A contract between an insurance provider (e.g. an insurance company or a government) and an individual or his/her sponsor (e.g. an employer or a community organization). The contract can be renewable (e.g. annually, monthly) or lifelong in the case of private insurance, or be mandatory for all citizens in the case of national plans. The type and amount of health care costs that will be covered by the health insurance provider are specified in writing, in a member contract or "Evidence of Coverage" booklet for private insurance, or in a national health policy for public insurance.
Historically, Health maintenance organizations (HMO) tended to use the term "health plan", while commercial insurance companies used the term "health insurance". A health plan can also refer to a subscription-based medical care arrangement offered through HMOs, preferred provider organizations, or point of service plans. These plans are similar to pre-paid dental, pre-paid legal, and pre-paid vision plans. Pre-paid health plans typically pay for a fixed number of services (for instance, $300 in preventive care, a certain number of days of hospice care or care in a skilled nursing facility, a fixed number of home health visits, a fixed number of spinal manipulation charges, etc.). The services offered are usually at the discretion of a utilization review nurse who is often contracted through the managed care entity providing the subscription health plan. This determination may be made either prior to or after hospital admission (concurrent utilization review).
The great positive impact of public health programs is widely acknowledged. Due in part to the policies and actions developed through public health, the 20th century registered a decrease in the mortality rates for infants and children and a continual increase in life expectancy in most parts of the world. For example, it is estimated that life expectancy has increased for Americans by thirty years since 1900, and worldwide by six years since 1990.
Usage Note: Some people insist on maintaining a distinction between the words healthy and healthful. In this view, healthful means "conducive to good health" and is applied to things that promote health, while healthy means "possessing good health," and is applied solely to people and other organisms. Accordingly, healthy people have healthful habits. However, healthy has been used to mean "healthful" since the 1500s, as in this example from John Locke's Some Thoughts Concerning Education: "Gardening ... and working in wood, are fit and healthy recreations for a man of study or business." In fact, the word healthy is far more common than healthful when modifying words like diet, exercise, and foods, and healthy may strike many readers as more natural in many contexts. Certainly, both healthy and healthful must be considered standard in describing that which promotes health.
Much in the same manner ought that oligarchy to be established which is next in order: but as to that which is most opposite to a pure democracy, and approaches nearest to a dynasty and a tyranny, as it is of all others the worst, so it requires the greatest care and caution to preserve it: for as bodies of sound and healthy constitutions and ships which are well manned and well found for sailing can bear many injuries without perishing, while a diseased body or a leaky ship with an indifferent crew cannot support the [1321a] least shock; so the worst-established governments want most looking after.
The UK's National Health Service (NHS) is a publicly funded healthcare system that provides coverage to everyone normally resident in the UK. It is not strictly an insurance system because (a) there are no premiums collected, (b) costs are not charged at the patient level and (c) costs are not pre-paid from a pool. However, it does achieve the main aim of insurance which is to spread financial risk arising from ill-health. The costs of running the NHS (est. £104 billion in 2007-8) are met directly from general taxation. The NHS provides the majority of health care in the UK, including primary care, in-patient care, long-term health care, ophthalmology, and dentistry.
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