INTRODUCTON – The term “health insurance” is commonly used in the united states to describe any program that helps pay for medical expenses health98.ir, whether through privately purchased insurance, social insurance or a non-insurance social welfare program funded by the government. Synonyms for this usage include “health coverage, ” “health care coverage” and “health benefits” and “medical insurance. ” In a more technical sense, the term is used to describe any form of insurance that provides protection against injury or illness.
In america, the health insurance industry has changed rapidly during the last few decades. In the 1970’s most people who had health insurance had indemnity insurance. Indemnity insurance is often called fee-forservice. It is the traditional health insurance in which the medical provider (usually a doctor or hospital) is paid a fee for each service provided to the patient covered under the policy. An important category associated with the indemnity plans is that of consumer driven health care (CDHC). Consumer-directed health plans allow individuals and families to have greater control over their health care, including when and how they access care, what types of care they receive and how much they spend on health care services.
These plans are however associated with higher deductibles that the insured have to pay from their pocket before they can claim insurance money. Consumer driven health care plans include Health Reimbursement Plans (HRAs), Flexible Spending Accounts (FSAs), high deductible health plans (HDHps), Archer Medical Savings Accounts (MSAs) and Health Savings Accounts (HSAs). Of these, the health Savings Accounts are the most recent and they have witnessed rapid growth during the last decade. Pakistan, as we all know is a developing country and we are currently going through lots of challenges and issues. These issues vary from terrorism, energy crisis and poverty to poorly developed education and health systems.
Health, which is the basic human right, has unfortunately not been our priority. This statement is supported by the fact that according to the World Health Organization 2013 statistics, the health system of our country is currently ranked as 122 out of 190 countries. This is a very alarming figure especially considering the fact that one of our neighboring countries Iran is ranked as 93 in the same list. This particular figure definitely draws our attention towards issues in the health sector which we are currently facing.
Firstly, we need to understand what is meant by health system. The health system does not only include hospitals and clinicians. It rather involves anything and everything which directly or indirectly affects the health of populations. The health system is composed of hospitals, environment, urban planning, food, nutrition and numerous other sectors which are directly or indirectly involved in determining the health of populations. What this means is the fact that by merely building new hospitals and producing more clinicians, we cannot make our health systems better. There has to be a multi-sectoral approach which needs to involve all the components of the health system.
The next and the most important factor to consider is that we need to reshape our current health system model. If we want to improve the health status of our population, we have to base our health system on the preventive approach rather than the curative approach, that is, we need to promote public health. The time has now come where we must come out of the downstream (clinician) approach and move towards upstream (public health) approach. This is the only way by which we can survive and can make the health status of our population better. We should reconsider and amend our current health policy and we will have to develop it on the model of public health. This is the need of the time and if we want to survive and compete with the world, we must follow the public health model instead of the clinician’s model. As clinical providers seek ways to improve the health of their patients at the population level, one great resource that they should tap is their county health department. There are many resources and skills that health departments will share with physicians and other providers that will improve their ability to improve the health of their patients.
In my work I have had numerous occasions to collaborate with the chief epidemiologist of the Kent County Health Department of Michigan-Mr. Brian Hartl. Through these contacts and through an introductory epidemiology course I have found that health departments are experts at providing population level health services. This is in contrast to most clinical providers who excel at working with their patients on a face-to-face level. Both staff of physician offices and staff of health departments are concerned with the health of individuals and groups of people.
Clinicians most often work with individuals during face-to-face encounters. They treat the disease or injury of an individual one at a time. For instance, if a physician is treating a patient with hypertension, she will plan a course of treatment with the individual in mind. If the physician considers the population level in her work, then she is looking at how the treatments and instructions that she provides affect a group of her patients. For instance, she may consider how effective she is in treating her patients with hypertension collectively.
The patients of a county health department are the population of the county. Only in a few instances do health departments treat individuals one at a time. Much of their work would not be considered clinical interventions. However, their work does affect the population as a whole. For instance, health departments are responsible for seeing that food at restaurants is handled and cooked correctly. Health departments track reports of communicable disease to identify potential clusters or outbreaks, such as measles, in order to mobilize the community and physician groups to respond and prevent further transmission.