Page 46 - Ebook health insurance IC27

The Insurance Times

Out of Pocket Payments : 18 %
Others :4%

So, we see that health is a large industry globally and commands US 5.3 trillion
dollars of the world's resources, of which health insurance, social and private,
commands a 43 % share. There are some examples of International experience
with Health insurance.
(i) In Germany, over 90 % of the residents receive health care through statutory

health insurance, whichfunctions through nonprofit sickness funds that collect
premiums from members and pay health care providers according to pre-
negotiated agreements. Employers and employees contribute equally to the
premiums. Being a social health insurance scheme, premiums are set
according to earnings, rather than risk and are not affected by a member's
marital status, family size, or health.

The unemployed continue to be a member of their sickness fund, and their
contributions are paid by federal and local government offices. The,
public health insurance program redistributes from higher to lower income
groups, from healthy to the sick, from young to the old, from those without
children to those with children. Employees who have private insurance,
also receive the benefit of part of their premiums being paid by their
employers.

(ii) France has a system of employment- based public health insurance that
now covers everybody of the country. There are three healthcare funds, a
main one covering most workers, one for self employed , and the other of
agricultural workers.

The financing ofthe system is through employers and employee contributions
in addition to general taxes, of which the latter have been increasing in

5 0 Guide for Health Insurance