaid. While the Plan is compatible with the “repeal and replace” approach favored by Republicans, it does not require the formal repeal of the Affordable Care Act. Indeed, the Plan uses a reformed version of the ACA’s health insurance exchanges as the basis for far-reaching entitlement reform.

The Plan would repeal many of the ACA’s cost-increasing insurance mandates, including the individual mandate. But it would preserve the ACA’s guarantee that every American can purchase coverage regardless of preexisting conditions. And it would utilize the concept of using federal premium support subsidies, on a means-tested basis, to defray the cost of private health coverage.

It would gradually migrate most Medicaid recipients, along with future retirees, onto these reformed exchanges. This change would dramatically increase the quality of health coverage offered to Americans at or below the poverty line, and preserve the guarantee of health coverage for low- and middle-income seniors, while ensuring the fiscal sustainability of both federal health care commitments. The Plan proposes minor changes to the treatment of employer-sponsored health coverage, while giving workers additional tools to lower their health care bills. It would curb the pricing power of hospitals, cap malpractice damages, and accelerate medical innovation.

Taken together, these changes could usher in a new era of consumer-driven, patient-centered health care.

According to our estimates, the Universal Exchange Plan would, by 2025, increase the number of U.S. residents with health coverage by 12.1million, relative to the Affordable Care Act. Over time, we project that the Plan would outperform the ACA by an even wider margin.

The Plan would also expand economic opportunity for those struggling with high medical bills. It would improve the quality of health care delivered to the poor, and put America’s finances on a permanently stable course.

LEARNING FROM THE BEST INTERNATIONAL HEALTH SYSTEMS

The plan has its roots in real-world examples of market-oriented, cost-effective health reform. Notably, two wealthy nations—Switzerland and Singapore—spend a fraction of what the United States spends on health care subsidies; yet they have achieved universal coverage with high levels of access and quality.

In 2011, the Singaporean government spent $851 per capita on health care: less than a quarter of what the U.S. spent, adjusted for purchasing power parity. Singapore has achieved its savings using a universal system of consumer-driven health care. The government funds catastrophic coverage for every Singaporean, and reroutes a portion of workers’ payroll taxes into health savings accounts that can be used for routine expenses.

Switzerland offers its citizens premium support subsidies, on a sliding scale, for the purpose of buying private health insurance; there are no “public option” government insurers. Low-income individuals are fully subsidized; middle-income individuals are modestly subsidized; and upper-income individuals are unsubsidized. The sliding scale addresses a key challenge posed by welfare programs: mitigating the disincentive for welfare recipients to seek additional work, for fear of losing their benefits.

The Universal Exchange Plan’s Key Reforms
Repeals ACA individual mandate, employer mandate, & all tax hikes except ‘Cadillac Tax’
Emancipates exchanges from costly federal regulation • Combats hospital monopolies
Migrates most Medicaid enrollees and future retirees onto reformed exchanges

Projected Fiscal and Coverage Outcomes
30-year deficit reduction of $8 trillion • 30-year revenue reduction of $2.5 trillion
Makes Medicare Trust Fund permanently solvent • Reduces private-sector premiums
For Medicaid population, improves provider access by 98%; medical productivity by 159%
By 2025, increases coverage by 12.1 million above ACA levels

The Swiss system shares some of the unattractive features of the ACA, including the individual mandate. But because Switzerland focuses its public resources solely on lower-income individuals, the federation’s universal coverage system is far more efficient than America’s. In 2012, Switzerland public entities spent approximately $1,879 per capita on health care: 45 percent of U.S. public spending. Put another way, if U.S. government health spending was proportional to Switzerland’s, the U.S. would be able to eliminate its budget deficit.

Of course, the U.S. is neither Switzerland nor Singapore. Each country has its own political system, its own culture, and its own demography. Those differences, however, are not large enough to erase the gains that would accrue here by adapting the most relevant features of the Swiss and Singaporean health care systems to that of the United States.

UNIVERSAL EXCHANGES: A NEW OPTION

The Universal Exchange Plan, contemplated in this monograph, has five goals: (1) to expand coverage well above ACA levels, but without an individual mandate; (2) to improve the quality of coverage and care for low-income Americans; (3) to make all U.S. health care entitlement programs permanently solvent; (4) to reduce the federal deficit without raising taxes; and (5) to reduce the cost of health insurance.

The Plan would achieve each of these goals in a manner that is minimally disruptive to those who favor their current arrangements. As noted above, it would employ a revised version of the ACA’s subsidized insurance exchanges as a mechanism for reforming entitlements, expanding coverage, and improving health care quality.

The Plan has five core elements:

Exchange reform. The Plan repeals the ACA’s individual mandate requiring most Americans to purchase government-certified health coverage. The Plan restores the primacy of state-based exchanges and state-based insurance regulation. It expands the flexibility of insurers to design exchange-based policies that are more attractive to consumers, because they are of higher quality at a lower cost. The Plan expands access to health savings accounts. Because these reforms lower the cost of insurance for younger and healthier individuals, they have the potential to expand coverage, despite the lack of an individual mandate.

Employer-sponsored insurance reform. The Plan repeals the ACA’s employer mandate, thereby offering employers a wider range of options for subsidizing workers’ coverage. The Plan preserves the ACA’s “Cadillac tax” on high-cost health plans, but it repeals other taxes, and reforms other regulations that artificially drive up the cost of employer- based insurance.

Medicaid reform. The Plan migrates the Medicaid acute-care population onto the reformed state-based exchanges, with 100 percent federal funding and state oversight. (Medicaid acute care is a form of conventional insurance for hospital and doctor services.) In exchange, the Plan returns to the states, over time, full financial responsibility for the Medicaid long-term care population. (Long-term care funds nursing home stays and home health visits for the elderly and disabled.) This clean division of responsibilities will improve coverage for the poor; reduce waste, fraud and abuse; and provide fiscal certainty to state governments.

Medicare reform. The Plan gradually raises the Medicare eligibility age by four months each year. The end result is to preserve Medicare for current retirees, and to maintain future retirees—in the early years of their retirement—on their exchange-based or employer-sponsored health plans. (Today, the government does not allow the newly retired to remain on their old plans; instead, it forces them to enroll in Medicare or forfeit their Social Security benefits.) In total, these changes would make the Medicare Trust Fund permanently solvent.

Other reforms. The Plan tackles the growing problem of hospital monopolies that take advantage of their market power to charge unsustainably high prices. The Plan reforms malpractice litigation in federal programs. And it accelerates the pace of medical innovation through reform of the Food and Drug Administration.

ASSESSING THE PLAN’S FISCAL EFFECTS

We estimated the fiscal effects of the universal Exchange Plan by utilizing several methodologies, including a model developed by the Health Systems Innovation Network, and drew on data projections from the Congressional Budget Office and the Centers for Medicare and Medicaid Services. We assumed that the Plan is implemented in 2016 and estimated federal budget outcomes for three decades, from 2016 through 2045.

As with projections generated by the CBO, estimates of the Universal Exchange Plan’s performance beyond the first decade harbor considerable uncertainty. However, given the gradual nature of the Plan’s reforms, assessing its long-term impact on the health care system is critical to evaluating its merits.

Relative to the ACA, we estimate that the proposal will do the following:

  • Over the first ten years, the Plan will reduce federal spending by $283 billion and federal revenues by $254 billion, for a net deficit reduction of $29 billion.
  • Over the first ten years, the Plan will reduce state tax revenues by $331 billion, offset by a larger reduction in net state Medicaid spending due to the transfer of acute-care Medicaid enrollees onto the federally funded exchanges.
  • Over the first 30 years, the Plan will reduce federal spending by approximately $10.5 trillion and federal revenues by approximately $2.5 trillion, for a net deficit reduction of approximately $8 trillion.
  • The Plan will render the Medicare Trust Fund permanently solvent, if the entirety of the proposal’s Medicare savings were applied to the trust fund instead of toward deficit reduction.

We do not model the effects of this proposal on Treasury bond prices: the benchmark for the federal government’s borrowing costs. However, it would be reasonable to assume that the proposal’s substantial fiscal consolidation would lead to lower interest rates, and thereby less federal spending on interest payments.

Lower interest rates—in combination with a reduced tax burden, lower hiring costs, and lower health insurance premiums—should lead to higher economic growth, and thereby additional tax revenue and deficit reduction. We did not model these effects, instead assuming that the Plan has no impact on the CBO’s 2014 long-term GDP projections.

COVERING MORE PEOPLE, MORE AFFORDABLY, AT HIGHER QUALITY

Policymakers and researchers focus intensely on the number and proportion of U.S. residents with health insurance coverage. There is, however, far less focus on the quality of the coverage that Americans receive. As noted above, enrollees in Medicaid—and, to a lesser extent, Medicare—suffer from poorer access to physician care, and thereby poorer health outcomes, compared with individuals with employer-sponsored private coverage.

A central tenet of the Universal Exchange Plan is that offering exchange-based coverage to the population currently eligible for Medicaid will improve the degree to which low-income Americans can gain access to physician care, and thereby improved health outcomes.

In order to gauge the impact of the Plan on these individuals, we employed two indices developed by Stephen Parente and colleagues at the University of Minnesota: the Patient to Provider Access Index (PAI), measuring the breadth of choice of doctors and hospitals in a given plan; and the Medical Productivity Index (MPI), measuring health outcomes for different coverage arrangements.

Over the entire non-elderly adult population, relative to current law, we estimate that the Universal Exchange Plan will increase average provider access—as measured by PAI—by 4 percent. Those individuals who migrate from the traditional Medicaid acute-care program onto the reformed ACA exchanges are estimated to experience a substantial improvement in PAI: 98 percent.

Over the entire non-elderly adult population, relative to current law, the Universal Exchange Plan is estimated to increase average health outcomes— as measured by MPI—by 21 percent.

As with PAI, those individuals who migrate from the traditional Medicaid acute-care program onto the reformed ACA exchanges are estimated to experience a much more dramatic improvement in PAI: 159 percent.

The HSI microsimulation model indicates that the Universal Exchange Plan’s reforms to the ACA exchanges would reduce the average cost of commercial insurance premiums by 17 percent for single policies and 4 percent for family policies. Despite the lack of an individual mandate, HSI models the Universal Exchange Plan as increasing health insurance coverage. If the Plan were adopted in 2016, 12.1 million more individuals would gain health insurance coverage by 2025 relative to current law.

A FAR-REACHING HEALTH-REFORM PROPOSAL

The Universal Exchange Plan contemplates a broad range of far-reaching reforms to the U.S. health care system.

We have estimated the fiscal effects of the Plan over three decades, but considerable uncertainty surrounds all long-term projections. The Congressional Budget Office assumes that, from 2016 to 2035, U.S. economic output will grow at an average nominal rate of 4.2 percent per year, and that inflation over the same period will approximate 2.5 percent per year. If long-term inflation is higher, and/or long-term economic growth is slower, the U.S. fiscal picture will worsen considerably, affecting the reach of our proposed reforms.

No proposal to reform the U.S. health care system is immune from trade-offs, and the Universal Exchange Plan is no different. What it tries to do is to stitch together ideas from all sides to fix flaws in the system, new and old. It would increase the progressivity of health care–related federal outlays and tax expenditures. It would spend less subsidizing insurance for high-income employed and retired individuals, but spend more on insurance for the poor and the uninsured. However, it would do so not by employing a single-payer, government-run system, but rather by migrating low-income Americans and younger retirees into private, consumer-driven insurance plans.

Many people have justly criticized the ACA for its complexity and length. Legislative language for the Universal Exchange Plan, while not nearly as complex, will not fit onto two pages. The Plan seeks to expand coverage and reduce costs while minimizing disruption to the currently insured, an approach that requires addressing the existing complexities of a health care system that consumes $3 trillion a year.

Those who believe that there is no legitimate role for the federal government in funding health coverage for the uninsured may not find it satisfactory that the Plan preserves that role. Also left unsatisfied may be those who believe that the existence of private insurers is morally illegitimate.

In contrast to some other areas of public policy, however, it is possible for both progressives and conservatives to achieve important objectives under the Universal Exchange Plan.

The Plan brings us closer to true universal coverage. It permanently stabilizes the fiscal condition of the United States, by reducing the federal deficit by approximately $8 trillion over its first three decades and, over the long term, by encouraging U.S. gross domestic product to grow at a faster rate than federal health care spending.

Most important, it sows the seeds for a consumer-driven health care revolution, one that could substantially improve the quality of health care that every American receives, and restore America’s place as the world’s most dynamic economy.

ABOUT THE AUTHOR

AVIK ROY is a senior fellow at the Manhattan Institute and the Opinion Editor at Forbes. In 2012, Roy served as a health care policy adviser to Mitt Romney. NBC’s Chuck Todd, on Meet the Press, described Roy as one “of the most thoughtful guys who has been debating” health care reform.

Roy is also principal author of The Apothecary, the influential Forbes blog on health care policy and entitlement reform. MSNBC’s Chris Hayes calls The Apothecary “one of the best takes from conservatives on that set of issues.” Ezra Klein, in the Washington Post, called The Apothecary one of the few
“blogs I disagree with that I check daily.”

In addition, Roy writes regularly for National Review Online on politics and policy. His work has appeared in The Atlantic, USA Today, National Affairs, and The American Spectator, among other publications. He is a frequent guest on television news programs, including appearances on Fox News, Fox Business, NBC, MSNBC, CNBC, Bloomberg, PBS, and HBO.

He is the author of How Medicaid Fails the Poor, published by Encounter Books in 2013, and a member of the Advisory Board of the National Institute for Health Care Management.

At the Manhattan Institute, Roy’s research interests include the Affordable Care Act, universal coverage, entitlement reform, international health systems, and FDA policy.

Roy is the founder of Roy Healthcare Research, a consulting firm in New York. Previously, he served as an analyst and portfolio manager at Bain Capital, J.P. Morgan, and other firms.

He was born and raised near Detroit, Michigan, and graduated from high school in San Antonio, Texas. USA Today named him to its All-USA High School Academic First Team, honoring the top 20 high school seniors in the country.

Roy was educated at the Massachusetts Institute of Technology, where he studied molecular biology, and the Yale University School of Medicine.

READ FULL REPORT

See the article here:
Transcending Obamacare: A Patient-Centered <b>Plan</b> for Near <b>…</b>

Pro-government MPs reject Dr Shakeela&#39;s re-nomination as <b>health</b> <b>…</b>

Pro-government MPs reject Dr Shakeela’s re-nomination as health minister thumbnail

Dr Mariyam Shakeela failed to secure parliamentary consent today after MPs of the ruling Progressive Party of Maldives (PPM) and ally Maldives Development Alliance (MDA) voted against approving her as Minister of Health.

Of the 73 MPs in attendance, 61 voted against endorsing her reappointment to the cabinet while 11 voted in favour and one abstained.

PPM reportedly issued a three-line whip against approving Shakeela following a secret ballot at a parliamentary group meeting this afternoon.

The health ministry has been under fire following a series of protests over regional healthcare services and mishaps in Malé.

The state-owned Indira Gandhi Memorial Hospital (IGMH) – long criticised for lack of qualified doctors and inadequate medical facilities – transfused HIV positive blood to a patient in February due to an alleged technical error.

In June, Fuvahmulah councillors called for Shakeela’s resignation after a case of stillbirth, an interrupted caesarean, and the death of a soldier on the island. A few weeks later, over 300 protestors demonstrated in Haa Dhaal Kulhudhuffushi over deteriorating conditions at the regional hospital.

Shakeela was up for parliamentary approval today for a second time after President Abdulla Yameen modified her initial portfolio as Minister of Health and Gender.

During a debate today on a report by the independent institutions committee – which narrowly recommended endorsing her appointment – PPM MP Mohamed Musthafa accused Shakeela of reversing a decision by the previous minister to raise wages for doctors under a 48-hour work week.

He claimed that Shakeela had reduced working hours to 45 hours and lowered salaries.

“The consequence was all specialists working at IGMH and doctors in hospitals in the atolls and health centres leaving the Maldives,” he said, adding that the health minister should bear responsibility for the alleged exodus.

Musthafa suggested that “circumstances have changed” since President Yameen nominated Shakeela for the post.

MPs of the opposition Maldivian Democratic Party (MDP) also voted against the health minister while Jumhooree Party (JP) MPs voted in favour.

MDP MP Rozaina Adam accused the health ministry of taking measures against health sector employees who provide information to opposition MPs. Such workers were threatened with dismissal and accused of “pestering” the government, she claimed.

Rozaina also strongly objected to the committee being unable to interview Shakeela due to a Supreme Court ruling.

JP MP Hussain Mohamed meanwhile noted that appointing cabinet ministers was a prerogative of the president, suggesting that the parliament’s confirmation role was a formality.

The party decided to endorse her as Shakeela’s reappointment implied that the president must have had confidence in her ability to implement his health policy, he said.

Health policy

Meanwhile, at a press conference yesterday, Shakeela said that the health sector had been strengthened despite “pressure” from elements within the government.

Shakeela insisted that she would not resign in the face of “obstacles and challenges” and said that President Yameen had not asked her to do so.

Shakeela contended that she had inherited a health sector “in ruins” with limited human resources and crumbling health centres and medical equipment.

She alleged that senior officials “within the system” were “obstructing” the ministry’s efforts.

Shakeela said she would “respect” the PPM MPs’ decision, but insisted that it would not be based on her performance.

Defending her track record, Shakeela said the ministry has formulated and submitted legislation to parliament on health services, health professionals, medical negligence, and medical devices.

The administrative framework of the health sector had been reviewed and revised, she said.

Shakeela said 70 percent of infrastructure had been damaged when the current administration took office, which has commenced repair work on 24 health centres at a cost of MVR14.1 million (US$914,397) while projects for repairing a further 49 centres were in the tendering process.

Contracts have been signed for constructing an 11-storey building for IGMH and upgrading the dialysis unit, she continued, adding that efforts were also underway to upgrade the Vilimalé health centre to a hospital.

Moreover, the ministry was purchasing equipment to upgrade the Hithadhoo and Kulhudhufushi regional hospitals to tertiary level, she said.

Among other ongoing projects were a quarantine facility and halfway house in Hulhumalé, a maternity waiting home in Kulhudhufushi, and newborn care centres.

A project to repair speedboats was also underway, Shakeela said, which has seen 13 out of 28 speedboats resume service. Four sea-ambulances have also been launched to fulfil a PPM campaign pledge, she noted.

While only 42 of 199 ambulances were functioning when she assumed office, Shakeela said 110 were now being used.

Noting that 80 percent of employees in the health sector were expatriates, Shakeela said the government was finding it hard to recruit professionals from overseas due to loss of confidence in the health sector by foreign workers.

A four-year long term plan for the health sector was being implemented, she noted.

Work has also begun on integrating a general practitioners service with the government’s ‘Aasandha’ health insurance scheme, Shakeela said.

See more here:
Pro-government MPs reject Dr Shakeela&#39;s re-nomination as <b>health</b> <b>…</b>

Universal <b>Health Insurance</b> – a win for the pharmaceutical industry <b>…</b>

According to the former Minister for Health Dr. James O Reilly Universal Health Insurance means that ‘everyone will be a winner’. However the real winners will be the pharmaceutical industry, the medical profession and the insurance industry.

They would like us to belive the myth, that universal health insurance equates to ‘free health care for everyone’. Imagine free health care for everyone! This is not the case. Instead we are all being forced to take out compulsory health care insurance. So now along with paying tax, we are now going to pay twice for health care!

The IMO president Prof. Trevor Duffy said the Government is misleading the public by describing its proposed insurance model as a type of health care with free care for all.

Dutch citizens are paying up to a quater of their income on healthcare. A family iwht a combined income of under €50,000 a year are paying almost €11,500 in health care costs in 2012 or 23.5 per cent of income according to the Dutch Health Performance Report.

In Ireland the Department of Public Expenditure and Reform have estimated that a family of two adult and two children will have to pay €1,600 per year. However the new Minister for Health Leo Varadkar said that a family of two adult and two children would have to pay €3,600 for UHI. This is an increase from the exiting average of €900 paid by the same family type.

Healthcare spending in the Netherlands has doubled in the last 11 years from €47 billion in 2000 to €90 billion in 2011 according to the report.

It seems to me that the only purpose of univeral health insurance is to increase healthcare expenditure, with the main beneficiaries being the pharmaceutical industry and the medical profession. I dont believe that universal health insurance will lead to more cures or a healthier nation. It will lead to more tests, more drugs, more side effects, more hospital visits and more fear.

The second myth being promoted by Government is that, after paying our tax and health insurance, we will get a better health care. Really! Medical negligence from misdiagnosis, hospital infections, side effects from pharmaceuticals are common in the current model of health care dominated by biomedicine and pharmaceutical medicine.

International studies have shown that medical accidents are the leading cause of death in modern western society. Figures show that between four and 11 per cent of all hospital admissions will suffer from some form of negligence. With four million hospital admissions each year in Ireland, that works out at potentially 160,000 patients injured or killed at least every year (source).

As an herbalist I haven’t been to see a GP since 2002 and that was to get my cholesterol checked. I haven’t taken antibiotics since 1995. My health is my responsibility and not the Governments. I know that if I deal with stress, eat healthy and exercise, I will continue to reduce my risk of developing health problems. As someone who has a history of heart disease on my father’s side of the family, I take Hawthorn berry tincture that I make from berries I pick myself. I take herbs like Skull Cap to deal with anxiety and stress. I have reduced my intake of dairy products and gave up meat for three years. I am currently off sugar again! Well except for a little bit of dark chocolate with a cut of tea!

If you continue to follow this blog, you will learn more about how to stay healthy, happy and avoid the hidden power of powerful vested interests that want to control you without your consent.

Excerpt from:
Universal <b>Health Insurance</b> – a win for the pharmaceutical industry <b>…</b>

<b>International</b> expat <b>health</b> – complete guide – CNN iReport

Expat (expatriate) is a term used to describe a person that is citizen of one country but resides in another country (permanently or provisionally). The term is similar to term immigrant, but it is a little bit narrower because expats are usually qualified professionals that reside in foreign countries because of their job. They usually have skills that are rare or non existing in the country where they are sent by their companies unlike immigrants who usually go to foreign countries to work whatever job they can find. The number of people that can be described as expats is growing every year and this raises an important question – what about their health insurance? Most countries require expats to get their own expat health insurance even though they will get a national health insurance too. Luckily there are many insurance companies that can provide these services and one of the most popular in the United Kingdom is Now Health International – an insurance company that is already taking care of hundreds of expats.

Since people go abroad mainly because of work, in many cases it is the companies that obtain the international health insurance for the employees. But, in some cases the expat has to choose his or her own health insurance. Since there are different types of health insurance and there are different insurance companies, expats should be aware about few things before they purchase insurance.

First of all, not all insurance packages cover the same things. Of course, the more the package cost the more it covers. However, there are some things that you might not need while abroad. A good example is maternity cover – you don’t have to cover that if you are not planning to become a mother while abroad.

Make sure to check which locations the health insurance covers. If you are travelling a lot you should consider purchasing a package that covers those areas where you need to travel. Furthermore, if you want to save some money the best option is to pay the insurance upfront at once instead of paying in installments. The first option is always cheaper.

With the advance of technology and especially the internet, you can now choose whether you want to purchase expat health insurance using your computer or do it in a traditional way – by visiting an agent. Many people choose the internet over any other method because it is more convenient (you don’t have to live the comfort of your home) and on top of that you can always expect some online discount. While we are talking about discounts make sure to check all the promotions and discounts because insurance companies often provide interesting offers. Once again, remember to check if you really need insurance that is covering what they have to offer.

Traditional insurance companies are offering various types of insurance, but it’s good to point out that there are specialized insurance companies like Now health International that deal only with expat health insurance. This field is very specific so it is always a good idea to make a deal with professionals that have experience in this area. Their agents have years of experience in international health insurance and they will be ready to answer all the questions you have.

Finally, just like any other type of insurance, consider it as a necessity not as a luxury. Accidents can happen anywhere and your health should always be a priority. In addition, consider purchasing an insurance package before you travel abroad. You can experience the first health problems even right after you step in the foreign country and that’s why you must be prepared.

What do you think of this story?

Select one of the options below. Your feedback will help tell CNN producers what to do with this iReport. If you’d like, you can explain your choice in the comments below.

Be and editor! Choose an option below:

See the article here:
<b>International</b> expat <b>health</b> – complete guide – CNN iReport

International expat health – complete guide

Expat (expatriate) is a term used to describe a person that is citizen of one country but resides in another country (permanently or provisionally). The term is similar to term immigrant, but it is a little bit narrower because expats are usually qualified professionals that reside in foreign countries because of their job. They usually have skills that are rare or non existing in the country where they are sent by their companies unlike immigrants who usually go to foreign countries to work whatever job they can find. The number of people that can be described as expats is growing every year and this raises an important question – what about their health insurance? Most countries require expats to get their own expat health insurance even though they will get a national health insurance too. Luckily there are many insurance companies that can provide these services and one of the most popular in the United Kingdom is Now Health International – an insurance company that is already taking care of hundreds of expats.

Since people go abroad mainly because of work, in many cases it is the companies that obtain the international health insurance for the employees. But, in some cases the expat has to choose his or her own health insurance. Since there are different types of health insurance and there are different insurance companies, expats should be aware about few things before they purchase insurance.

First of all, not all insurance packages cover the same things. Of course, the more the package cost the more it covers. However, there are some things that you might not need while abroad. A good example is maternity cover – you don’t have to cover that if you are not planning to become a mother while abroad.

Make sure to check which locations the health insurance covers. If you are travelling a lot you should consider purchasing a package that covers those areas where you need to travel. Furthermore, if you want to save some money the best option is to pay the insurance upfront at once instead of paying in installments. The first option is always cheaper.

With the advance of technology and especially the internet, you can now choose whether you want to purchase expat health insurance using your computer or do it in a traditional way – by visiting an agent. Many people choose the internet over any other method because it is more convenient (you don’t have to live the comfort of your home) and on top of that you can always expect some online discount. While we are talking about discounts make sure to check all the promotions and discounts because insurance companies often provide interesting offers. Once again, remember to check if you really need insurance that is covering what they have to offer.

Traditional insurance companies are offering various types of insurance, but it’s good to point out that there are specialized insurance companies like Now health International that deal only with expat health insurance. This field is very specific so it is always a good idea to make a deal with professionals that have experience in this area. Their agents have years of experience in international health insurance and they will be ready to answer all the questions you have.

Finally, just like any other type of insurance, consider it as a necessity not as a luxury. Accidents can happen anywhere and your health should always be a priority. In addition, consider purchasing an insurance package before you travel abroad. You can experience the first health problems even right after you step in the foreign country and that’s why you must be prepared.

What do you think of this story?

Select one of the options below. Your feedback will help tell CNN producers what to do with this iReport. If you’d like, you can explain your choice in the comments below.

Be and editor! Choose an option below:

See the original article here:
International expat health – complete guide

Your 5-Step Medical Tourism Checklist | Oxstones Investment Club™

Why Is U.S. Health Care So Much More Expensive?

After years of research and many conversations with health policy experts, I see three key culprits of expensive health care in the U.S.

In no particular order, they are the third-party payer system (i.e., employer-provided health care), malpractice suits, and administra­tive support costs/paperwork.

The unintended consequence of in­stitutionalized employer-provided health care — a third-party payer for over 80% of the population — is to remove the pricing element from patients’ decision making.

“Medical tourism is not a new phe­nomenon. Canadian and British patients have been traveling for decades in order to escape their universal health care systems.”

Take Lasik eye surgery as a counter-example. Lasik is an elective proce­dure and, therefore, is NOT covered by insurance. The result is in just one decade, the average price has decreased from approximately $2,500 per eye to $400–1,500 per eye, depending on your location and the technology used.

All while the average employer-sponsored health insurance pre­mium for a family rose 29% over the last four years, according to a recent Kaiser Family Foundation and Health Research & Educa­tion Trust study.
But before deciding if medical tour­ism as a valid option for you or your family…

Is Medical Tourism Safe?

Medical tourism is not a new phe­nomenon. Canadian and British patients have been traveling for decades in order to escape their universal health care systems, in which extensive surgical wait times are the norm.
Important safety facts about medical tourism:

  • Many international hospital staff and doctors are educated and board certified in U.S.
  • MedRetreat uses only hospitals accredited by the Joint Commis­sion on Accreditation of Health­care Organizations (JCAHO). This is the same organization that accredits top U.S. hospitals.

So a JCAHO hospital is required to follow the same standards, procedures, and protocols as U.S. hospitals

  • Hospitals employ the same ad­vanced prosthetics, equipment, and medical devices as U.S. hospitals
  • Hospitals cross-train with John Hopkins, the Mayo Clinic, Harvard Medical, and others.

So if your insurance deductible is too high or you are denied access to the surgical procedure that you need, it may be time to consider packing your bags and heading off to a foreign hospital.

But before you do so, I suggest you follow this five-step checklist. It will save you time, money, and hassle.

The 5-Step Medical Tourism Checklist

Step 1: The $6K rule. Determine the approximate cost of your procedure to ensure that it will cost more than $6,000. If your procedure will cost you $6,000 or less out of pocket, you will not financially benefit once you factor in travel-related expenses.

Step 2: Obtain a com­plete diagnosis, along with your doctor’s report and images. Include any X-ray, MRI, CAT, and/or PET work. You will use these to obtain a detailed price quote and treatment plan from your selected foreign hospital.

Step 3: Determine if you want to go directly to the hospital or work with a medical tourism fa­cilitation agency. Directly means you will research, plan, and make all arrangements on your own. A medical tourism facilitator will guide you through all the planning and arrangements.

Step 4: Inform your doctor of your decision to travel abroad for your procedure. Verify if he or she would be willing to see you for follow-up care upon your return. Who knows, they may even try to compete with the foreign hospital on price.

Step 5: Obtain a firm quote and treatment plan from the foreign hospital before booking your travel arrangements.

If medical tourism sounds like a good option for you, send me an email at janglin@medretreat. com and I will send you a copy of MedRetreat’s comprehensive facilitation process to best guaran­tee a safe and pleasurable medical retreat.

Sincerely,

Jud Anglin

Jud Anglin is founder of MedRetreat.com and a board member of the Laissez Faire Club.

Tags: expensive health care, international hospital, medical tourism, MedRetreat, U.S. health care system

Link:
Your 5-Step Medical Tourism Checklist | Oxstones Investment Club™

How to get a better deal on private health insurance

private health insurance comparison

*This post is based on the Australian private health care system, if you are an international reader, please be sure to check for information relevant to your country*

Dealing with health insurance is enough to raise most people’s blood pressure. There are so many options and it is extremely difficult to compare. Here I’ve got some simple tips to ensure you are getting the best deal and making the most of your health insurance.

Over 30?

If you don’t take out private health insurance before you are 30 the government will kindly lump you with an age based loading. It’s therefor very important to ensure you take out private health insurance by your 30th birthday. If you are over 30 and haven’t taken it out yet, do it as soon as possible as the loading increases the older you get! You need to take out either a hospital or combined package to avoid the loading. Extra’s only cover won’t cut it.

Earning over the threshold?

There is an additional Medicare levy surcharge for individuals and families who earn over the Medicare levy surcharge threshold (currently $88,000 for singles and $176,000 for families). In most cases, the extra you will pay in tax is equal to or more than what you would pay to take out a basic hospital policy so you are much better off taking out a hospital policy. Taking out an extra’s only policy won’t prevent you from being charged the surcharge so make sure you get a hospital or combined policy. There is also a cut off on the excess your policy can have so if you take out a policy with an excess over $1000 you will still be charged the levy. Make sure you check with the insurance company before signing up.

Choose where you compare carefully

There are quite a few online companies that offer to find you the best deal on your health insurance. These can be a good option for some but in reality they don’t compare even a fraction of the available options and in my experience, exclude some of the best member run not for profit insurers. The companies take a commission for recommending various products so the not for profit insurers without big advertising policies often miss out.

My pick for comparing policies is the government website www.privatehealth.gov.au This website compares all the available policies and you can download an overview of each one to compare like for like. Keep in mind that the policy premiums stated are before any rebate but you can work out what rebate you would receive using the calculator on their site.

Review your policy once a year

Most companies increase their premiums in April each year so this is a good time to review your policy. Premium increases vary from company to company and the best deal last year may not be so great this year.

Do the sums on extras benefits

You can make extras benefits really work for you if you are selective about the policy you choose. Some policies cover things such as vitamins, remedial massage, gym memberships and yoga as well as the basic dental and optical. If you are a big user of natural therapies make sure your policy has good limits for these. A good starting point is to work out roughly what you spend each year on various categories and what you will get back from your extras cover. Compare this to the benefit you pay and work out if it is worth it. If you don’t wear glasses, rarely visit the physio etc then you may find you are better off putting aside the equivalent of the extras cover payment into savings each month and drawing on it as needed. Also check the overall limits for each category. If you use lots of physiotherapy for example make sure it has a high individual limit. Consider the difference between basic dental and major dental as well, if you are likely to need root canal, a tooth removed or braces, take this into account when choosing your policy.

Check exclusions

Make sure your policy includes all the services you need (and preferably doesn’t include those you don’t). Are you likely to want to have you baby in a private hospital? Make sure obstetrics is covered. Likewise, if you are a 60 year old couple you can probably drop the obstetrics cover from your policy. Things like cataract surgery, joint replacements and IVF are commonly excluded benefits. My parents recently discovered that their otherwise good health insurance policy was not going to cover even a cent of my dad’s cataract surgery. An expensive lesson to learn after the fact!

Claim, Claim, Claim!

This may sound silly but many people have private health insurance but no idea what they can claim on it. This is mostly the case for extra’s cover where everything from massages to vitamins can often be claimed. Check your policy and lodge claims for everything!

Who are you currently insured with? Are you happy?

Taken from:
How to get a better deal on private health insurance

ICA introduces Afghanistan&#39;s first ever private <b>health insurance</b> <b>…</b>

di6ebLa4TThe Insurance Corporation of Afghanistan (ICA) announced release of its comprehensive private health insurance, which is introduced for the first time in Afghanistan.

The product comes with international standards features including comprehensive inpatient and outpatient healthcare coverage, access to approved nationwide medical providers and cashless claims settlement system.

According to ICA officials, the healthcare coverage is supported by a local 24-hour claims service through Interhealth Afghanistan, which is the first privately owned Medical Third Party Adminstrator (TPA) Company in Afghanistan.

The following plans are available under ICA’s comprehensive private health insurance coverage:

Essential Plan

The Essential Plan provides USD 25,000 annual medical coverage per member and is designed for employees living and working in Afghanistan. The comprehensive coverage provided includes outpatient and inpatient, maternity and emergency dental treatment.

Comprehensive Plan

The Comprehensive Plan provides USD 100,000 annual medical coverage per member and is suitable for those living and working in Afghanistan and traveling overseas for business. The area of cover is Afghanistan, India and Pakistan. The key benefits of the plan include outpatient and inpatient, maternity, emergency dental treatment and emergency medical evacuation within area of cover only.

Supreme Plan

The Supreme Plan provides USD 100,000,000 annual medical coverage per member Worldwide (including or excluding USA). The plan is designed for members that travel extensively as part of their business. The key benefits of coverage provided include outpatient and inpatient, maternity, emergency dental treatment, emergency medical evacuation Worldwide and well being benefit.

ICA Health Insurance is underwritten and reinsured by AXA PPP. AXA PPP healthcare is one of the world’s largest and experienced international private healthcare insurers, providing insurance in around 80 countries.

ICA was the first private commercial insurance company licensed by the Ministry of Finance in Afghanistan and was established in 2007.

The company operates from its office headquarters in Kabul, Afghanistan and to date, has arranged insurance coverage in excess of US$ 23 billion on behalf of clients operating in all sectors of the economy.

More:
ICA introduces Afghanistan&#39;s first ever private <b>health insurance</b> <b>…</b>

Suggestions About <b>Health Insurance</b> – Honor & Glory <b>International</b> <b>…</b>

healthy supplement how to build muscle fast workout routineOne of the most valuable kіnds оf insurɑnce plans are health insurance. Health insurance helps save dollars by healthy supplements to gain weight fast loѡering the charge that you Һave to purchase medical doctor sessions, sսrgical oрerations, prescription medications, and other medical геquirements. Рicking medical insսrance that is certainly affordable сan be hard, nevertheless the recommendations on this page need to remedy that difficulty.

Whіle you are thinking about medical hеalth insurance ensure that you spend some time to investigation all the companies you could. If yoս find that you do not have enough time or the patіence to look about and гead by way of almost everʏthing you should think of working with a insurance polіϲy brokeг.

Look at personal coverage, since you may obtain a better level as compared to going with a team program. The downsіde to team protection is that everyone is acknowledged. This means that the costs needs to be better to help you profile foг people who maʏ become ill or ԝill need emergency proper care.

Group of peoplе medical insurance is often significantly less high-priced thɑn purchasing insurance by youгself. Should yoս ƅe ѕelf-utilized, resеarch all arоund and find out if you will find any group programs you could fall under. Talk with alumni associatіons, unions, and industry groups to ascertain if they feаtսrе team programѕ below their սmbrella.

Even with health insurancе, getting crisis treatment can Ƅe pricey. Uѕе mеdical facility e . r . amenitieѕ exclusively for acϲurate еmergencіes. For program but emergency health problems, you’ll reduce costs by using a walk-in medical cеnter. Some phɑrmacy likewise havе small-clinics wherе you can be observed, get aѕsesѕed and have a prescription. If requiгed, they will help you find more advanced health care assist.

Before choosing your health insurance plan, you might like to check out each government and native laws regarding medical insurance. Usually it іs quite common information and facts, but armіng oneself with expertise prior to sреaking to a broker ϲan ensuгe that you aren’t taken benefit of by ɑ realtor seɑгching for top level payment.

With health insurance, several alternatives are prеsent that you could pick from. Ahead of bеing seated together with your insurance broker, or signing up toǥether with your employer’s insսrance company, spend the time essential to understand all of the possibilitiеs. Make sure that yoս comprehend precisely what every little thing signifies before you make your variety.

Bеar in mind each and every year to verify precisely what is engrossed in your medications. Often overall health insurance providers alter the preѕcription Ԁrugs they will likelу ρroteсt, so each year once you re-register, assess the terminology carefully. When you all of a sudden гealize that your hеalth insurance plan is not covering up yοur on-going medications any more, then begin your search for a new strateɡy.

Avoid suƄstitutes to Һealth сaге insurance ideas. Some options to health insurance proǥrams supplү quite distinct protection. As they may wеll protect everything from cancer to Ebola, they may be mostly աorthless to you. Helρ save the money you will be organiƶing аside on tҺem. Just purchase ɑ appropriate health insurance prepare, when you can afford to pay for it.

For those who have health conditions, be sure you check around to improve your health insurance plan. Some insurance firms ɦave more liberal medical suggestiоns when compared to theіr opponents. For example, some insurance cаrrіers enable a total chοlesterol levels levelѕ uƿ to 270 to qualify for their cheapest guidelineѕ, in contrast to other іnsurance companies stiρulate an absοlute cholesterol levels degree as high as just 230.

If you need to swaр insuгance cоmpanies and you will have been uѕing a healthy supplement express el paso texas ԁoctor’s exercіse foг quite a while and want to sticк with them, cɑll the eҳercise and have suggeѕtions from their website regarding the insurance policy possibilities that are available for yοu. They will be able to proνiԁe you with their perspective in the options available fօr yoս.

Try and continue to your parеnt’s health care insurance plan ǥivеn that feasible. Ιn cаse your mom or dad includes a good occupation plus a wonderful insurance plan and iѕ also happy tо prоtect you, drivе them through to it. In certain claims, ƴоu could keep covered by yߋur parent’s health care insurance prepare until you ɑre 30.

Whenever your youngster goes off to college or university you’ll should take into account their own health insurance coveraǥe. Contact your insurance firm to vіew at what era you should remove them out of your insurance policies and ɑcquire them their verү own personalized insurɑnce coverɑge. It could vary from 19 to 31 years, according to which status you reside in.

With regɑrds to planning to cɦange your health care insuгance plan, be surе you make a list of the pгescription drugs that ƴou or ʏour dependents take. Add more the annual total. If they’гe paid by your existіng plan, inclսde уour co-spend as a stand alone and ѵiеw the cost of what it’d be wіthout ʏour policy.

With a decent teɑm hеaltɦ insurance program in positіon, you will absolսtely have satiѕfied and proƿerly-determined staff members. Although getting team meԀical insurance may seem like an expensive expenditure, you may definitely see excellent returns on yߋur own expense once you remоve the problem of frequеnt worker turn oveг аnd worker disϲontentment. Additionally, by handling your employees, you will end up creating a wοrk place that уou jսst and everyone witɦin your place of work will look forward to simplу being a part of.

This entry was posted onMonday, August 4th, 2014 at 1:00 am and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site. Both comments and pings are currently closed.

Continue reading here:
Suggestions About <b>Health Insurance</b> – Honor & Glory <b>International</b> <b>…</b>

Expat <b>Health Insurance</b> News and Health Tips » Travel insurance vs <b>…</b>

travel insurance need

Do you know the differences between travel insurance and expat insurance?

As the summer gets underway travellers are being warned about the importance of buying insurance if they plan on going abroad. According to a survey from The Points Guy, only 21 percent of people buy travel insurance, and of those, only 7 percent purchase it regularly.

So what is travel insurance?

Designed for short trips abroad, a standard plan covers cancellation, personal belongings, and emergency medical treatment. It can bought as a single- or multiple-trip policy and prices vary depending on many factors such as: where you are travelling, additional winter or water sports coverage, your age, pre-existing conditions and so on.

And international insurance?

An international medical insurance plan is designed to cover people who are living and working abroad. It generally includes inpatient treatment, check-ups, and long-term care of chronic conditions. An expat health plan usually allows you to choose where you receive treatment, even transferring you to another country if necessary. You can include extras such as compassionate visits, maternity care, and dental treatment. Expat health plans generally last a minimum of 12 months, though there are some options for people moving abroad for less than a year.

When buying travel insurance

If you’re planning your holiday this year there are a few things to consider when buying travel insurance. First, buy it as soon as you book your trip. That way if you have to cancel due to illness you may be able to recoup some of the money. Secondly, shop around. There are some great comparison sites online to help you find the best quote. Alternatively you can use a broker who will research and find the best policy for you.

A warning

The necessity of travel insurance was highlighted again recently by Brian Hodges’ story. Travelling with friends across the border from California to Mexico for a few short days, none of the group thought about buying travel insurance.

In a horrific zip-line accident Hodges suffered head injuries, a broken neck and trauma to his upper body. His wife used a credit card to pay $50,000 so Hodges could receive treatment. Since being transferred to a hospital in California Brian is improving, and an online fund has been set up to help the family deal with the medical bills, reports BakersfieldNow.com.

See original article:
Expat <b>Health Insurance</b> News and Health Tips » Travel insurance vs <b>…</b>

Panama <b>Health Care</b> and <b>Health Insurance</b> – Casa de Montaña

By Eliecer Andres Lay

hospi

If you are thinking of moving to Boquete, or just visiting, you might wonder “what’s the Panama health care like?”

Last week I began to feel sick and it later turned into a really bad cold and fever as well. I assumed that I had a virus. The first thing I did when I started to feel sick was to take an over-the-counter flu medicine for the cold and it did not help me with my symptoms at all. I soon started to feel worse. Then I decided to go to a private system clinic to see a doctor. My out-of-office cost was only $10 and the doctor prescribed me some medicines, including antibiotics. In total I spent around $35 that included the doctor’s appointment and my medicines. Within a few days I felt better. As you can see a doctor’s appointment is inexpensive but the medicines can be a little costly, depending on what you need to purchase.

In Boquete, there are different ways that you can get medical attention when you are sick. Even If you come from another country you can get medical attention in a clinic. The pricing is really low and is usually under $20.00 depending on where you go. Boquete has several clinics that are really accessible and designed for the community as well as If you have a bad emergency they will take you in an ambulance to a hospital in David. There is also an emergency number similar to 911 in Boquete and the name of the person is Rodny who is charge of responding to the calls. His phone number at “Alto Al Crimen” is 6677-6662. He is available 24/7/365 days and is able to assist you in any emergency you have in both English and Spanish. Most Boquetenians contact Rodny first and he in turn contacts all the emergency responders.

Panama health care is divided into three different systems:

  • National Health Care – Called “Ministerio de Salud”, also known as MINSA. These are yellow, green, and white buildings and are located in almost every community. It is basically free or low cost to the locals. This system is designed to mainly treat the poor community and those who do not have social security health benefits.
  • Social Security Clinic– Everyone who works in Panama must by law pay into the Panamanian Social Security system. Basically the employer pays around half and the employee pays the other half. For the coffee farm workers their medical coverage is about $4 a week and for government workers the cost will average $15 a week. Often doctors prescribe pharmaceuticals that are at no cost and are available at the social security pharmacy. Also, pharmacies throughout Panama sell pharmaceuticals by single dose (one pill). So if your doctor prescribes something, you buy only as many as you have been prescribed, you desire, or you can afford.
  • Private System – This system is widely used by the expat community and also by the increasing number of people who are coming to Panama to have medical procedures done. Such procedures as bypass surgery or cancer recovery is a growing industry called “medical tourism” in Panama. In Chiriqui province, where Boquete is located, there are five private hospitals where you can get any surgery and most of the treatments you need. For more involved procedures and treatment one has to go to the hospitals in Panama City. The private hospital costs are higher than if you go to a small clinic.

The information below is taken from an article about Health Care in Panama: Excellent Care at Half the Cost of the U.S.

Here are some personal stories:

I’ve been living in Panama full-time since 2005, and one of the best things about living here is the health care. I’m not the only one who thinks so, either. I’ve interviewed slews of expats here, and nearly every single person I talk to is mightily impressed by the health care in Panama.

International Living editor Dan Prescher says the health care in Panama is modern and affordable. He went to see my eye doctor in Panama City—he liked the doctor and the modern facility so much, Dan decided to have laser eye surgery done here. He estimates he saved up to 50% by having the procedure in Panama instead of back in the United States.

Expat resident Linda McKee says she likes the personal attention she and her husband, Eric, have received here: “Have you ever called a doctor in the U.S. at home on a weekend? My husband Eric and I had never had the pleasure…until we came to Panama. And we’re not the only ones—most of the expats I’ve met agree that the personalized health care in Panama is excellent.”

You’ll find excellent hospitals in Panama—in popular towns like Panama City, Chitre, Coronado, Boquete and David, the modern facilities are first rate. The country is so small, you’re likely to never be no more than an hour or two away from a major hospital (with plenty of smaller facilities, dental clinics, eye doctors and more close by). Boquete is only 35 minutes away from the nearest hospital.

Health care in Panama: One expats’ success story

One night in Boquete, expat Lee’s wife Jennifer began experiencing severe stomach pains. He rushed her to the local Boquete clinic, but she was soon sent to Hospital Chiriqui in the town of David, a 35-minute drive away. His normally healthy wife was experiencing acute liver failure and her kidneys began to shut down. Her doctors in David decided she needed specialized care in Panama City. A private plane was chartered to take her to Hospital Punta Pacifica, where Jennifer spent eight days in intensive care.

Says Lee: “She was never left unattended…the care and facility is as good as or better than any I have experienced or observed in the U.S.” Lee adds that the doctors were “beyond exceptional” and the nursing and technical staff were excellent.

Lee believes that Punta Pacifica’s affiliation with Johns Hopkins Medicine International was critical to saving Jennifer’s life. Specialists at both hospitals were in constant contact, affording her the best possible medical care her “international team” could provide. Despite living in the small mountain town of Boquete, Jennifer was able to get top-notch treatment thanks to the professionalism and timely actions of Panamanian health care professionals.

Giving health care in Panama a “good rep”

Another reason the health care in Panama has such a good rep is that many doctors here are U.S.-trained. Not only have that, but the standards at the top hospitals in Panama compared favorably with those in the U.S., Canada and Europe.

The largest hospitals in Panama are affiliated with First World facilities in the U.S. and elsewhere. In fact, Panama is the only Latin American nation to boast a John’s Hopkins-affiliated facility: Hospital Punta Pacifica (known as the most technologically advanced hospital in the region).

Although insurance is available in Boquete, for example, through Magda Crespo insurance, phone number, 6671-8800, located in San Francisco Plaza, many expats choose to purchase the insurance only for travel outside of Panama. Magda also covers home and auto insurance. So you can be rest-assured that you are in good hands should you have any healthcare needs. There are many other insurance agents also available in Boquete and David area in addition to Magda.

As you can see, health care and health insurance options abound in Boquete/David area and Panama in general that would meet the needs of expats with varying health concerns. The key to ascertaining the best options for you is to come down in person to Panama and talk to a reputable agent who can answer any questions you may have. Also, don’t forget to ask other expats who have already been living here who can share with you their own personal experiences. As we say here in Panama “Buena Suerte!” (Good Luck!).

View the original here:
Panama <b>Health Care</b> and <b>Health Insurance</b> – Casa de Montaña

<b>Health Care</b> in Colombia: Top Quality and Affordable – <b>International</b> <b>…</b>

Before moving to South America in 2008, I worked independently and couldn’t afford health insurance. Here in Colombia, where health care costs are low, I used to pay out of pocket for medications and basic services, such as a dental checkup, which costs around $25. Even so, I often went without the care I needed to avoid extra expenses. But I don’t have to worry about that anymore, because I recently enrolled in a health insurance plan. Getting started in the Colombian health care system has been a bit of an adventure, but one that has revealed many pleasant surprises.

Everyone Has Access to Colombia’s Health Care System

To understand Colombian health care, it’s important to understand the way in which Colombians view health. In 1991, Colombia drafted a new constitution that called for sweeping reforms. The new governing document deemed a person’s health a basic human right that applies to all citizens and foreign residents. It was a groundbreaking decision that paved the way for everyone living in Colombia to have access to the health care system.

And the Colombian court system stands behind the right to health care. If your doctor recommends a treatment that the insurance company refuses to pay for, you can contest the denial of service using a legal instrument known as a tutela, which you can file with any civil court. Although most civil cases languish on dockets for months or years, the law requires judges to rule on tutelas within three days, and they often rule in favor of patients.

How it Works

Colombia has one public health insurance company, Nueva EPS, and dozens of private companies. All Colombian policyholders have the same basic health care plan, which includes medical, dental, and vision care. Private companies offer premium policies that expand upon the basic coverage. For instance, basic insurance won’t cover the cost of LASIK eye surgery, but some premium plans will pay a portion of those costs.

All plans will cover you and at least one beneficiary—a spouse, minor child, dependent parent, or partner—at no extra cost. If you’re married and have three minor children, a single policy can cover your whole family. Dependent employees pay 12.5% of their salary—8.5% paid by the employer and 4% paid by the employee. Independent workers must pay the entire 12.5% from their own funds. Retirees also must pay the full premium, but they get a slightly lower rate—12%. Copayments vary by income level and break down as follows:

Healthcare Table in Colombia

If you’re paying an arm and a leg for health insurance, Colombia’s health care system probably sounds very affordable—and it is! I’m covered as a beneficiary of a basic plan. The primary insured works as an independent contractor, so we have to pay the full cost of the policy, $200 a month, $100 per person.

A Positive Experience With Colombia’s Health Care

Shortly after I enrolled, I received a call from a representative of the insurance company, Coomeva EPS, telling me that I needed to make appointments for checkups. Really? An insurance company encouraging me to use my coverage? First, I met with a nurse, who took my health history and checked my blood pressure. The service was included in the policy, so I only paid a $4.91 (the Tier II rate) copayment. Then, the nurse asked me what I wanted to do next. I opted for dental and eye exams, and she suggested blood work to check my cholesterol, triglyceride, and blood sugar levels. That sounded good to me, so I made all three appointments before I left the office.

Dental exams and teeth cleaning are included in the policy, so I only paid $4.91 on my first trip to the dentist. But, the dentist found four cavities. Argh! When I returned to get the first filling, I thought I would have to pay the copayment and 11.5% of the costs—since I’m a beneficiary. But I was surprised to learn that fillings are covered. So, an exam and four fillings cost me less than $25. Blood work, eye exams, and basic frames and glasses are also included in the coverage and only require a copayment. Since the policy covers the cost of many generic drugs, I’ll pay just $4.91 for most prescriptions.

I haven’t had extensive experience with the Colombian health care system, but so far, I’ve been pleased with the care I’ve received. The health care professionals I’ve dealt with seem just as knowledgeable and well equipped as their North American counterparts. And here, doctors spend time with me. I never feel rushed in and out of their offices, as I often did back home.

Colombia’s health care system isn’t perfect, but it’s beginning to attract a lot of outside attention. In a 2012 study of 190 Latin American clinics and hospitals conducted by América Economía magazine, 16 Colombian facilities ranked among the top 40. And medical tourism is becoming a hot industry here. Last year, 50,000 people visited Colombia to take advantage of lower costs on cardiovascular surgery, fertility treatments, dental work, cancer treatments, and cosmetic surgery, spending an estimated $216 million, up from $134 million the previous year.

Free Health Care Report:

Learn more about where to find the best-quality, most affordable health care in the world from our expert expats, who share their overseas health care experiences. Simply enter your email address below to sign up for IL’s free daily postcard e-letter and we’ll also send you a FREE REPORT – How Americans Save $15,000 a Year on Healthcare… by Looking Abroad

Get Your Free Report Here

No spam pledge. We value your privacy.

Visit link:
<b>Health Care</b> in Colombia: Top Quality and Affordable – <b>International</b> <b>…</b>

Travel Alert – Ebola Update West Africa – Travelchannelshows.com

The World Health Organization has issued this latest warning for U.S. Citizens traveling in the country of West AFrica.  This information is available to GeoBlue plan members from the GeoBlue website daily…

Ebola hemorrhagic fever update in West Africa Government Warning Issued for West Africa Category: 3 (Moderate)

Severity: 2 (Low)

Source: World Health Organization

07/24/2014 (Guinea,Sierra Leone,Liberia) – WHO continues to monitor the evolution of the Ebola virus disease (EVD) outbreak in Sierra Leone, Liberia, and Guinea. Between 18 20 July 2014, 45 new cases and 28 deaths were reported from Guinea, Liberia, and Sierra Leone. These include suspect, probable, and laboratory-confirmed cases. The respective Ministries of Health continue to work with WHO and its partners to implement outbreak containment measures.

Health sector response

The Regional Director, WHO African Region, began official visits to the three West African countries of Guinea, Liberia, and Sierra Leone on 21 July 2014. On the first leg of his mission, the Regional Director visited Liberia from 21 – 22 July 2014. The goal of the visit is to make a first-hand assessment of the EVD outbreak, review the current outbreak response and challenges, and explore the best ways to rapidly contain the EVD outbreak in West Africa. The Regional Director held official meetings with the President of Liberia and the Minister of Health, including senior government officials. The President and the Regional Director also participated in the Ebola national coordination meeting at the Ministry of Health. During this meeting, the Regional Director emphasized the need to step up implementation of key outbreak containment strategies, including community engagement and involvement, effective contact tracing, cross-border collaboration and effective coordination. Discussions were also held with international and local non-governmental organizations, UN agencies, and other stakeholders to enhance collaboration and effective coordination. The Regional Director called upon all partners to be fully involved in the EVD outbreak response. Following his visit to Liberia, significant financial contributions and commitments were made, including from the Government and partners.

In Liberia, the Minister of Health launched the national strategic plan for accelerated response to the EVD outbreak. The plan is aligned to the inter-country strategy for accelerated response to the outbreak, adopted in the Accra Ministerial meeting. It is expected that the launch and subsequent implementation of this strategic plan will bring tangible improvement and scale up effective outbreak containment measures at field level. Similarly, the Ministry of Health and partners in Guinea and Sierra Leone are conducting planning meetings to re-strategize and come up with concrete, action-oriented national operational plans to accelerate the response to the EVD outbreak response.

Efforts are currently ongoing to scale up and strengthen all aspects of the outbreak response in the three countries, including contact tracing, public information and community mobilization, case management and infection prevention and control, and coordination.

WHO does not recommend any travel or trade restrictions be applied to Guinea, Liberia, or Sierra Leone based on the current information available for this event.

Disease update

New cases and deaths attributable to EVD continue to be reported by the Ministries of Health in the three West African countries of Guinea, Liberia, and Sierra Leone. Between 18 20 July 2014, 45 new cases of EVD, including 28 new deaths, were reported from the three countries as follows: Guinea, 5 new cases and 4 deaths; Liberia, 28 new cases with 11 deaths; and Sierra Leone 12 new cases and 13 deaths. These numbers include laboratory-confirmed, probable, and suspect cases and deaths of EVD.

As of 20 July 2014, the cumulative number of cases attributed to EVD in the three countries stands at 1 093, including 660 deaths. The distribution and classification of the cases are as follows: Guinea, 415 cases (304 confirmed, 98 probable, and 13 suspected) and 314 deaths (204 confirmed, 98 probable, and 12 suspected); Liberia, 224 cases (77 confirmed, 68 probable, and 79 suspected) and 127 deaths (56 confirmed, 44 probable, and 27 suspected); and Sierra Leone, 454 cases (405 confirmed, 35 probable, and 14 suspected) and 219 deaths (182 confirmed, 32 probable, and 5 suspected).

Copyright © 2014 World Health Organization

Shop GeoBlue Travel Medical and International Health Insurance div.wpa>div margin-top: 1em; #google_ads_div_wpcom_below_post_adsafe_ad_container display: block !important;

Read More:
Travel Alert – Ebola Update West Africa – Travelchannelshows.com