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The root is the verb insure. To insure
something is to pay money in installments so
that somebody
or his inheritors get an amount of money agreed upon or a
compensation
for what he had lost.
Term of Insurance: It is regarded as a
contract that one of his two parties (insurer) abides
by
fulfilling what had been agreed upon to the (insured) in
case of a condition or definite
time against a known cash.
The compensation agreed upon is given from the
accumulated
amount paid by the contracted parties what is called as
“insurance installments”. Insurance, is therefore, regarded
as one of financial
instruments for collecting risks and
distributing them among greater number of
risk-exposed
persons.
Insurance can be defined as “Fund into which
contracted parties’ subscriptions flow
and the capital of
the insurer whereas the insured gets the amount agreed upon
in
case of occurrence any of the known or insured-on-risks.
Medical Insurance is one of the social
insurance types concerned directly with social
disasters of
virology origin such as temporary disease, disablement and
old age.
Medical Insurance: is a matter of a Fund into
which contracted parties’ subscriptions
flow (State
–Employer – worker) and in turn the insured gets from this
money an amount
that enables him to receive total or partial
necessary health care as the case may be
in the event of
disease occurrence, injury or disablement. There are so many
definitions
for medical insurance among which are:
·
Financial means for protection
against potential diseases.
·
Means of advance payment for
receiving medical services upon need.
·
Means for removing the economic
impediment that stands between the patient
and demand of
medical services. |
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The medical insurance was not different from
the other types of insurance. It is, thus, regarded as a
part of social insurance which emerged in Europe during the
industrial revolution. Insurance emerged in its current
feature due to the emergence of big cities.
The special medical insurance started, first,
in a form of joint liability or cooperation by workers of
different professions in joint liability associations. These
associations, in the beginning, aimed at assisting the
subscriber to meet the treatment cost against a small and
organized subscription. Theses associations were very back
warded, for they are not subject to government control.
These associations formed a base for insurance companies in
general. Germany (before division), however, is regarded as
the first country in Europe that established medical
insurance system. Its system started in 1883, and then
followed by Czechoslovakia. England, however, created such
system as an integrated system in 191. USA introduces
medical care system for medical treatment within the
legislations of social security in 1965.
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In
Arab Republic of Egypt, the Public Medical Insurance
Corporation (PMIC) was established under the
Republican Resolution No. (1209) for the year 1964.
The law defined the functions and the activities of
PMIC as follows:
·
Insurance against
disease and work injuries.
·
Insurance against
disease for pensioners, widows – families.
·
Periodical check on
persons subject to vocational diseases.
·
Medical Committees work
(leaves, service starting and disablement)
In Saudi Arabia kingdom, the social insurance system
was issued under Royal Decree No (200m) dated
6/9/1389 A.H. (Sixth of Ramadan one thousand three
hundred and eighty nine A.H.). In paragraph one it
stipulated that this system should be named as
Social Insurance System and should be applied on
waged workers and under it they shall be provided
with compensations stipulated in the cases of:
·
Work injuries and
vocational diseases.
·
Disablement, old age
and death. In paragraph 2 of the same article it
stipulated that ( It is not permissible by a
resolution of the Cabinet no protection should be
expanded which this systems provides in later stages
with the intension of providing other types of
compensations).
In Jordan Hashemite kingdom Act o social security No
(30) for the year 1978) has been issued and it
comprise 6 types of insurances to be applied n
phases as follows:
·
Insurance against work
injuries and vocational diseases.
·
Insurance against
disablement, old age and death.
·
Insurance against
temporary disablement due to vocations or
motherhood.
·
Insurance for the
worker and his family.
·
Family grants.
·
Insurance against
unemployment.
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The American medical insurance system is
the
most strange one, where there commercial insurance. The
American market has intensively different types of
contracts, private, semi private and public institutions.
This Art in the institutional structure in American medical
insurance system led to enrichment of dialogue about the
ideal system for services medical provision. This dialogue
is still on. We, thus, find that there are two parties of
different points of view; one party calls for maintaining
the principles of economic liberty and the other party calls
for introduction of the national medical system subsidized
by the state.
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Agreement No. (13) for the year 1971
is the Arab Agreement for the minimum limit of
social insurance discussed medical insurance and its
advantages, particularly treatment, lab.
Examination, stay in hospital, receiving of medicine
and surgical operation. The Agreement It also talked
about motherhood insurance (pregnancy and delivery)
and what should be included in these advantages in
terms of pre-natal medical care, during delivery,
post-stay and treatment.
Six Arab countries have approved this
agreement, as follows: (Sudan, Syria, Iraq,
Palestine, Republic of Libya and Egypt) |
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In Africa, medical care emerged through western
colonization, where colonial authorities,
missionaries, explorers and humanitarian
associations entered at that time. Health care and
medical services developed after the end of
colonization era in Africa, where the independent
governments in most African independent countries
were able to set integrated systems for their
practical services. In spite of clear difference in
their levels, there were able to reduce mortality
rates among citizens of different ages. The
legislative and legal form of medical care in Africa
at present has four forms which can be listed as
follows:-
·
Legislative form under
which opportunities are provided for workers to
benefit from public health services. This form was
mainly implemented in Anglophone African countries.
A form under which medical care cost is met or at
least partially met by means of insurance fund for
workers and the cost portion is deducted from
insurance fund by means of subscriptions collected
from their wages. This legislation is similar, in
some way, to social insurance system.
·
The third form: is from
medical care legislations and it is represented in
obliging employers to directly bear medical care
cost for their workers.
·
The fourth form: is
enrolling protection against disease within the
framework of social security under the name of
medical insurance.
The World Bank, however, conducted in 1993 a survey
on (370 African countries. It found out that (15)
countries out of (37) were covered by the survey,
that’s to say 40% had official medical insurance
system and there are (4) countries having a system
presented by the employers, and (180 countries did
not have official medical insurance system.
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