Public vs. Private Health Care Author:    Posted under: Health InsuranceHealth Insurance questions answered


Health care insurance is a process wherein an insurance company pays for the medical bill of the insured. The amount being paid by the insurance company depends on the agreed coverage.

There are essentially two types of health insurance plans in the US- public and private health care. Having either one helps the people defer the costs of medical treatment.

Private health care, as term private implies, is run by for-profit businesses. People pay up premiums in exchange for getting insured against injuries or illnesses. It is considered to be the primary source of health care. Large numbers of individuals have private health care through their employers.

In private health care, individuals are allowed to choose a policy that will best benefit them- based on coverage, premiums they can afford to pay and their medical conditions.

Public health care insurance is a government-subsidized health care plan. The main goal is to provide health care to citizens without them having to pay for anything. It does not, however, cost taxpayers more money just so the government can continue to pay for public health care.

There are different types of programs under the public health care system. They are: Medicare, Medicaid, Children’s Health Insurance Programs and Special programs.

Medicare is available for citizens over 65 years old, people with disabilities or with end-stage diseases like kidney disease. There are four components under Medicare.  Part A covers hospital care, home health care, institutions and nursing homes. Part B covers doctor’s consultations and some preventive care. Part C is actually run by private health care providers that includes Part A and Part B and sometimes with other services like prescription drugs. Part D is also run by private health care providers and includes prescription drugs.

Medicaid is administered by the state combining the resources from state and federal funds to accommodate low-income families and individuals. The state determines the guidelines for eligibility that includes family size, income, health conditions or disabilities even pregnancy and immigration status. It is also the state that determines the coverage each individual or family will get.

Children’s Health Insurance Program (CHIP) is for children and families who are not eligible for Medicaid because of income but cannot afford private health care insurance as well. State and federal resources also fund this particular public health plan. And just like Medicaid, the state determines the eligibility of families and individuals who apply for CHIP. The state also determines the coverage they will get and how much each participant will contribute.

Special Programs are for those who do not qualify for Medicare, Medicaid or Children’s Health Insurance programs. This program varies from state to state.

Choosing between Public and Private Health Care depends on the capability or power of an individual to pay. The employed individual can very much afford private health care since it is part of the benefits they get from their employers. But not all employers pay for their employees’ health care insurance. This is where the individual has to pay for the insurance premium out from his or her own pocket.

I think having a better public health care system will eventually lead the private insurance providers to be more competitive in terms of costs and coverage.

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