Social Functions and Economic Aspects of Health Insurance

ISBN-13: 9780898382198 / Angielski / Twarda / 1987 / 226 str.

William A. Rushing

Opis

Statistics published by the U. S. Department of Commerce (1980) indicate that in 1977 we spent 8. 1% of our gross national product (GNP) on life, health, property-casualty, and other forms of insurance. An additional 5. 7% was used to pay the Social Security tax, which is another form of insurance premium, for a total of 14. 8% of the GNP. Although insurance had its historical origin in marine insurance, it has now developed into one of the major industries of the American economy and extends into many areas of economic activity. One area where growth has been particularly strong is the medical sector. Health insurance is a major institution in all industrialized countries. It became a government responsibility in 1883 when Bismarck intro- duced a compulsory program of health insurance for industrial workers in Germany. Programs for workers in various industrial and income categories soon followed in other European countries-Austria (1888), Hungary (1891), Norway (1909), Servia (1910), Great Britain (1911), and Russia and Romania (1912) (Rubinow, 1913:250). Programs in these countries were extended in subsequent years, and other countries in Europe followed with their own programs. Consequently, today most industrial countries have universal or near-universal health insurance coverage. In the United States the issue of national health insurance has been seriously debated since just prior to World War I, and polling data since the 1930s show that a substantial majority of the public has been supportive of such a program (Erskine, 1975).

Spis treści

1 Introduction.- Outline of the Book.- 2 Insurance, Social Relations, Moral Community, and the Cost of Medical Care.- Insurance and Social Relations.- Pooled Interdependence and Social Control.- Primitive Societies.- Mutual-Aid Societies in Europe.- Mutual-Aid Societies Among American Ethnic Groups.- Health Insurance and Expenditures for Medical Care in Japan.- Cultural Values and Behavior Patterns.- Kinship Organization.- Number of Physicians and Organization of Medical Care.- Private and Public Insurance.- 3 Medical Care: Actual Effects and Public Perception.- The Historical Decline in Mortality Rates and III Health.- Cross-National Evidence.- The Special Case of Japan.- Is Curative Medicine Irrelevant?.- Contrary Evidence?.- Other Criteria for Assessing the Effectiveness of Medical Care.- Minor Ailments.- Medical Judgment as the Reason for Seeking Care.- Improvement in Role Functioning.- Stress and Anxiety Reduction.- Public Perception and Social Definition.- Conclusion.- 4 Health and Economie Factors in Health Insurance.- Health of the Population.- Economic Productivity and National Efficiency.- Economic Insecurity.- Insurance as Risk Reduction.- Conclusion.- 5 Cultural Factors in Health Insurance.- Medical Technology.- Moral Imperative of Medical Care as a Right.- Conclusion.- 6 Health Insurance and Institutionalizing Marginal Utility Decisions.- Health Insurance and Marginal Utility.- Institutionalizing Decisions to Purchase Medical Care.- Health Insurance as Ritual.- Medical and Economic Anxiety.- The Sacred, the Profane, and Moral Anxiety.- Conclusion.- 7 Health Insurance, Social Integration, and Social Cohesion.- Medical Care, Health Insurance, and Social Policy.- Provider-Patient Relations.- Class Structure.- Private Industry, Health Insurance, and Employee Morale.- Generations, Kinship Units, and the Family.- Social Policy and Social Exchange.- Conclusion.- 8 Economic Costs Versus Social Benefits of Health Insurance.- Moral Hazards, Social Control, and Social Cohesion.- Implications for Medicare and Social Security.- Conclusion.- 9 Health Insurance, Cost Containment, and Social Conflict: A Future Perspective.- Supply of Physicians.- Medical Technology.- Trends in Illness and Disability.- Public Attitudes and Perceptions.- Health Insurance: From Conflict Between Classes to Conflict Between Generations.- Social Security as the Source of Generational Conflict.- Social Relations Between Generations and Social Security.- The Elderly, Social Security, and the Social Control of Conflict.- Conclusion.