Cost sharing, when you first hear it, might sound like a good thing. Something to help lessen the burden of costs you’re being socked with for your health insurance. Unfortunately, cost sharing in the United States often ends up to the detriment of the consumer, as health insurance companies raise their rates and have to ask consumers to pay a higher portion of what services cost. Sometimes insurance companies have to raise the rates for employers, who then have to turn around and raise the co-pays for their employers. It’s a vicious cycle, but other countries around the world have developed models to help lower and limit cost sharing that falls on the shoulder of consumers, and the United States might do very well to look into these models and implement them here. Especially with things as they are in our current economy, anything that can be done to keep hitting already weighed-down consumers with more costs should be a high priority.

What Exactly IS Cost Sharing in Health Insurance?

There are a few key specific points to understand when looking at the role cost sharing plays in health insurance. Direct forms of cost sharing between consumers and health insurance providers are things like the following: co-payments (what you pay per service), coinsurance (a percentage of the charge that you have to pay) and deductibles (the amount you have to pay out of your own pocket before coverage begins. This can be on all services or you can have a certain deductible on a type of procedure). Indirect cost sharing isn’t typically included in the standard definition of cost sharing in insurance, but they still cost consumers money and come right out of your pocket. These can be things like: charges when you go to see an out-of-network doctor, going to a specialist before seeing a primary care physician and being charged full price for that, any health services not covered by your insurance plan and health care premiums.

(more…)

The debate about health care in the United States has been raging for years and will probably continue to rage for years to come. People across the country, from the girl next door to a politician of the highest office all have differing opinions on what would be best for our country. No matter what you think of the current system and its pros and cons, it is important examine the way things are done elsewhere in the world. The United States may be one of the world’s biggest superpowers, but is our health care system the best way to do things? Let’s look at other capitalism economies around the world and how their health care systems function.

Health Care in the United Kingdom

photo credit: Sar-ah Bear-ah

The UK spends about 8.3% of its Gross Domestic Product (GDP) on health care for its citizens. Families there do not pay any kind of premium for health insurance; it is all funded by taxation. Most of the time there is no-copay for patients, but occasionally one will pop up for dental care, eyeglasses and 5% of prescriptions. The young and elderly are exempt from co-pays of any kind.

The system in the UK can be deemed socialized medicine, meaning that the government both provides and pays for health care. Citizens living in the UK pay taxes in order to make this happen, and the HNS (National Health Service) distributes those funds to health care providers. General practitioners who run their own private practices are paid based on how many patients they see, while hospital doctors are paid salaries. There are a small number of specialists who operate outside the NHS and they see privately paying patients.

(more…)