Wednesday, June 15, 2022

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No Mandatory Health Insurance: Disadvantages

Why the U.S. never got universal health care

It takes a very savvy healthcare consumer to score discounts from providers, not all of whom will necessarily go along with such requests. Normally, insurance companies, not individuals, are the ones negotiating with hospitals and doctors to lower prices for large member groups.

The main drawback when health insurance isn’t mandatory, however, is the risk you assume when choosing the self-pay route. The downside of going health insurance-free could be substantial if you end up needing expensive medical care and you don’t have the money to pay for it from savings or your monthly income.

“You’re one major accident or illness away from falling into long-term debt, as medical bills can be quite excessive out of pocket,” Steiner says.

Many Lost Jobs Were In Industries That Did Not Offer Coverage

The job loss caused by the pandemic and resulting recession has hit some workers harder than others. Workers with essential jobs, such as at grocery stores or in hospitals, continued to report in-person; many of those employed by businesses forced to close to comply with social distancing guidelines were laid off; and some office-based employees were able to switch to working from home. Employees who were able to work from home during the pandemic were likely to have higher incomes and be more highly educated.13

Many of those who lost work over the past year were less likely to be covered through employer-sponsored insurance in the first place. The Congressional Budget Office estimates that an average of 14.3 million people had permanently or temporarily lost their job at any given point in 2020, but only half of those people had the option of employer-sponsored coverage when they were employed. Out of the 7.2 million people who temporarily or permanently lost their job in 2020 and had access to employer coverage, most retained some form of coverage and 1.3 million became uninsured.14 In addition to public insurance programs, some workers who lost job-based insurance may have been able to enroll in ESI through a parent or spouse.

What Will Health Insurance Cost For A Uk Expat In The Us

Of course, typical premiums for US citizens arent exactly the same as those for British expats. 

It all depends on your age, health, where youre going in America, and how extensive you want your medical cover to be. For instance, a young adult male moving from the UK to the US might expect to pay around $180-$200 per month for basic health insurance. 

Want to find out how much you can expect to pay? Start creating your own insurance policy with Cignatoday.

For example, the nations lowest monthly premium for a 27-year-olds benchmark plan was $282 , while the highest was $723 .

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Consumer Satisfaction With Health Care Systems In 3 Countries

One interesting question is whether people in various nations are satisfied with their current health care system. From the data several conclusions are worth mentioning. The first is that Canadians are most satisfied with their health care system. The Canadian health care system offers national health insurance financed by taxes, private production of health care services, and regulated budgets and fees for health care providers. Approximately 56% of the respondents in Canada believed the health care system requires only minor changes, and only 5% thought the system needs complete rebuilding.

How Being Uninsured Affects Your Life Quality And Finance

New U S Census Data Show The Number Of Uninsured Americans

Several studies have been conducted to determine how being uninsured is bound to affect the quality of life of individuals, including their overall financial well-being.

A healthy life entails regular visits to the doctor, to determine whether there is any pre-existing condition bound to cause trouble later down the road. Hence, being uninsured is bound to cause quite a bit of trouble. This is also due to the expensive costs associated with preventive and investigatory services.

However, being uninsured is worse in the case of a medical emergency that entails in-depth treatment and hospitalization. In situations like this, uninsured Americans often find themselves deep in medical debt that is difficult to repay; health insurance can play a vital role in drastically reducing spending, despite the monthly premiums.

Quality of life is linked to healthcare access; lack of health insurance also leads to increased stress and anxiety over what-ifs, as compared to people who are guaranteed medical coverage.

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Who Are The Uninsured

Most people who are uninsured are nonelderly adults and in working families. Families with low incomes are more likely to be uninsured. In general, people of color are more likely to be uninsured than White people. Reflecting geographic variation in income and the availability of public coverage, people who live in the South or West are more likely to be uninsured. Most who are uninsured have been without coverage for long periods of time.

Key Details:
  • In 2019, over seven in ten of the uninsured had at least one full-time worker in their family and an additional 11.5% had a part-time worker in their family .

Figure 4: Characteristics of the Nonelderly Uninsured, 2019

  • Individuals with income below 200% of the Federal Poverty Level 1 are at the highest risk of being uninsured . In total, more than eight in ten of uninsured people were in families with incomes below 400% of poverty in 2019 .
  • Most of the uninsured are nonelderly adults. The uninsured rate among children was 5.6% in 2019, less than half the rate among nonelderly adults , largely due to broader availability of Medicaid and CHIP coverage for children than for adults .

Figure 5: Uninsured Rates among the Nonelderly Population by Selected Characteristics, 2019

  • Nearly seven in ten of the nonelderly adults uninsured in 2019 have been without coverage for more than a year.2 People who have been without coverage for long periods may be particularly hard to reach in outreach and enrollment efforts.

American Health Insurance Vs International Cover: Whats The Cost Difference

International health insurance is a product designed to offer cross-border coverage. Many Americans are surprised by how affordable health coverage can be when they spend time overseas so how does this product compare to domestic cover?

At William Russell, our most comprehensive international health plans provide standard coverage in every country except the USA. Weve published a full guide on how we calculate premiums for health insurance. By comparing our typical premiums to U.S. averages, its possible to get an idea of the cost difference between health insurance in the USA and other nations.

Typical US health insurance costs in 2020The average William Russell international health insurance premium in 2020*
Individual cover

*Based on William Russell premiums in Thailand and Vietnam

We have a full guide on how much expat health insurance can cost in different countries, together with a list of most expensive and cheapest countries for health insurance.

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Germany Socialized Medicineoverview Origins And History

Germanys health care system has its origins in the mutual aid societies created in the early 19th century. The German system of social benefits is based on the concept of social insurance as embodied in the principle of social solidarity. This principle is a firmly held belief that government is obliged to provide a wide range of social benefits to all citizens, including medical care, old age pensions, unemployment insurance, disability payments, maternity benefits and other forms of social welfare. When Otto von Bismarck became Germanys first chancellor in 1871, hundreds of sickness insurance funds were already in operation. Bismarck saw the working class movement of that time as a threat. This concern led him to advocate the expansion of the existing sickness benefit societies to cover workers in all low wage occupations. In 1883, the Sickness Insurance Act was passed, representing the first social insurance program organized on a national level.

Top 5 States With The Most People Covered By Group Health Insurance

The real reason American health care is so expensive

The five states with the greatest total number of people covered by employer-sponsored health insurance are:

  • California 18,253,400 people or 47 percent of the state population.
  • Texas 13,126,800 or 48 percent of the state population.
  • New York 9,536,300 or 49 percent of the state population.
  • Florida 8,155,800 or 40 percent of the state population.
  • Illinois 6,675,200 or 53 percent of the state population.
  • Some of the largest and most economically robust states in the nation correspondingly have almost half or over half of their citizens benefiting from employer-sponsored health coverage.

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    What Is Being Done To Promote Delivery System Integration And Care Coordination

    The ACA introduced several levers to improve the coordination of care among medical/clinical providers in the largely specialist-driven health care system. For example, the law supported adoption of the patient-centered medical home model, which emphasizes care continuity and coordination via primary care, as well as evidence-based care, expanded access, and prevention and chronic care management.

    The ACA also expanded the Centers for Medicare and Medicaid Services ability to test alternative payment models that reward quality, reduce costs, and aim to improve care coordination. This trend has since been continued by public and private payers.

    One of these alternative payment models is bundled payments, whereby a single payment is made for all the services delivered by multiple providers for a single episode of care. Another trend is the proliferation of accountable care organizations . These networks of providers assume contractual responsibility for providing a defined population with care that meets quality targets. Providers in ACOs share in the savings that constitute the difference between forecasted and actual health care spending.

    Does Obamacare Apply To Expats

    In short: no. 

    Until January 2019, the obligation to purchase some form of health insurance applied to expats and Americans alike but President Trump had something to say about this, and he promptly changed the law. 

    Today, the US Government does not require anyone to subscribe to an ACA-compliant health insurance policy. However, a handful of states still impose a penalty on people who do not comply with the ACA. These are:

    • California
    • Massachusetts
    • New Jersey

    Other states are also currently processing legislation that will make health insurance compulsory, so before you move to America, check your new states laws.

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    What Are The Top Five Largest Health Insurance Companies

    The largest health insurance companies include Anthem, Centene, UnitedHealthcare, Humana and Health Care Service Corp. . These five companies represent nearly 44% of the total market share in the health insurance industry. Anthem is the largest health insurer by market share. However, UnitedHealthcare is the largest by membership and by revenue, with total revenue of over $257 billion in 2020.

    Up To 86 Percent Of Older Americans Have A Pre

    Obamacare.... how many people are uninsured???

    Not surprisingly, as people age, their likelihood of having or having had a health condition increases.  Looking only at pre-existing conditions used in determining eligibility for high-risk pools, the percentage of Americans with these health conditions ranges from 5 percent of children to 48 percent of people ages 55 to 64.  Adding in common conditions that major insurers generally use in medical underwriting raises the risk to 24 percent for children, increasing to 86 percent for people ages 55 to 64 .

    Translating these percentages into numbers of people, there are 4 to 17 million children under age 18 with some type of pre-existing condition.  Already, due to the new health reform law, insurers cannot deny coverage to children under the age of 19 based on a pre-existing condition a protection that would be revoked without the health reform law.

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    Coverage Trends Under President Trump

    Gains in healthcare coverage under President Obama began to reverse under President Trump. The CDC reported that the number of uninsured rose from 28.2 million in 2016 to 32.8 million in 2019, an increase of 4.6 million or 16%.

    The Commonwealth Fund estimated in May 2018 that the number of uninsured increased by 4 million from early 2016 to early 2018. The rate of those uninsured increased from 12.7% in 2016 to 15.5%. This was due to two factors: 1) Not addressing specific weaknesses in the ACA; and 2) Actions by the Trump administration that exacerbated those weaknesses. The impact was greater among lower-income adults, who had a higher uninsured rate than higher-income adults. Regionally, the South and West had higher uninsured rates than the North and East. Further, those 18 states that have not expanded Medicaid had a higher uninsured rate than those that did.

    Approximately 5.4 million Americans lost their health insurance from February to May 2020 after losing their jobs during the COVID-19 recession.The Independent reported that Families USA report “found that the spike in uninsured Americans â adding to an estimated 84 million people who are already uninsured or underinsured â is 39 per cent higher than any previous annual increase, including the most recent surge at the height of the recession between 2008 and 2009 when nearly 4 million non-elderly Americans lost insurance.”

    Types Of Health Insurance Plans

    When purchasing health insurance, your choices typically fall into one of three categories:

    • Traditional fee-for-service health insurance plans are usually the most expensive choice. They offer the most flexibility in choosing health care providers.
    • Health maintenance organizations offer lower co-payments and cover the costs of more preventive care. Your choice of health care providers is limited to those who are part of the plan.
    • Preferred provider organizations offer lower co-payments like HMOs but give you more options when selecting a provider.

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    Why Do Us Health Insurance Costs Keep Going Up

    The cost of US health insurance has almost doubled in a decade, as the table shows:


    Whats behind this trend is the subject of debate some argue government programmes, such as Medicare and Medicaid , have relieved providers of pressure to keep insurance affordable.

    However, its likely that some factors driving up the cost of healthcare in the USA may be similar to those in other countries, including population ageing and an increase in chronic illness. Check out how much medical treatment can cost abroad.

    At the same time, a shift towards high-deductible health plans is increasing the out-of-pocket costs for Americans. Under such plans, families can be asked to pay for their first $14,000 of medical costs, so the impact may be greater even if their insurance package costs the same overall.

    Irene Papanicolas
    Visiting assistant professor in the Department of Health Policy and Management at Harvard Chan School

    What Impacts The Rate Of Uninsured People In The Us

    Which Countries Have The Best Healthcare? | NowThis World

    At the moment, it is widely believed that Government-sponsored policies represent the main factor of influencing health insurance rates both in the US, but also in most of the worlds countries.

    4. An overview of the Affordable Care Act, or Obamacare

    With this in mind, its worth noting that the overall number of uninsured Americans first started improving back in 2011. As such, the most recent and most significant policy change was made in 2010 when President Obama fought to get the Affordable Care Act signed into law. The official version of the act is 906 pages long hence why we will try to offer a brief overview of the law, outlining its main goals, how it plans to achieve them, while also offering several Obamacare statistics. Before anything else, it is important to keep in mind that Obamacare was incredibly successful in increasing the rates of insured Americans and it has managed to achieve such an impact within only a few years.

    5. The main goals of Obamacare

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    Why Are Insured Americans Spending So Much Of Their Income On Health Care Costs

    Several factors may be contributing to high underinsured rates among adults in individual market plans and rising rates in employer plans:

  • Although the Affordable Care Acts reforms to the individual market have provided consumers with greater protection against health care costs, many moderate-income Americans have not seen gains. The ACAs essential health benefits package, cost-sharing reductions for lower- income families, and out-of-pocket cost limits have helped make health care more affordable for millions of Americans. But while the cost-sharing reductions have been particularly important in lowering deductibles and copayments for people with incomes under 250 percent of the poverty level , about half of people who purchase marketplace plans, and all of those buying plans directly from insurance companies, do not have them.4
  • The bans against insurers excluding people from coverage because of a preexisting condition and rating based on health status have meant that individuals with greater health needs, and thus higher costs, are now able to get health insurance in the individual market. Not surprisingly, the survey data show that people with individual market coverage are somewhat more likely to have health problems than they were in 2010, which means they also have higher costs.
  • Growth in Americans incomes has not kept pace with growth in health care costs. Even when health costs rise more slowly, they can take an increasingly larger bite out of incomes.
  • Why Is Life Expectancy In The Us Lower Than In Other Rich Countries

    The graph below shows the relationship between what USA as a country spends on health per person and life expectancy in that country between 1970 and 2015 for a number of rich countries.

    The US clearly stands out as the chart shows: Americans spend far more on health than any other country in the world, yet the life expectancy of the American population is shorter than in other rich countries that spend far less.

    What are the best places for healthcare globally?

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    Trends In Private Coverage

    The proportion of non-elderly individuals with employer-sponsored cover fell from 66% in 2000 to 56% in 2010, then stabilized following the passage of the Affordable Care Act. Employees who worked part-time were less likely to be offered coverage by their employer than were employees who worked full-time .

    A major trend in employer sponsored coverage has been increasing premiums, deductibles, and co-payments for medical services, and increasing the costs of using out-of-network health providers rather than in-network providers.

    Health Coverage For People With Disabilities

    QuickStats: Reasons for No Health Insurance Coverage ...

    If you have a disability, you have three options for health coverage through the government. 

    • Medicaid provides free or low-cost medical benefits to people with disabilities. Learn about eligibility and how to apply

    • Medicare provides medical health insurance to people under 65 with certain disabilities and any age with end-stage renal disease . Learn about eligibility, how to apply and coverage.

    • Affordable Care Act Marketplace offers options to people who have a disability, dont qualify for disability benefits, and need health coverage. Learn about the .

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    Sen Sanders Cites Study Findings On The Floor Of The Senate

    In arguing against the Better Care Reconciliation Act on June 26, 2017, Sen. Sanders said, The horrible and unspeakable truth is, that if this legislation were to pass, many thousands of our fellow Americans, every single year, will die, and many more will suffer and become much sicker than they should. He submitted the Annals of Internal Medicine review, published earlier that day, to the Congressional Record.

    Thirteen Million People In The Us Have Two Weeks To Apply For Free Health Insurance

      Thirteen Million People In The U.S. Have Two Weeks To Apply For Free Health Insurance

      • EmbedEmbed

      About 13 million uninsured people in the U.S. are eligible for free health insurance plans. They have two weeks left to apply.


      Free health insurance. If you are uninsured or you’ve been on unemployment benefits this year, please listen up. There’s new financial help passed by Congress earlier this year that means you might be eligible for health plans with zero – yes, $0 premiums. As of today, there are two weeks left to enroll during the pandemic special enrollment period, so we’ve brought in NPR health policy correspondent Selena Simmons-Duffin to explain. Hello, Selena.


      GARCIA-NAVARRO: All right. I got to tell you free health insurance doesn’t sound like a real thing. How is it even possible?

      GARCIA-NAVARRO: All right. So we know there are around 29 million uninsured people, still, in the United States. How many of them qualify for one of those plans?

      SIMMONS-DUFFIN: Almost half.


      SIMMONS-DUFFIN: So the nonprofit Kaiser Family Foundation estimates about 13 million people who are uninsured qualify for $0 premium plans.

      GARCIA-NAVARRO: So this is really news you can use.


      GARCIA-NAVARRO: But free plans might mean not very good plans. I mean, we’ve heard about these lower-tier plans perhaps not being the best, you know, quality. How much do these actually cover?

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        Dont Have Health Insurance Whats The Worst That Could Happen

          While the number of uninsured Americans has dropped, many people still dont have any type of healthcare insurance coverage. The passage of the Affordable Care Act allows millions to choose a government-subsidized healthcare plan. However, many consumers are ineligible for subsidies, and many of those who qualify have chosen not to participate. 

          In 2018, according to a report by the U.S. Census, 8.5 percent of people, or 27.5 million adults , did not have health insurance at any point during the year. Census findings showed that the uninsured rate and number of uninsured increased from 2017 .

          As of 2019, individuals and families without insurance are no longer taxed, due to the repeal of the tax-penalty portion of the Affordable Care Act.

          Us Health Insurance Statistics

          Are US health insurance companies covering COVID-19 patients?

          1. Around 49% of the countrys total population receive employer-sponsored health insurance .

          Health insurance coverage statistics show this to be the case and most of the group insurance may include life, health or some other type of personal insurance coverage.

          The highest percentage of state residents that benefit from group insurance are currently working in the northeast and midwest regions. Utah and North Dakota top this list with more than half of their residents being covered by group insurance.

          Additionally, California, Texas and New York respectively have the highest number of individuals receiving employer-sponsored health insurance in the United States. This is primarily because these are large and economically strong states, with almost half of their populations having group insurance.

          2. In 2019 most US states eliminated the individual mandate penalty. 

          This is part of the many health care economic issues faced by the country today. People were concerned about paying penalties, which is why at the end of 2018, the penalty was reduced to $0 and will remain so throughout 2021. 

          There are, however, penalties in 2021 for not being insured in the states of New Jersey, California, Massachusetts, Rhode Island and the District of Columbia, unless you are eligible for an exemption. The penalties everywhere else are removed but the original individual mandate still exists.

          5. Roughly 21% of Americans were insured by Medicare in 2019.



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          No More Tax Penalties

          In 2018, the ACA tax penalty was $695 for adults and $347.50 for children, or 2% of one’s annual income, whichever amount was more. However, on December 22, 2017, when President Trump signed the Tax Cuts and Jobs Act, it repealed the ACA-related tax on Americans who refuse to purchase health insurance.

          As of 2019, Americans without health insurance are not taxed by the government. However, individuals and families who choose to go without health insurance do so at their own risk.

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