The Advantages and Disadvantages of Health Insurance

15 May

The Advantages and Disadvantages of Health Insurance

(Discussion Essay)

By: Winarsih

As a human being, a health is the worthy wealth besides money. We cannot enjoy that we have, we got, and we obtain if we are not healthy. In the other hand, we cannot avoid the diseases in our daily life, such as influenza, cough, fewer, or other serious illness. Moreover, the way people live today is not healthy anymore. It is because they tend to do so many activities without doing any exercises. Therefore, some serious diseases such as stroke, heart attack, and cancer might appear as the effects. For those reasons, the government gives some health insurgences to the society for instance ASKES, JAMSOSTEK, and ASKIN.         Health insurance itself is an insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement. By giving health insurances to the society, the government’s hope it will help them cure their illness. Nevertheless, in my opinion, the health insurance still has some disadvantages beside the advantages.

In terms of the advantages, health insurance might be able to help us when we are sick or get an accident effectively. Effectively here means that by using health insurance we save our time and our money. In fact, someone cannot predict when and where she might get disease or an accident. Consequently, we do not prepare for having that condition financially. It will not happen if we have health insurance then someday we get an accident we can get service and pay directly. It is because the amount that the insured must pay out-of-pocket before the health insurer pays its share. For example, policy-holder might have to pay Rp 5.000.000 deductible per year, before any of their health care is covered by the health insurer. As a result, we can use that money when we need it. In addition, paying affix amount up front (a co-payment), the co-insurance is a percentage of the total cost that insured person may also pay. For example, the member might have to pay 20 percents of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80 percents. If there is an upper limit on co-insurance, the policy-holder could end up owing very little or a great deal, depending on the actual cost of the service they obtain.

In contrast, health insurance also has some disadvantages, medical coverage, and pre existing exclusion. Actual medical coverage can also be a disadvantage to some people with health insurance. The medical coverage might not be enough sufficiently to cover the cost of tests, surgeries, and procedures that need to be carried out. This can leave the person paying high bills for medical services and may even cause some people to refuse medical care that they need. This can lead to an exacerbation of illness or even death, which can end up costing the person, the person’s family, taxpayers and even the government more money. The next disadvantage is pre-existing exclusion. If a person enrolls in a new group health insurance plan, they might be asked if they have any pre-existing conditions. According to, which is provided through the Georgetown University Health Policy Institute, some people that have a pre-existing illness have to undergo a waiting period if changing employers. In addition, after enrolling in a new group health insurance plan, if claim is made during the first year, the insurance company has the right to “look back” to see if this was due to pay for any charges related to this “pre-existing condition”. This might be in effect for up to 18 months and can be quite expensive for someone with a serious illness.

In summary, health insurance is important for both individuals and families, as it relieves the burden of any unexpected medical emergencies. Simple surgeries, blood test and emergency room visits can add up to thousands of dollars in hospital bills. The benefits of health insurance are clear; it provides you with the means to look after yourself and your family, without worrying about the cost of medical care. Unfortunately, beside those advantages, we also have to consider the disadvantages that are mentioned in the previous paragraph. Even though we have had health insurance, we should not relay on that without doing any prevention such as doing exercising, consuming a healthy food, and having a good life style.

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Posted by on May 15, 2012 in Winarsih


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