风险与保险原理课件_ch21 介绍（英文版）（79页）ppt.pdf

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