Numerous countries and associations, organizations, and even ordinary people favor the concept of medical insurance or health insurance, given the benefits that are derived from being covered for injuries and illnesses; (Health insurance) has been one of the most significant health-related projects that a vast amount of nations and organizations are proud to have achieved in achieving the most critical strategic goals at the financial, health and developmental levels as well as in promoting social solidarity between themselves.
So, what exactly does health insurance mean? What are its advantages for people with insurance, and what are its benefits for sponsoring countries and institutions? And why do many governments and institutions choose to adopt it? Why is this health insurance system not implemented in many nations, especially in economically poor ones, even though they require funding outside of the budget for the high health expenses?
Health insurance is described as (that kind of insurance that covers illnesses and health risks that could affect individuals and will cover the cost of medical assessment, diagnosis, and treatments) as well as according to the World Health Organization defines it as (a method of paying a portion or all the costs of health care. It safeguards the insured from having to pay the entire price. The basis for health insurance lies in that an “insured” beneficiary pays a regular fee to an administration institution accountable for managing the payment within an arrangement to pay medical expenses to health care providers.
Health insurance typically comprises three major parties. These include the person who is insured (the insured) as well as the insurer (the insurer) and the clinic or hospital (the medical service company). Every party is entitled to their rights.
Health insurance is a great benefit. One of its advantages is that it helps finance the astronomical healthcare sector expenses. The world cannot pay for health care expenses without the involvement of society. It helps achieve economic, psychological, and social stability for specific categories of workers and employees who work in the private sector. It also helps improve the quality of healthcare services offered to the general population and ease the burden on health facilities in the public sector.
The health insurance system is founded on the notion that some individuals may fall sick and be unable to afford their treatment or, in the case of some patients, pay only a portion of the cost and cannot pay for others. Additionally, the state that has to cover the cost of treatment, in principle, cannot cover the costs for various reasons. Or, it can only afford essential medical services, like offering health facilities or hospitals and paying salaries to nurses, doctors, and other workers in the health field as well as providing necessary medical treatments, but is not capable of providing all the needs for the treatment of different ailments and all people.
One way of ensuring the treatment of patients who are unable to pay for the cost of treatment costs is to collect many citizens like the workers in the Ministry of Commerce, for instance, and create an account under its designation (Health Insurance Fund) that each of them agrees to pay a specific monthly fee in his pay for benefits of this fund subject to the condition that the fund for his treatment or a part of it based on the internal structure for the funds in case of his sickness.
Or, the locality members get together and decide to create funds for them. Each member pays a set amount monthly, quarterly, or yearly. Themselves.
The state, as the one accountable for the health of its citizens and providing them with health care services and health care, can require all of its employees to deduct a portion of their monthly salary as a legally regulated percentage, for example, 1, 2, or 1 percent, and the funds are put into the account of the body created for this reason, provided that the body pays for the costs of treating employees who are sick or suffer injuries that impact their health. The bodies and funds, which are non-governmental or governmental, can invest the funds in projects that are beneficial to the insured, like the establishment of special health facilities for the insured, as well as providing extra social or medical services that are beneficial to the insured. This is an economic system based on the cooperation and cooperation of people to shoulder what one of them cannot bear.
However, (health insurance) contributes to providing a financial resource to help finance the expensive healthcare sector. It also reduces the burden on general budgets of the governments or institutions, corporations, or individuals accountable in the care of employees and their families, as is evident through the experiences of the wealthy developed nations that no one will be able to do this, regardless of how its economic strength has risen to the extent of covering the enormous health sector costs without the involvement of the people who benefit by these programs.
Research studies that have examined the benefits associated with (health insurance) have proved that implementing health insurance plans will deliver the highest quantity of healthcare services to the population. In addition, it will provide a significant incentive to provide high-quality healthcare services that keep up with the advancements in technology worldwide and also help increase the competition among medical providers. This lowers the cost of healthcare on the part of the individual and family and eases the burden placed on public hospitals, and improves the quality of their treatment.
However, the reverse is also true. In the absence of (health insurance), the patient will orally suffer with his condition or resort to selling his home and assets, take loans from friends or relatives, or be forced to engage in illegal and unjust actions to get the funds needed for treatment. Examples include embezzlement and theft, extortion, and other activities that may help him pay for a portion of the cost of the treatment.
While many countries adopted the health insurance system and made significant progress in establishing the core of the health insurance system, a few eventually abandoned this concept. Perhaps one of the main reasons is due to the demands for the International Labor Organization, which was founded in the latter part of the 20th century, and called for “medical services” for all citizens of society” (one of the responsibilities of government in the sense that it is one of the essential public services that are viewed as an insurance (or the health insurance). The development of the concept (that treating illnesses and improving the standards of health generally isn’t something that only the wealthy demand as disease impacts all people, however, it is more prevalent in cases of poverty because of malnutrition and inadequate life circumstances … and on. If a person or family can’t afford insurance due to poverty, unemployment, or another reason, they are at risk of being afflicted by various diseases and illnesses).
Maybe these issues and others have prompted some capitalist societies, like Britain, to drop commercial health insurance and to work towards tying the income of an individual with his capacity to avail medical treatment by establishing the idea of offering medical care for all citizens without distinction as one of the roles of the government which determine who it’s an obligation to meet the necessities of its citizens as a right acquired by them.
The health system remains in direct contact with the government. It is accountable for each citizen’s overall health and well-being and, in theory, responsible for providing health services for those who require these services. It is expected to provide health services to all of its citizens, in all cases, through health centers, hospitals, and medical clinics. However, the government is usually in a position not to offer all the health services or provide these services at the appropriate level.
Due to the insufficient healthcare services provided by the government on the one hand and the increasing costs of healthcare services offered by private hospitals on the other, the state has designed the health clinic system and private wards. These are specially designed areas within every health center or hospital that provide high-quality medical care compared to hospital services. Itself. It is treated with particular respect and specialized care for patients because they pay for their treatment. These costs are significantly less than the expenses of private hospitals. However, who will pay her excessive salaries or sell her savings to receive practical and effective medical care?
In this way, the state urged government ministries to set up health insurance plans for employees and their families to pay a portion of health costs by deducting a per-month amount of cash (optional). Recently government ministries like the Ministry of Interior, Youth, and Defense have implemented the same. However, they’re still in basic beginnings and haven’t been improved. Moreover, due to the level of service offered to employees, many employees cannot get the money or even a part of the money they spend for treatment or circulation.
In 2020, Health Insurance Law No. (22 from 2020) was passed in 2020. According to this legislation, the definition of health insurance (is health services offered by governmental and private hospitals, such as exams, analyses, medications, and surgeries for citizens under a contract between the Health Insurance Authority and the hospitals).
The law also calls for the creation of a HICA (Health Insurance Authority) within the Ministry of Health, intending to provide extensive health insurance coverage for the insured and achieve the principles of social equity and solidarity, decreasing financial burdens on people and reducing poverty, increasing sources of financing for the health sector, and establishing an environment conducive to competition and enhancing the performance of employees as well as health institutions in the private and public sectors, as well as improving the quality of medical care offered by regulating the work of both the private and public sectors, encouraging competition in the field of medical services, and encouraging private sector participation and investment in the area of healthcare (Article 5.).
The monthly installment paid by the head of the household includes the following categories, and they are not required to pay this monthly amount. (A husband or wife. B – Children under the age (of 21) years and those who continue their studies until the age (of 24) years. C – Single, unemployed or widowed, divorced or divorced girls. D Parents (if they aren’t working or are retired). E Sisters Single women (other than female retirees and employees) (Article 28/First).
In terms of healthcare coverage rates, the law imposes specific percentages that people covered by the law have to pay out of the value of medical treatment, the costs of x-rays and laboratory services, and dental surgeries. For example, the law’s beneficiaries have to pay the following percentages of surgeries (10 percent of the cost of surgical procedures that are performed in public hospitals (private wards that are part of the system of health insurance), 25 percent of the expense of surgical operations that are performed in private hospitals) But, the law is not yet in force. Is not yet been implemented.
From the above:
1. Human societies are experiencing an exponential increase in numbers. However, despite the incredible growth in the health field, this has not stopped the spread of various illnesses and epidemics resulting from human activities that threaten the environment. This is a cause for concern for all governments.
2. Despite the proliferation of private and public medical centers as well as hospitals,
patients are still not receiving the required medical treatment due to inadequate services, such as within the public system, or expensive costs, which is typical for the private sector.
3. The concept of health insurance is
one of the most critical medical and social ideas that could help to cover a portion of the costs of treatment for people who don’t have the funds to pay for the cost of treatment, or a part of it, in particular in the case of the poor or those earning a living are exempt from paying for fees and subscriptions.
