As the cost of medical care increases, it has become increasingly important for people to obtain health insurance to maintain access to preventative and emergency health care and afford treatment. Without health insurance, a person has limited access to physicians and specialists and generally pays more for health care, especially emergency treatment. The average total of charges for a four-day hospital stay for an uninsured person can reach more than $19,000, according to a February 2009 Agency for Healthcare Research and Quality report.
How it Works
When a person enrolls in a health care plan, he joins a group that together shares the expense of injury or illness. Health insurance pools the financial resources of many to pay the medical cost of group members who require drugs, hospitalization or outpatient care to maintain their health. Health insurance policies generally involve monthly payments called premiums. In addition, a health plan member may have to pay a deductible, which makes him responsible for total charges up to a certain level before the insurer will begin paying a portion of claims. A member also may have to supplement the amount the insurer pays with a co-pay, a fee paid at the time of a doctor visit.
Health insurance allows individuals to manage the cost of health care related to the birth of a child, preventative care and treatment for complaints such as a headache or the common cold. Regular checkups and some standard medical tests, generally paid by the health insurer, also allow physicians to detect and treat health problems that could become serious illnesses. People without access to health insurance to cover preventative care who can't afford to see a physician often miss the opportunity to diagnose and treat chronic diseases in their early stages.
Emergency and Chronic Care
Health insurance provides access to and financial protection against medical costs in the event of an accident, injury or diagnosis of a chronic illness that requires ongoing treatment by a specialist. Medical coverage also protects individuals who need immediate care for a broken leg, stroke or heart attack. The insurance policy gives patients access to medical care and alleviates at least some of the worry associated with treatment costs.
Paying for prescription drugs to manage and treat chronic illnesses also has become a major purpose for enrolling in a health plan. Between 1999 and 2009, the number of filled prescriptions in the United States increased 39 percent to 3.9 billion from 2.8 billion, according to the Kaiser Family Foundation. The cost of prescription drugs also has increased during that time period. About a quarter of adults in the U.S. don’t fill a prescription and 21 percent cut pills in half or skip doses due to the cost of the medicine, according to a September 2009 KFF survey.
Many Americans receive health insurance through group health policies that employers offer workers and their families as part of the employee's compensation package. In employer-sponsored coverage, the company often pays a portion of the cost of each employee’s health care premium to an outside insurer or the employer itself pays for the worker’s medical care. Health plans and self-insured employers also negotiate with hospitals and health care providers for lower rates on medical treatment and procedures. A person who pays out-of-pocket for health care services may not receive these savings.
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