Health care in America .. Who provides it and who pays the cost .. And how we will Istlhmha
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| Health care in America .. Who provides it and who pays the cost .. And how we will Istlhmha |
But some of these treatises are based on inaccurate information .. Because the ruling on the branch of his perception I like to give a simple explanation as far as possible about the US health care system .. I say simplified because it is really complicated and the details are endless and most of the generalizations that we see around him is incorrect.
It is not true, for example, that everyone has health insurance. It is not true that those who do not have health insurance do not have treatment. It is not true that the health services are provided by an exclusive private sector. The truth is a mixture of all this and to understand it, we must dismantle its interlocking threads. Is the separation between two important and fundamental things .. The first is the health care providers themselves .. ie clinics and hospitals .. The second is the providers of health coverage service .. In other words medical insurance.
Health care providers can be divided into two main categories: First, small clinics or hospitals ranging from one doctor to a specific specialty to several departments with different specialties and services. The second is a large hospital with a majority of specialties, advanced services, specialized treatment and even research centers.
Most of these clinics operate in coordination with major hospitals and under its umbrella, despite being owned by the operators and despite the difference of purpose between them.
The aim of these clinics is primarily profitable, although some doctors provide voluntary services to low-income people by allocating a proportion of their services to this category free of charge and some of them are offered free of charge but at the expense of charities coordinated with them (the charity society tells him that we can treat 5 patients per month, for example). Every month, 5 of those who cheat you, and when they have insurance, do not pay money and cover their expenses. But this does not take them out of the lucrative profit sector.
In addition to these clinics there are other free clinics dedicated to the service of low-income .. Some of the government follows either the city or the province or even the state and some belong to charitable societies or religious organizations .. The Islamic Society of Greater Houston, for example have clinics .. Services of these clinics and their potential but limited presence is necessary The only option for some categories.
The second category is the large hospitals, the vast majority of which are non-profit. Few of them are directly owned by the government, some are indirectly owned by the government, and the rest are either independent or affiliated with non-profit private universities. Religious .. The majority of major hospitals known internationally and locally in America fall within this classification is the best provider of specialized health service as it is the pioneer in the development of medical science and treatment methods in the world.
But it should not be confused .. Being a non-profit does not mean that it offers its services free .. It does not earn profits because its expenses are greater than its income is covered by a mix of direct and indirect government support and donations from various quarters .. And if found to have a surplus financial reinvested In expanding the scope of the service or even re-donating it to other non-profit entities with less material capacity.
But in spite of all this, it is very expensive. The health service in America is generally very expensive. It is advanced but its cost is more expensive than that of other countries by a significant margin. The major hospitals are the most expensive.
There is also a health system for ex-combatants or ex-servicemen. They have their own independent hospitals, which offer their services exclusively for free. There are also military hospitals that provide services to the current military and cooperate with other health services in some areas and situations.
After we gave an overview of the structure of the health service delivery sector, we can clearly see that although there is a free service provider for specific sectors or for all, although a large percentage of it is not for profit. And in return for a high .. Rarely can any person to bear in the event of an emergency or sick or chronic illness.
How is this cost covered? Who pays for it ??
The answer, as we mentioned at the beginning, is the providers of insurance coverage services. Medical insurance in America is also very complex and intertwined, and many parties enter it and we will try to dismantle its threads.
The insurance services can be divided according to the provider whether it is the government or the private sector. Each of these categories can be divided according to the method of obtaining coverage.
Government insurance is of two types. The first is limited because it concerns state employees. The employees of the federal government (about 3 million) have medical insurance provided by the government, which has a uniform system regardless of the place of work or residence. The military also have their own insurance. In other government entities, whether states, provinces, cities or otherwise, they usually have the most medical insurance, although each side offers its own programs. Government medical insurance is often good for coverage and tolerance, and government agencies often pay the full premium Or at least a good proportion of it.
But this program is limited by the fact that workers in the government sector represent a small percentage of the population.
The government also provides insurance services for citizens, but it is not a general one for all. It is limited to two programs under one umbrella. The first is the Medicaid and the second is the Medicare.
The first is for the very poor. We are talking here about a group whose income is less than 15 thousand dollars a year. This category is not only poor but poverty-stricken. The program is considered one of the parts of the social safety net. Its service is reasonable. It is necessary that the person be very infirm.
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But it also covers the wider categories in certain cases often emergency. For example, 50% of births in America are covered by the cost of it .. It also covers some cases of emergency and emergency .. That it exists for major calamities only does not include the citizen coverage only And with multiple conditions. There is no special tax for financing, but it is funded jointly by the federal government and the states, where the federal government bears the largest share of funding, while the states bear the largest proportion of employment.
The second program is the Medicare .. Medicare coverage is fairly good .. like anything else in America has categories, details and complex regulations .. But in a simplified coverage is good and worthy of any citizen aged 65 years .. There is a federal tax special funding for this program paid by any worker In America, whatever his age and place of work, he currently accounts for 2.9% of his work between the worker and his employer (ie, anyone who works in America is small or large, citizen or expatriate, pays 1.45%
This program is similar in one way or another to the Canadian and British health care program, with the difference that it covers the specific Senya category. The idea is called single payer, meaning that the provider of insurance coverage is one and includes everyone without exception and is financed by everyone without exception .. The liberals demand that the program be distributed to all citizens without exception They use the term Medicare for everyone sometimes to describe their demand. But large sectors oppose this and the intellectual debate between supporters and opponents is long and each has a long list of justifications for its positions.
The second section is the medical insurance provided by the private sector .. This is also divided into two parts .. The first is the insurance that is obtained through the employer .. The second is purchased by the citizen from the insurance company directly .. Each has its own complex organizations.
Insurance provided by employers is the umbrella that includes the largest proportion of citizens and residents in America, so its legislation is the most important and most sensitive.
The employers were not forced to do anything about the medical insurance of the workers before Obamaker .. It seems that it will return after the end of the current Congress of work on this project .. But most of them keen to do so even before Obamakir .. The submission of the employer of medical insurance The worker does not mean that he gets an insurance card that offers comprehensive coverage and salvation, as is done in Saudi Arabia, not before Obamakir and not after it. It is more complex and detailed and the behavior of the organizations is different.
What happens is that the employer first negotiates with the various insurance companies to obtain a specific offer to insure their employees and their families. The offers that companies can get are different. Before Obama, this was absolutely optional, whatever the size of the company. After Obamakir, It has more than fifty employees forced to take this step .. Of course, the details of Obamakir and what is left or left in this area is complex and this is not the subject of discussion.
After the company gets the insurance offer it has two options. The first is to pay the full cost and give the cards to the employees. This is similar to what happens in Saudi Arabia, but it is rare and is usually practiced only by very large companies and specific categories of employees only.
The second option is that the company offers insurance to the employees .. and choose them to get it or not .. Here some companies to pay nothing at all .. In the sense that the employee pays the entire value of insurance through the deduction of his salary .. Some of them bear certain ratios, such as to pay half the cost For example, the company pays 70% to insure the worker and 40% to his family members or even nothing to them or any other divisions and percentages determined by the company .. Deductible from the salary of the employee is exempt from taxes Companies also receive certain tax advantages for their contributions.
Employees often seek insurance through work even if the employer does not bear any proportion because the laws governing it are better than the commercial insurance, which is purchased by the citizen directly .. And it is more often the price is cheaper because the company can obtain insurance offers better than Which individuals can obtain.
Therefore, the insurance offer offered by the employer is one of the most important sections of the job offer and is an important factor in the evaluation of the next work for the various job offers offered to him .. But the cost of insurance is really high .. Studies built by Obamakir reached the minimum is 9 .. This means that you pay 9% of your income in return for covering 60% of the costs of your treatment. Of course, this is very general, and it contains a lot of details that make it short, but it gives an idea of how high the cost of health care is in America One of the main points of political conflict between the various parties and why all concerned Almost community categories.
Finally, regarding the specific situation in Saudi Arabia, I can not claim that I do not have any specific information. But what I will quote here is my own conclusion, On the other hand.
I think that the adoption of the American experiment is in two things. First, the government abandons the provision of health services directly. That is, the state stops managing hospitals as government entities with budgets and no income. These hospitals become non-profit organizations that are financially independent and fund themselves. By charging for services and being in competition with the private sector.
The competition here will not be direct because the government hospitals will be similar to the major non-profit hospitals in America while the private will be similar to the commercial profit sector .. The fact that although both hospitals but the service provided vary and determine your destination which depends primarily on the quality of your health needs. For a moment, it is not your preference to serve government hospitals on private or vice versa.
On the other hand .. This is the second thing .. The citizen will not pay to hospitals directly for health service .. But it will be through insurance companies .. Private sector employees actually get medical insurance .. The change will be for government employees and free workers (traders, His request or unemployed etc.).
These will be provided with special government insurance programs either directly through the state or through the establishment of a private medical insurance company wholly owned by the state and guaranteed profits such as the electricity company (for example, even if it is not a contribution).
In this way, the state will continue to bear the cost of health service to citizens by providing them with medical insurance while ensuring the efficiency of spending and performance of government health services because they will be responsible for financing themselves by billing their services will have to reduce financial waste and improve the service for sustainability. Without lowering the level of performance.
But this all put my theory .. Beautiful yes .. But the theoretical .. The real rule is after the application when the detailed legislation of the announcement first and applied and judge the efficiency of the second .. This organization, if formulated in a good manner and executed accurately and efficiency accepted will represent a significant shift in the level and method The provision of health services in Saudi Arabia .. But the gaps that can occur in such a large and very large and can turn into a nightmare that lies on the shoulders of the citizen .. We have only to wait and pray for the success of the planners and implementers to this transition to the best of the country and the people.
And you,
Ahmed Al-Hanti
Houston .. Texas
9 July 2017
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