Health insurance

With health care costs rising higher and higher, health insurance is becoming a near necessity. Even minor surgery can run into thousands of dollars.

To protect their employees from financial disaster — and to protect themselves from the potential loss of employees — most businesses provide their employees with some kind of health insurance. Almost 75 percent of the US population is covered by employer-provided health insurance. Some companies pay the full price of the insurance; others require their employees to pay a certain percentage of the premium, which is deducted from their pay-checks.

Employers are also trying to cut costs in other ways. Some companies offer wellness programs right at the work place. Their objective is to keep employees healthy and thus cut down on absenteeism. Such programs emphasize nutrition, physical fitness, cessation of smoking, weight loss, and stress reduction.

Health care coverage generally includes hospital expenses, surgical and doctors' fees, major illness, and disability income.

Hospital expenses such as room fees, emergency room fees, operating-room charges, and prescription and nonprescription drugs ordered by the doctor or requested by the patient are covered by hospitalization insurance. The insured usually pays a deductible, and the insurance company pays a specified dollar or percentage amount.

Surgical and medical payments insurance covers the fees of surgeons, anesthesiologists, and other attending physicians, the cost of doctors' visits before and after surgery, and other related expenses.

Major medical insurance covers expenses associated with serious illnesses such as cancer and serious procedures such as open heart surgery. Major medical insurance covers expenses that exceed the limits of the hospitalization and surgical and medical policies. Because the probability of having a serious medical problem is small, major medical insurance is reasonably priced. Limits of $ 1 million on a major medical policy are not uncommon.

Disability insurance provides steady payments while a worker is sick or disabled and unable to work. Many people who become seriously ill or are hospitalized for an extended period of time lose their jobs. Because the combination of huge medical bills and the loss of wages or salaries can be financially devastating, private insurers offer disability coverage. It is also frequently a significant benefit offered by employees. Usually a disabled worker receives a percentage of lost income — about 60 percent of the total. Social Security supplements this coverage.

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Blue Cross and Blue Shield are probably the best-known sources of health insurance. They offer paid subscription plans in which medical, hospital, and surgical expenses are covered by the pool of funds created from the fees of subscribers.

Explain the meaning of the following words:

Wellness program; absenteeism; nutrition; deductible; financial devastating; pool of funds

What is the difference between the following words:

Disability — inability; physician — physicist; sick — ill; prescription — subscription

Agree or disagree with the following statements:

1. The only reason why businesses provide health insurance to their employees is that they care about their workers.

2. Hospitalization insurance covers room fees and drugs.

3. Major medical insurance are very expensive because the expenses they cover are very high.

4. If a person is disabled, about 40% of the payment they get come from Social Security and the rest is paid out by an insurance company.

DISCUSSION

1. Preventing industrial accidents: problems and solution. What safety precautions do you consider reasonable?

2. If an industrial accident happens whose responsibility is it and what formalities should be performed?

3. What steps could an employer take to ensure himself against possible losses in case of an industrial accident.

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UNIT 9