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Comparison of Various Models of Health Insurance Paint: The concept of insurance in health financing has evolved through various approaches of the social (social health insurance) and commercial (commercial health insurance). Developing both Dantara Health Insurance is regulated in a World Bank report (1993) recommended to be implemented as a substitute for the principle Commercial / Private Helath InsuranceIn Indonesia, the development of social health insurance (Health Insurance / JK) is regulated in Law No. 40 of 2004 on the Social Security System (Forecast) which is one of the program with Accident Compensation Insurance Program (JKK), Security Hari Tua (JHT), Security Death ( JKM) and the Pension Guarantee (JP). JK program held nationally, based on the principle of social insurance and equity. The goal is to provide benefits kesehatran maintenance and protection in meeting the basic needs of healthThe principle of social insurance programs in the Forecast includes JK mandatory participation and non-discriminatory for a formal group, based on percentage revenue contribution to be a burden shared between the giver and the recipient’s work to some extent, so that there is mutual between rich and poor, high-risk hospital – low, old and young with the benefits of the same medical service (the principle of equity), and accessible services nationally (portability), is comprehensive, with healthcare benefits promotive, preventive, curative and rehabilitative, including drugs and medical consumable materials. Management is carried out with prudence, nonprofit, transparency and accountability high. Fund of funds mandate program is used as much as possible for the interests of participants.Specialty programs in the Navigation JK is that the Organizing Board must develop a system of health care, service quality control systems and healthcare payment systems to improve efficiency of health insurance. Organization of health insurance to apply the principles of managed healthcare concept, such as application of the concept of family physicians, the concept of reference, the concept of territory and the prospective payment (Prospective Payment System) as capitation, rates, packages, and DRG’s (Diagnosis Related Groups). Drug services provided in accordance with the list and the highest price of medicines, medical materials and consumables specified.

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Health Through Financing Social Health InsuranceHealth financing has increased from time to time and felt good weight by government, particularly the business community in general. For that many countries choose the type of health financing system for his people, who applied nationally. The dominant models of implementation adapted to the situation in their respective countries.Some of the dominant model is:1. Model of social health insurance (Social Health Insurance). This model was pioneered since Germany under Bismarck in 1882. This model is developed in several European countries, Japan (since 1922) and then to the State, other Asian countries namely the Philippines, Korea, Taiwan etc.. The advantages of this system allows 100% population coverage and the relatively low increase in health service costs.2. Model of commercial health insurance (Commercial / Private Health Insurance). This model developed in the United States. However, this system failed to reach 100% population coverage. Approximately 38% of the population not included in the system. Besides the cost increases are very large because of moral hazard opportunity. Since the year 1993; by the World Bank recommended the development of a model where the Regulated Health Insurance membership based group with a certain minimum amount requirement, thereby reducing the chance of moral hazard3. Model NHS (National Health Services) who pioneered the British government since the second world war ended. This model also opens opportunities 100% population coverage. However, health financing is secured through the government budget will be a heavy burden.Health InsuranceSick individual risk groupsThe law of lsrge numberUncertainty mustPrinciple:1. Paying Premiums / Fees (Small) Benefit / compensation of large2. Protect participants from risk (economics)Among the various models, the social health insurance choice in many countries. The use of the term insurance in this program is because of an aspect of risk transfer (economics) because of illness and the legal requirements the law of the large number. Tendency (universal) from the implementation of social health insurance are:1. That the social health insurance programs starting from formal groups, labor, and then develop the non-formal groups and self-employed. Program for the poor are often developed as part of a group of non-formal, or developed independently of each depend on state policies. Social health insurance programs in various countries showed an increase throughout the population to access health facilities and the cost control.2. In many countries, this program begins with several agencies, but organizers will decrease the amount. Starting with the cooperation / coordination among various agencies organizer, then the merger that eventually became a provider agency which conducted a national program (for example; Taiwan, South Korea). Thus the bargaining power greater penyelengara body, while the law the law of the large number is also growing.The development of social health insurance in many countries has changed the traditional concept of health insurance where the next social health insurance is not only considered as a system of financing but also the health care system. Therefore, the concept of modern social insurance, health insurance programs base their work on two important issues namely; integration of financial systems (financing of healthcare) and system services (delivery of healthcare) are efficient and effective.

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Health Insurance Company to the Company’s investments Why Smoke?Who would have thought, turned out to insurance companies engaged in the health and life insurance in the United States, Canada, and England, it invests billions of dollars in tobacco companies. According to a report of a study published in the medical journal, The New England Journal of Medicine.Wesley Boyd, the study’s lead author, found at least 4.4 billion dollars in insurance company funds invested in companies associated with tobacco products, cigars, and chewing tobacco (chewing). “Although the doctors have asked these companies to come out of the cigarette business, but they still take advantage of the health of the people,” said Boyd, the faculty at Harvard Medical School. “It is clear, their main priority is to make money, not health care,” he wrote.Tobacco is considered as the main cause of lung cancer and main risk factors for heart attack, stroke, lung disease, and cancer. According to the World Health Organization, tobacco contributed to the 5.4 million deaths per year.Regarding insurance companies that invest in the tobacco industry, is not really new news. Earlier in the year 1995 it was reported in a British medical journal, Lancet.”While investing in tobacco companies, while selling life insurance or health, may seem to embarrass myself, but can reap huge profits from those two things is more important for these companies,” writes Boyd. “Insurance does not include protection for smokers, or they charged high premiums. Insurance profit-and loss-smokers twice,” said Boyd.Based on Boyd’s report, the U.S. insurance company, Prudential Financial Inc., has 264.3 million U.S. dollar investment in three U.S. tobacco companies, including Reynolds America and Philip Morris. Meanwhile, the Canadian insurer, Sun Life Financial Inc., which sells life insurance policies, disability insurance (disability), and health insurance have a stock portfolio with a value of more than one billion dollars in two tobacco companies, including U.S. $ 890 million in Philip Morris.Prudential Plc, which sells health insurance policy and disability insurance, has a 1.38 billion U.S. dollars in the two tobacco companies, including British American Tobacco (BAT). The study also details the major investments in tobacco companies from the U.S. insurance company, Northwestern Mutual and Massachusetts Mutual Life, and Scottish companies, Standard Life Plc.

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Health Insurance Program and Acting Minister Premium Donate 24 MillionMinister of health insurance programs and certain officials conducted by PT Asuransi Kesehatan Indonesia (Askes) estimated only contributed premiums of USD 24 billion per year. So it was made by Director Askes.

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