Jump up ^ Bump, Jesse B. (19 October 2010). "The long road to universal health coverage. A century of lessons for development strategy" (PDF). Seattle: PATH. Retrieved 10 March 2013. Carrin and James have identified 1988—105 years after Bismarck's first sickness fund laws—as the date Germany achieved universal health coverage through this series of extensions to minimum benefit packages and expansions of the enrolled population. Bärnighausen and Sauerborn have quantified this long-term progressive increase in the proportion of the German population covered by public and private insurance. Their graph is reproduced below as Figure 1: German Population Enrolled in Health Insurance (%) 1885–1995.
Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". 1984 WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities".[10] Thus, health referred to the ability to maintain homeostasis and recover from insults. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and independent living.[9] This opens up many possibilities for health to be taught, strengthened and learned.
In general, the only people who should be enrolling off-exchange are those who are 100 percent certain that there is no way they will qualify for a premium tax credit during the year – keeping in mind that the premium tax credits are available well into the middle class and are larger in 2018 than they were in 2017 in order to offset the higher premiums. (A family of four earning $98,400 is eligible for premium subsidies in 2018.)
Practices like meditation, deep breathing and yoga have been shown to dial down the stress response. In 2017, the AHA endorsed seated meditation as a “reasonable intervention” along with other strategies for maintaining cardiac health. Research also shows that yoga improves circulation and blood pressure and may lower heart disease risk as much as brisk walking.
Before the development of medical expense insurance, patients were expected to pay health care costs out of their own pockets, under what is known as the fee-for-service business model. During the middle-to-late 20th century, traditional disability insurance evolved into modern health insurance programs. One major obstacle to this development was that early forms of comprehensive health insurance were enjoined by courts for violating the traditional ban on corporate practice of the professions by for-profit corporations.[64] State legislatures had to intervene and expressly legalize health insurance as an exception to that traditional rule. Today, most comprehensive private health insurance programs cover the cost of routine, preventive, and emergency health care procedures, and most prescription drugs (but this is not always the case).
Since the late 1970s, the federal Healthy People Initiative has been a visible component of the United States’ approach to improving population health.[11][12] In each decade, a new version of Healthy People is issued,[13] featuring updated goals and identifying topic areas and quantifiable objectives for health improvement during the succeeding ten years, with assessment at that point of progress or lack thereof. Progress has been limited to many objectives, leading to concerns about the effectiveness of Healthy People in shaping outcomes in the context of a decentralized and uncoordinated US health system. Healthy People 2020 gives more prominence to health promotion and preventive approaches and adds a substantive focus on the importance of addressing social determinants of health. A new expanded digital interface facilitates use and dissemination rather than bulky printed books as produced in the past. The impact of these changes to Healthy People will be determined in the coming years.[14]
Long-term care (Pflegeversicherung[36]) is covered half and half by employer and employee and covers cases in which a person is not able to manage his or her daily routine (provision of food, cleaning of apartment, personal hygiene, etc.). It is about 2% of a yearly salaried income or pension, with employers matching the contribution of the employee.

1. hale, hearty, robust. 3. nutritious, nourishing. Healthy, healthful, salutary, wholesome refer to the promotion of health. Healthy, while applied especially to what possesses health, is also applicable to what is conducive to health: a healthy climate; not a healthy place to be. Healthful is applied chiefly to what is conducive to health: healthful diet or exercise. Salutary suggests something that is conducive to well-being generally, as well as beneficial in preserving or in restoring health: salutary effects; to take salutary measures. It is used also to indicate moral benefit: to have a salutary fear of devious behavior. Wholesome has connotations of attractive freshness and purity; it applies to what is good for one, physically, morally, or both: wholesome food; wholesome influences or advice.
A recent study by PricewaterhouseCoopers examining the drivers of rising health care costs in the U.S. pointed to increased utilization created by increased consumer demand, new treatments, and more intensive diagnostic testing, as the most significant.[69] However, Wendell Potter, a long-time PR representative for the health insurance industry, has noted that the group which sponsored this study, AHIP, is a front-group funded by various insurance companies.[70] People in developed countries are living longer. The population of those countries is aging, and a larger group of senior citizens requires more intensive medical care than a young, healthier population. Advances in medicine and medical technology can also increase the cost of medical treatment. Lifestyle-related factors can increase utilization and therefore insurance prices, such as: increases in obesity caused by insufficient exercise and unhealthy food choices; excessive alcohol use, smoking, and use of street drugs. Other factors noted by the PWC study included the movement to broader-access plans, higher-priced technologies, and cost-shifting from Medicaid and the uninsured to private payers.[69]

Practices like meditation, deep breathing and yoga have been shown to dial down the stress response. In 2017, the AHA endorsed seated meditation as a “reasonable intervention” along with other strategies for maintaining cardiac health. Research also shows that yoga improves circulation and blood pressure and may lower heart disease risk as much as brisk walking.
No individual applying for health coverage through the individual marketplace will be discouraged from applying for benefits, turned down for coverage or charged more premium because of health status, medical condition, mental illness claims experience, medical history, genetic information or health disability. In addition, no individual will be denied coverage based on race, color, religion, national origin, sex, sexual orientation, marital status, personal appearance, political affiliation or source of income.
Health, as defined by the World Health Organization (WHO), is "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."[1][2] This definition has been subject to controversy, as it may have limited value for implementation.[3][4][5] Health may be defined as the ability to adapt and manage physical, mental and social challenges throughout life.[6]
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