风险与保险原理课件_ch21 介绍（英文版）（79页）ppt.pdf
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Medical expense insurance provides for the payment
of the costs of medical care that result from sickness and injury.
Covers expenses of physicians, hospital,
nursing, and related services, as well as medications and supplies.
May provide reimbursement of actual
expenses (up to a limit), cash payments, or the direct
provision of services.
Medical expense coverage is sold
on both an individual and a group basis.
Although private insurance is an important tool for
financing health care, most health care costs are paid
from sources other than private insurance.
State and federal governments cover 46.4% of health care expenses in U.S.
Out-of-pocket expenditures from private resources
cover about 21.8 percent of total expenditures for health care.
Private insurance, written by various types of insurers,
provides financing for the remaining 31.9 percent of health
care expenditures.
Financing Health Care Costs
State & Federal Government
Private Insurance
Out-of-Pocket
Expenditures
Historical Development of Health Insurance in U.S.
Coverage for expenses associated with sickness did not
become popular until after World War I.
Medical
expense insurance did not originate with traditional
insurance companies, but hospitals, which began to
offer prepaid hospitalization to individuals in 1920s.
Blue Cross and Blue Shield
Blue Cross plans are said to have originated at Baylor
University in 1929, when a group of teachers arranged
for hospital benefits on a prepaid basis.
The first Blue
Shield plan was organized by physicians in California
in 1939 to offer prepaid surgical expense coverage
Commercial Insurance Companies
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