Content of health insurance in Germany. The task of medical insurance is to provide expenses and services to safeguard and restore the health of the insured and their families when they are ill or when preventive measures are taken. The specific contents are: health promotion, prevention of disease, early detection of disease, treatment of disease, medical rehabilitation and patient care.
The scope of health insurance policyholders. Germany's statutory health insurance is mandatory, including: wages more than the minimum (weekly wages of not more than 480 marks) and less than 58,500 marks per year or less than 4875 marks per month, all employees. Farmers, cottage industry workers, the unemployed, university students, the disabled and retired employees, as well as spouses and children of insured persons, are insured free of charge as long as their income does not exceed the minimum. In addition, employees whose annual income exceeds DM 58,500 may voluntarily enroll in the statutory health insurance scheme or take out insurance with a private insurer. Civil servants, freelancers and independent operators are not covered by statutory health insurance.
Funding of health insurance. Statutory health insurance is financed by premiums paid by the insured and the employer, and is generally not directly subsidized by the state. The employer and the employee each pay 50% of the premiums for the insurance of employees of an enterprise, but if the employee's income is between DM 481 and DM 610 per month, the employer pays all of the premiums for his or her health insurance. The proportion of the contribution to the employee's wage income varies from one insurance organization to another; since July 1, 1976, the contribution has been 11.3% of the employee's gross income, and is paid half by the employee and half by the employer. Pensioners' premiums are paid by their respective pension insurance institutions and amount to 4.5 per cent of their annuity per month. Premiums for recipients of unemployment benefits, unemployment benefits and family benefits are paid by the labor offices. The employer pays 3.5-9.8 per cent of the gross salary, depending on the need for funds; employees earning less than DM 510 per month pay 7-19.6 per cent of their gross salary by the employer. in 1985 the employer and the employee actually paid 11.8 per cent of the average monthly salary. The governing body of compulsory sickness insurance is the Sickness Insurance Institute, which is obliged to provide insured persons with proof of free examinations and visits to the doctor, referred to as "payment in kind", and to provide insured persons with the necessary financial support during their illness, referred to as "cash payment".
The standard of medical insurance benefits. In addition to the employee himself, dependent family members are also entitled to sickness insurance, provided their monthly income does not exceed DM 430. The expenses covered by the sickness insurance include surgical, medical and dental treatment, medicines, and hospitalization expenses that cannot be paid. The sick person brings a medical certificate to the doctor, who settles the bill with the patient's insurer. If the sick employee is incapacitated, he or she is entitled to sick leave payments, which are paid by the employer for six weeks, and from the seventh week onwards at 75 per cent of normal earnings, up to a maximum of 85 per cent. The law provides that when an employee is ill, he/she has the right to demand that the employer pay him/her six months' wages during the period of sick leave, after which the health insurance unit pays the sick person 78 weeks of benefits, up to a maximum of 85% of the original wage. The employee's family receives benefits during hospitalization or convalescence. One of the employee's spouses can't go to work due to caring for a sick child, and the employee can be subsidized for 50 working days due to a reduction in income, and so on.
In recent years, Germany in order to control the increasingly large health insurance expenditure, the health insurance system has made two reforms: First, the implementation of the fixed-price system, to achieve the purpose of medical treatment, but also to prevent luxury and waste. The so-called fixed cost system, the insurance company and the doctor's committee on the treatment of a certain prescription drugs and medicines to make the cost of the provisions of the provisions of the cost within the insurance organization to bear more than the provisions of the cost of the patient to take care of their own. The second is the establishment of a mechanism for restraining the economic interests of medical institutions, sickness insurance organizations and medical insured persons. Since 1989, some regions have experimented with a system of refunding insurance premiums, whereby if the insured does not utilize the premiums within a year, the insured can receive a refund of 1/12 of the annual premium. If the amount of medical care used in a year does not exceed 1/12 of the annual premium, the refund is 1/12 of the annual premium minus the amount of medical care used. Medical insurance in Japan. The basic purpose of this system is to ensure that people can receive the least amount of medical treatment in the event of illness without being overburdened by the financial burden of the patient. Premiums are deducted from monthly wages or paid from living expenses, and if you do not fall ill in a year, the premiums are paid for someone else. The so-called universal health insurance system consists of two major systems: health insurance for general residents and national health insurance for local residents such as self-employed persons and farmers. There are also various kinds of mutual aid societies, etc. for specific occupations such as civil servants and seafarers.
Funding sources of health insurance: employed people generally pay 8.4% of their gross wages, with employers and employees each paying 50%; civil servants and teachers generally pay 0.5%-12.86% of their wages, with organizations and individuals each contributing 50%. The government pays 16.4% of the insurance premiums, as well as the cost of governance. The maximum amount of income for premiums and benefits is 710,000 yen per month and the minimum is 68,000 yen per month. In addition, each health insurance group contributes 1 per cent of its actual income to the National Health Insurance Federation as a national health insurance group transfer fund. Employees enrolled in the health insurance group pay 1.5-4.75% of their individual salary income, according to the 39 salary scales of the annuity insurance. Employers contribute 1.5-4.75% of their gross payroll. Individuals enrolled in the National Health Insurance pay the premium rates set by the Health Combination of the City, Town and Village of Faji.
When an employee suffers from an injury or illness, he or she can go to a hospital for treatment with an insurance card. At the time of the initial consultation, a permanent worker pays 400 yen and a temporary worker pays 50 yen; at the time of hospitalization, a permanent worker pays 300 yen per day for a month, and the insurance company pays for all other expenses. Starting in 1984, the insured person pays 10% of the medical expenses, while his/her family members pay 30% for outpatient treatment and 20% for hospitalization.
When resting from illness or injury, the private sector employees' health insurance, the crew insurance and the hired laborers' insurance pay a sickness and injury benefit equal to 60% of the person's salary for a period of time ranging from half a year to three years. In the case of national civil servants, local civil servants, employees of public **** enterprises, and employees of private schools, sickness and injury benefits are paid at the rate of 80% of one's monthly salary for a period of one and a half years. Japanese health insurance also covers comprehensive treatment including disease prevention, health management, rehabilitative therapy, and patient reintegration. Swedish citizens and citizens of other countries residing in Sweden are eligible for insurance and receive three types of benefits: medical expense benefits, sick leave benefits, and two-parent benefits.
Medical expenses assistance. Health care for insured persons is reimbursed on a reimbursement basis, i.e. the patient pays for it himself and then reimburses the insurance organization. Medical expenses, including doctor's treatment fees, hospitalization fees, medication fees, and travel expenses to and from the hospital or clinic, are reimbursed by the insurance agency at a set rate.
Sick leave benefits. This is used to make up for the loss of income reduced by the patient's illness and is equal to 90% of normal income. Housewives receive 8 kroons a day as sick leave benefit, which is raised to 48 kroons a day if they voluntarily join health insurance. Pregnant women receive a pregnancy benefit for 50 days before giving birth and a parental benefit for 12 months after the birth (90 per cent of their income for the first nine months, and 48 kronor per day for the second three months only for those employed before the birth). In 1965, the United States adopted national health insurance programs in the form of amendments to the Social Security Act of 1935, namely Medicare for persons over 65 years of age and Medicaid for the poor and disabled. The United States continues to have private health insurance based on the employment relationship, supplemented by a national health insurance program.
According to regulations, all enterprises and individuals participating in social insurance for the elderly, disabled and survivors must participate in medical insurance. Premiums are borne by the employer and the employee at an even rate (1.35% in 1985) and are included in the social insurance tax. This insurance can be divided into two parts: one is the transfer insurance, the insured short-term hospitalization due to disease, can be reimbursed for most of the medical expenses, generally not more than 90 days of a transfer; the second is the supplementary health insurance, is a voluntary health insurance, the actual scope of implementation is wider than the transfer insurance, the insured can be reimbursed by the insurance agency for the general clinic, the treatment costs and the cost of medication, and so on.