Social insurance system

It seems likely that in the future we will need to tackle health problems from an angle that has more in common with the idea of a social insurance system. System for a better interlocking of ultimate objectives and health care services between public and private actors, and between different public actors, all politically legitimated throughout the territory, and for their better coordination, crucial for the success of ary health policy. Insurance because of the inescapable nature of the idea of specifying levels of health care coverage and... 

The MHW sets prices for reimbursable drugs (those approved for the Social Insurance System). Physicians, clinics, and private hospitals are reimbursed at a price slightly higher than their actual acquisition cost. The government has scheduled annual reductions in the reimbursement prices to reduce this source of additional income to physicians. Patients make copayments of 20%, although for children and low-income elderly the copayment is waived, and recently a plan to eliminate copayments for persons 70 years of age and older was introduced. 

These similarities are offset by contrasts in their health insurance arrangements, access of patients to the political process, the authority wielded by physicians, and social insurance systems. For example, health care in the United States is generally seen as a private good associated with individual choice and the availability of menus for insurance, thereby rationing care by price. In Germany, by contrast, health care is seen primarily as a right or entitlement. It serves as an instrument of broader social justice, and rationing, if at all, is controlled by providers on a local and individual level. 

The question is whether discussions of the future of the social insurance system make enough allowance for the fact that the system also provides for people affected by incidents and damage in the domain of physical safety. 

Social insurance net of contributions (that is, amount corresponding to tax-financed coverage of the deficit in the social insurance systems)... 

Health-related programs usually fall under the auspices of the ministry of health or the social insurance system and are administered locally in the case of community financing schemes. The individual point of service (clinic or hospital) may or may not be reimbursed... 

There are two medieal insurance systems in Japan Social Insurance System for those working at a company or an office and National Health Insurance System for those not covered by the Social Insurance System. The hospital receives individual payments from patients and the remaining medical service fees from the medical insurance system. The fees are established for the rental rate of the equipment such as a ventilator and a humidifier. TTie currency has been converted using a rale of 110 to the US. ... 

In countries with an existing (social) health insurance system, it is usually rather simple do receive a close-to-reality estimate of the provider Costs-of-Illness. The insurance pays the bills of general practitioners, specialists, hospitals, pharmacies, laboratories, etc. so that the total costs per patient can easily be determined. However, in some countries we cannot receive this data, and sometimes confidentiality regulations do not permit the transfer of insurance data, so that, for instance, provider costs of difference phases of HIV/AIDS can be calculated. In this case, a sample of patient files has to be analyzed with permission of the patients so that the provider costs can be recorded. 

However, these results are not applicable to compulsory pubhc insurance, nor to National Health Systems. The most notable differences between drag co-payment in an insurance market and in a National Health System or compulsory public insurance environment lie in their voluntariness or otherwise (users ability to choose their coverage) and the ultimate financing of the services (risk-adjusted premiums as opposed to taxes or social insurance contributions adjusted according to economic capacity). Hence, in compulsory public insurance systems, co-payment regulation is used not only as a health policy instrument but also as one of redistribution of income. 

All advanced industrialized nations except the U.S. have a system of universal health care coverage. The coverage is a form of social insurance that assures that all citizens have access to health care services and are protected from financial devastation as a result of illness or injury. Under these systems, the national government assures that its citizens have health care coverage. Beyond assuring that all citizens are covered, rmiversal health care takes a different form in each country. There is wide variation in the forms of financing, administering, and delivery of health care. 

Medicare is an entitlement program and serves all eligible beneficiaries regardless of income or medical history Like Social Securify, Medicare is based on a system of social insurance. Medicare is composed of two programs. Medicare Part A covers inpatient care in hospitals and skilled nursing facilities. It also covers hospice care and some home health care. Part A is financed by a 1.45% payroll fax paid by bofh employees and employers (2.9% for self-employed persons). Currenf employers and employees pay for the health care of current Medicare beneficiaries, wifh the expectation that when they reach age 65 they will receive the same benefits. In the U.S., when people turn 65 years of age, they are automatically eligible for Medicare s Parf A, and they do not have to pay for the hospital insurance if they, or a spouse, paid Medicare taxes when they were working. 

The social security system covers health services for government employees, managed by the Social Insurance Institute of State Employees (ISSSTE), and for private-sector workers, managed by the Mexican... 

Martikainen J, Rajaniemi S. 2002. Drug reimbursement systems in EU Member States, Iceland and Norway, Helsinki The Social Insurance Institution, Finland, Social Security and Health Reports 54. 

The social security system covers health services for government employees, managed by the Social Insurance Institute of State Employees (ISSSTE), and for private-sector workers, managed by the Mexican Social Security Institute (IMSS). The two agencies operate their own networks of hospitals and clinics and provide similar benefits. Some other smaller social security agencies exist, providing medical services for special groups such as the army, navy, and state oil company personnel. 

Although Germany has a long-standing reputation as a passive welfare state with elaborate schemes of status-protecting income replacement through social insurance in case of unemployment and a full-blown system of active labour market policies, all benefit systems had formal elements of activation and work requirement - but they had not been enforced systematically. 

Social security system, labour law and unemployment insurance... 

Securite sociale, introduced in 1945, includes the traditional branches of social insurance (assurance sociale), and thus forms the core area of the French social protection system (Barjot et al. 2004). It was largely conceived on the basis of the social insurance principle, but simultaneously shaped by universalistic principles of coverage for the entire population. With the introduction of universal health insurance, couverture maladie universelle (CMU), the latter notion was put into effect for this branch of insurance. The formerly envisaged aim to incorporate under one regime (regime general) all individual protection schemes which existed at the time securite sociale was established was never achieved. Hence, the social security system continues to be characterised by both diversity and disparity. 

Assistance is a convenient word to present French programmes in a comparative perspective. However, the French distinction between assistance (it would rather be "aide et action sociales outside unemployment insurance and regime de solidarity within) and social insurance, i.e. social security, is not functionally the equivalent of the distinctions in other countries. We will, however, use it by way of simplification, in full knowledge that systems cannot be understood only on the face of universalistic simplifications. 

The fragmentation of the social security system and the presence of different actors whose interests are not always compatible constitute an obstacle to the development of a coherent activation policy. The biggest difficulty lies in the coordination of four schemes that are at the core of activation unemployment insurance, social assistance, invalidity insurance and sickness insurance. 

The entry into force in 2005 of the third AVIG/LACI Revision established the statutory requirements for inter-cantonal and inter-institutional cooperation. Thus, on the one hand, the cantons have been authorised under Article 85e AVIG/LACI to operate joint institutions, notably the RAV/ORP. On the other hand, their cooperation with the bodies of other social security systems, in particular social assistance agencies and IV/AI offices, are now permitted under Articles 85f AVIG/ LACI. These forms of cooperation are likewise intended to make the unemployment insurance system more efficient and to counteract the previous rigidity of the labour market integration framework (Nussbaumer 2007 2461-2462). 

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