Health Insurance
Health Insurance
Introduction
Health insurance, which can be either public or private, is the kind of insurance that covers a
person's whole medical expenses.
Public health insurance covers the medical needs of the entire country's population.
Lower total cost of healthcare: The cost of medical care would be regulated and negotiated by
the government. Additionally, since doctors would only have to deal with one government entity,
administrative costs could perhaps go down.
Remove obstacles to education relating to health: Children with unidentified and untreated
medical conditions might not benefit fully from education
Encourage equality: Rather than a person's capacity to pay the expensive medical costs, access
to healthcare should be based on need. Every citizen can obtain comparable level of care with
lower total health expenses and uniform services.
Boost the economy: South Africa might have a healthier workforce if the NHI can offer
preventative care. Increased preventive medicine would also lessen the need for trips to the
emergency room, which would lower the price of medical care.
Dependency on welfare and crime: The NHI might also provide assistance to vulnerable
populations who have been neglected by the current inequitable healthcare system, such as the
elderly or low-income women.
The most ill pay for the health of others: According to US statistics, 90% of healthcare
expenses are related to chronic disorders. According to these studies, the healthiest 50% of the
population only contribute 3% to healthcare costs, whilst the sickest 5% of the population
generate 50% of them.
Little financial motivation to maintain good health: The basic worry is that without co-
payments, consumers could visit doctors and emergency rooms excessively.
Long waits: Long wait times for elective procedures may be experienced by patients as
government funding would be devoted to fundamental and emergency healthcare.
Decreased level of care quality: In order to decrease expenses, doctors may reduce the amount
of care they provide if they are not adequately funded by cost-cutting governments.
The potential for corruption: Public trust in the government's ability to manage complex
institutions is at an all-time low. Such faith is not encouraged by the mounting evidence of public
sector corruption.
Private health insurance is a sort of health insurance in which you abide by the rules set forth by
a qualified health insurer.
You can receive hospital care as a private patient if you have private health insurance.
Additionally, it can assist in covering medical expenses that Medicare doesn't cover, including
physiotherapy. Your policy determines how much it costs and what it covers. (Zhang, 2020)
You can select the health insurance provider that is most affordable for you.
Private health insurance may cover all or part of the costs of: care in public or private hospitals
as a private patient with the doctor of your choice; non-Medicare services including
physiotherapy, dentistry, and vision care. This depends on the specifics of your policy.
You might be able to obtain some hospital services more quickly if you have private health
insurance.
You can receive medical care at a hospital as a private patient if you have private health
insurance. It may also cover additional medical procedures that Medicare does not pay for you,
in order to obtain private health insurance you must purchase a policy from a licensed health
insurer and pay consistent premiums to maintain coverage.
Hospital coverage assists with the expense of care and lodging for private patients.
Both a public hospital and a private hospital will treat you as a private patient.
Medicare will pay percentage of the Medicare Benefits Schedule's (MBS) cost if you decide to
get hospital care as a private patient.
Hospital's lodging, theatre fees, intensive care expenses, medications, dressings, and other
supplies, as well as the price of surgically implanted prostheses and diagnostic tests
Health services that are not offered by a doctor are covered under extras. This includes dental,
physiotherapy, and optical services. 'Ancillary cover' is another name for this. (government, 2021)
Hospital and extras coverage provided by combination policies rather than by individual hospital
and extras policies
Standard
Bronze
Silver
Gold
More conditions are covered the higher the category. Higher levels of hospital insurance are
more expensive. (healthdirect, 2022)
Conclusions
Health insurance is the agreement of government or private health insurer to their customer so
it’s important to be insurer and also I emphasize to be part of the private health agency or
company which fulfills health insurance.
References
1. Zhang, C. (2020). tilization of public health care by people with private health insurance:
a systematic review and meta-analysis. BMC Public Health.
4. https://www.insuranceoptions.co.za/blog/advantages-and-disadvantages-of-national-
health-insurance/