Types of health insurance

health insurance
health insurance

However, the application of any type of health insurance is better than the complete absence of insurance, because the alternative to insurance is the direct payment, which causes the face of low-income problems of high costs For health services, and if the need for health insurance is recognized even among non-specialists, it is important to know the various types of health insurance applied worldwide and the characteristics of each type so that we can devise the most appropriate mechanism for our Yemeni society. Health in the following: -

Comprehensive health insurance systems.

These systems are based on the payment of the costs of processing expenses through the general taxes collected by the citizens. The contribution to these systems does not depend on the extent of utilization of the health services but on the mechanisms used to collect taxes. These systems achieve some justice if the taxes are collected gradually, So that the poor can benefit from the high taxes paid by the rich, while on the other hand, when relying on other taxes such as the sales tax of goods and services taxes, they harm the poor and do not affect the poor. Cure.
While the most prominent feature of these systems is the inclusion of all citizens in one risk portfolio as a result of the mandatory tax payment even theoretically, it is noticeable in developing countries that taxes are burdensome to the average and low-income while providing services to the potential. The main problem remains that these systems are often accompanied by low Of the level of health services provided and low efficiency due to economic reasons (such as inflation, the shift of staff to non-government jobs and the weakness of tax systems), making the taxes collected from workers in many countries limited, as well as the continued decline in income of some governments Leading to their inability to afford health services And thus the emergence of semi-special health systems characterized by low quality and effectiveness, and also leads to the outbreak of irregular payments, which is a natural result of the low budget allocated to treatment and low income level of health providers, which drives the beneficiaries of the health services of asylum to pay for the informal level of better Of services. Informal payment is therefore an aspect of health systems that are not adequately funded or adequately managed.

Social health insurance

This type of health insurance emerged in Europe in the late 19th century, expanded during the 1930s in Latin America, and has emerged since the 1990s in Eastern Europe in the so-called Soviet Union, as has also emerged in some developing countries, but often covers government employees and those Who usually follow the compulsory membership of limited groups by contributing part of the salary to limited benefits. This is often part of a broader social system such as social security, retirement, etc. However, it is always recommended that Min Social Health has an independent budget and management because no other type of insurance Accompanied by health insurance is often adversely affected by the disbursement of pooled amounts of insurance on account of health insurance, and even many social health insurance systems can not continue without additional support from governments.
The probability of success of this type of insurance is greater when it is based on previous comprehensive tax systems, and it is easier to spread in high-income countries. For example, the prevalence in Thailand was 13% in a decade, Because income levels in Thailand are three times higher than in India and Argentina, the prevalence of social health insurance is more than twice the rate in Mexico, although it began to apply in both countries about eight decades ago because Argentina's income level of $ 8,000 per capita per year About double the level Income in Mexico, which does not exceed four thousand dollars per capita per year,The chance of success of this insurance is also greater in the industrialized countries, where most of the workers are in enterprises, companies, factories and laboratories (government and private), whose population is concentrated in limited areas, so that it facilitates the delivery of health services.
On the other hand, the situation is quite different when the social health insurance system is applied in agricultural countries where informal workers (whose contributions are difficult to collect), where the population is scattered in scattered areas, are more difficult to complain about administrative weakness and entry level Where it is difficult in such countries to be covered well, so we find that a number of countries believed that the social health insurance will solve their problems, but the results disappointed expectations, so it was natural to find some countries in Latin America began this type of insurance since the thirties Century Doanh and insurance coverage is still low as in Bolivia, El Salvador and Albarjoa (coverage ratio between 11-18%), because the per capita income does not exceed $ 1,500 annually (Although this income is considered to be twice the annual income level in a number of Arab countries).
To try to increase the effectiveness of this type of insurance, it is recommended that it be managed through an independent body whose board consists of the government, representatives of the community and representatives of health providers (public and private), so that this body will be responsible for collecting and distributing health allocations to service providers, Efficiency of service providers, while the role of the Ministry of Health remains limited to policy development, planning and management of national programs, pricing and licensing of health services provided.


Community Health Insurance (Optional)

This type of insurance for social health insurance differs from the fact that community insurance is optional and therefore its use is limited. It targets workers, farmers and entrepreneurs so it can be used for those who are not covered by other types of insurance. It is difficult to put this type of insurance in a specific pattern, It is different in the same country from one region to another, as in Vietnam and Thailand. The most important differences are the differences in the benefits offered by these insurance programs. At the same time, we find programs that deal with the most expensive cases, In order to protect patients from high costs, we find other programs that deal with low-cost cases (such as visits to health centers) With the aim of raising the level of health services provided, which are usually used at the village level.
Community insurance schemes are based on household payments, so they target middle-income rural areas rather than the poorer areas, because premiums will not be able to pay the cost of benefits for their limitations. In response, it is common for these systems to cover community insurance as part of the cost of services. Cover the rest of the cost through donor support, CSO cooperation and patient engagement, and some villagers help build clinics to reduce costs for infrastructure.
The success of these insurance systems can be increased by being part of a wider development program, in addition to reorganizing health services in the regions, reducing the misuse of services, and coordinating various local programs to benefit from each other in design, training and information systems as in the Philippines. It is very important to include the community in the design of insurance programs from the early stages and formulation in a way that makes it accessible to society, it raises the degree of interest of the community and encourage them to participate.
The risk distribution in this type of insurance is limited because it is restricted to limited areas, but when compared to direct or non-formal payments, community insurance is better for distribution among a limited group, and it is difficult to cover full health services (always with specific exemptions and ceilings) Services are often improved over time, especially if the benefits are designed in an attractive and accessible manner, taking into account the balance between priority, need and enforceability.
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