Insurance 2019. The term health insurance is generally used to describe
a form of insurance that pays for medical expenses. It is sometimes
used more broadly to include insurance covering disability or long-term
nursing or custodial care needs. It may be provided through a
government-sponsored social insurance program, or from private insurance
may be purchased on a group basis (e.g., by a firm to cover its
employees) or purchased by individual consumers. In each case, the
covered groups or individuals pay premiums or taxes to help protect
themselves from high or unexpected healthcare expenses. Similar benefits
paying for medical expenses may also be provided through social welfare
programs funded by the government.
estimating the overall risk of healthcare expenses, a routine finance
structure (such as a monthly premium or annual tax) can be developed,
ensuring that money is available to pay for the healthcare benefits
specified in the insurance agreement. The benefit is administered by a
central organization, most often either a government agency or a private
or not-for-profit entity operating a health plan. History and evolution
The concept of health insurance was proposed in 1694 by Hugh the Elder
Chamberlen from the Peter Chamberlen family.
the late 19th century, "accident insurance" began to be available,
which operated much like modern disability insurance .This payment model
continued until the start of the 20th century in some jurisdictions
(like California), where all laws regulating health insurance actually
referred to disability insurance. Accident insurance was first offered
in the United States by the Franklin Health Assurance Company of
firm, founded in 1850, offered insurance against injuries arising from
railroad and steamboat accidents. Sixty organizations were offering
accident insurance in the US by 1866, but the industry consolidated
rapidly soon thereafter. While there were earlier experiments, the
origins of sickness coverage in the US effectively date from 1890. The
first employer-sponsored group disability policy was issued in 1911.
the development of medical expense insurance, patients were expected to
pay all other health care costs out of their own pockets, under what is
known as the fee-for-service business model. During the middle to late
20th century, traditional disability insurance evolved into modern
health insurance programs. Today, most comprehensive private health
insurance programs cover the cost of routine, preventive, and emergency
health care procedures, and also most prescription drugs, but this was
not always the case.
and medical expense policies were introduced during the first half of
the 20th century. During the 1920s, individual hospitals began offering
services to individuals on a pre-paid basis, eventually leading to the
development of Blue Cross organizations. The predecessors of today's
Health Maintenance Organizations (HMOs) originated beginning in 1929,
through the 1930s and on during World War II. How it works A health
insurance policy is a contract between an insurance company and an
individual. The contract can be renewable annually or monthly.
type and amount of health care costs that will be covered by the health
plan are specified in advance, in the member contract or Evidence of
Coverage booklet. The individual policy-holder's payment obligations may
take several forms: Premium : The amount the policy-holder pays to the
health plan each month to purchase health coverage.
: The amount that the policy-holder must pay out-of-pocket before the
health plan pays its share. For example, a policy-holder might have to
pay a $500 deductible per year, before any of their health care is
covered by the health plan. It may take several doctor's visits or
prescription refills before the policy-holder reaches the deductible and
the health plan starts to pay for care. Copayment : The amount that the
policy-holder must pay out of pocket before the health plan pays for a
particular visit or service.
example, a policy-holder might pay a $45 copayment for a doctor's
visit, or to obtain a prescription. A copayment must be paid each time a
particular service is obtained. Coinsurance : Instead of paying a fixed
amount up front (a copayment), the policy-holder must pay a percentage
of the total cost. For example, the member might have to pay 20% of the
cost of a surgery, while the health plan pays the other 80%. Because
there is no upper limit on coinsurance, the policy-holder can end up
owing very little, or a significant amount, depending on the actual
costs of the services they obtain.
: Not all services are covered. The policy-holder is generally expected
to pay the full cost of non-covered services out of their own pocket.
Coverage limits : Some health plans only pay for health care up to a
certain dollar amount. The policy-holder may be expected to pay any
charges in excess of the health plan's maximum payment for a specific
service. In addition, some plans have annual or lifetime coverage
these cases, the health plan will stop payment when they reach the
benefit maximum, and the policy-holder must pay all remaining costs.
Out-of-pocket maximums : Similar to coverage limits, except that in this
case, the member's payment obligation ends when they reach the
out-of-pocket maximum, and the health plan pays all further covered
costs. Out-of-pocket maximums can be limited to a specific benefit
category (such as prescription drugs) or can apply to all coverage
provided during a specific benefit year.
: An amount paid by an insurer to a health care provider, for which the
provider agrees to treat all members of the insurer. In-Network
Provider : A health care provider on a list of providers preselected by
the insurer. The insurer will offer discounted coinsurance or
copayments, or additional benefits, to a plan member to see an
providers in network are providers who have a contract with the insurer
to accept rates further discounted from the "usual and customary"
charges the insurer pays to out-of-network providers. Prior
Authorization : A certification or authorization that an insurer
provides prior to medical service occuring. Obtaining an authorization
means that the insurer is obligated to pay for the service, assume it
matches what was authorized.
smaller, routine services do not require authorization Explanation of
Benefits : A document sent by an insurer to a patient explaining what
was covered for a medical service, and how they arrived at the payment
amount and patient responsibility amount Prescription drug plans are a
form of insurance offered through some employer benefit plans in the US,
where the patient pays a copayment and the prescription drug insurance
part or all of the balance for drugs covered in the formulary of the
plan. Some, if not most, health care providers in the United States will
agree to bill the insurance company if patients are willing to sign an
agreement that they will be responsible for the amount that the
insurance company doesn't pay.
insurance company pays out of network providers according to
"reasonable and customary" charges, which may be less than the
provider's usual fee. The provider may also have a separate contract
with the insurer to accept what amounts to a discounted rate or
capitation to the provider's standard charges. It generally costs the
patient less to use an in-network provider. Health plan vs. health
insurance Historically, HMOs tended to use the term "health plan", while
commercial insurance companies used the term "health insurance".
health plan can also refer to a subscription-based medical care
arrangement offered through HMOs, preferred provider organizations, or
point of service plans. These plans are similar to pre-paid dental,
pre-paid legal, and pre-paid vision plans. Pre-paid health plans
typically pay for a fixed number of services (for instance, $300 in
preventive care, a certain number of days of hospice care or care in a
skilled nursing facility, a fixed number of home health visits, a fixed
number of spinal manipulation charges, etc.)
services offered are usually at the discretion of a utilization review
nurse who is often contracted through the managed care entity providing
the subscription health plan. This determination may be made either
prior to or after hospital admission (concurrent utilization review).
Comprehensive vs. scheduled Comprehensive health insurance pays a
percentage of the cost of hospital and physician charges after a
deductible (usually applies to hospital charges) or a co-pay (usually
applies to physician charges, but may apply to some hospital services)
is met by the insured.
plans are generally expensive because of the high potential benefit
payout — $1,000,000 to 5,000,000 is common — and because of the vast
array of covered benefits. Scheduled health insurance plans are not
meant to replace a traditional comprehensive health insurance plans and
are more of a basic policy providing access to day-to-day health care
such as going to the doctor or getting a prescription drug.
recent years, these plans have taken the name mini-med plans or
association plans. These plans may provide benefits for hospitalization
and surgical, but these benefits will be limited. Scheduled plans are
not meant to be effective for catastrophic events. These plans cost much
less than comprehensive health insurance. They generally pay limited
benefits amounts directly to the service provider, and payments are
based upon the plan's "schedule of benefits".
benefits maximums for a typical scheduled health insurance plan may
range from $1,000 to $25,000. Inherent problems with multiple insurance
funds and optional insurance The basic concept of insurance is
population solidarity. There are inherent risks in a population but the
population absorbs the cost of risks to an individual by spreading the
impact of incurred costs amongst the insured population.
if the population is split into insured and uninsured groups, or into
selectively groups (as with private insurance with pre-insurance
selection either by the insurance company or the insured) the concept of
population solidarity breaks down. Insurance systems must then
typically deal with two inherent challenges: adverse selection and
ex-post moral hazard. Some national systems with compulsory insurance
utilize systems such as risk equalization and community rating to
overcome these inherent problems.
of single-payer health care in the United States aim to provide the
population of the country with health care from a single fund and thus
avoid problems and costs associated with adverse selection, moral
hazard, and private profiteering from insurance. Adverse selection
Insurance companies use the term "adverse selection" to describe the
tendency for only those who will benefit from insurance to buy it.
Specifically when talking about health insurance, unhealthy people are
more likely to purchase health insurance because they anticipate large
the other side, people who consider themselves to be reasonably healthy
may decide that medical insurance is an unnecessary expense; if they
see the doctor once a year and it costs $250, that's much better than
making monthly insurance payments of $40. (example figures). The
fundamental concept of insurance is that it balances costs across a
large, random sample of individuals (see risk pool).
instance, an insurance company has a pool of 1000 randomly selected
subscribers, each paying $100 per month. One person becomes very ill
while the others stay healthy, allowing the insurance company to use the
money paid by the healthy people to pay for the treatment costs of the
sick person. However, when the pool is self-selecting rather than
random, as is the case with individuals seeking to purchase health
insurance directly, adverse selection is a greater concern.
disproportionate share of health care spending is attributable to
individuals with high health care costs. In the US the 1% of the
population with the highest spending accounted for 27% of aggregate
health care spending in 1996. The highest-spending 5% of the population
accounted for more than half of all spending.
patterns were stable through the 1970s and 1980s, and some data suggest
that they may have been typical of the mid-to-early 20th century as
well. A few individuals have extremely high medical expenses, in extreme
cases totaling a half million dollars or more. Adverse selection could
leave an insurance company with primarily sick subscribers and no way to
balance out the cost of their medical expenses with a large number of
of adverse selection, insurance companies employ medical underwriting,
using a patient's medical history to screen out those whose pre-existing
medical conditions pose too great a risk for the risk pool. Before
buying health insurance, a person typically fills out a comprehensive
medical history form that asks whether the person smokes, how much the
person weighs, whether the person has been treated for any of a long
list of diseases and so on.
general, those who present large financial burdens are denied coverage
or charged high premiums to compensate. One large US industry survey
found that roughly 13 percent of applicants for comprehensive,
individually purchased health insurance who went through the medical
underwriting in 2004 were denied coverage. Declination rates increased
significantly with age, rising from 5 percent for individuals 18 and
under to just under a third for individuals aged 60 to 64.
those who were offered coverage, the study found that 76% received
offers at standard premium rates, and 22% were offered higher rates. On
the other side, applicants can get discounts if they do not smoke and
are healthy. Moral hazard Moral hazard occurs when an insurer and a
consumer enter into a contract under symmetric information, but one
party takes action, not taken into account in the contract, which
changes the value of the insurance.
common example of moral hazard is third-party payment—when the parties
involved in making a decision are not responsible for bearing costs
arising from the decision. An example is where doctors and insured
patients agree to extra tests which may or may not be necessary. Doctors
benefit by avoiding possible malpractice suits, and patients benefit by
gaining increased certainty of their medical condition. The cost of
these extra tests is borne by the insurance company, which may have had
little say in the decision.
deductibles, and less generous insurance for services with more elastic
demand attempt to combat moral hazard, as they hold the consumer
responsible. Other factors affecting insurance prices A recent study by
PriceWaterhouseCoopers examining the drivers of rising health care costs
in the US pointed to increased utilization created by increased
consumer demand, new treatments, and more intensive diagnostic testing,
as the most significant driver. People in developed countries are living
population of those countries is aging, and a larger group of senior
citizens requires more intensive medical care than a young healthier
population. Advances in medicine and medical technology can also
increase the cost of medical treatment. Lifestyle-related factors can
increase utilization and therefore insurance prices, such as: increases
in obesity caused by insufficient exercise and unhealthy food choices;
excessive alcohol use, smoking, and use of street drugs.
factors noted by the PWC study included the movement to broader-access
plans, higher-priced technologies, and cost-shifting from Medicaid and
the uninsured to private payers. Comparison Health care systems The
Commonwealth Fund, in its annual survey, "Mirror, Mirror on the Wall",
compares the performance of the health care systems in Australia, New
Zealand, the United Kingdom, Germany, Canada and the U.S. Its 2007 study
found that, although the U.S. system is the most expensive, it
consistently under-performs compared to the other countries. One
difference between the U.S. and the other countries in the study is that
the U.S. is the only country without universal health insurance
Health care in Australia The public health system is called Medicare.
It ensures free universal access to hospital treatment and subsidised
out-of-hospital medical treatment. It is funded by a 1.5% tax levy. The
private health system is funded by a number of private health insurance
organisations. The largest of these is Medibank Private, which is
government-owned, but operates as a government business enterprise under
the same regulatory regime as all other registered private health
Coalition Howard government had announced that Medibank would be
privatised if it won the 2007 election, however they were defeated by
the Australian Labor Party under Kevin Rudd which had already pledged
that it would remain in government ownership. Some private health
insurers are 'for profit' enterprises, and some are non-profit
organizations such as HCF Health Insurance. Some have membership
restricted to particular groups, but the majority have open membership.
aspects of private health insurance in Australia are regulated by the
Private Health Insurance Act 2007. The private health system in
Australia operates on a "community rating" basis, whereby premiums do
not vary solely because of a person's previous medical history, current
state of health, or (generally speaking) their age (but see Lifetime
Health Cover below). Balancing this are waiting periods, in particular
for pre-existing conditions (usually referred to within the industry as
PEA, which stands for "pre-existing ailment").
are entitled to impose a waiting period of up to 12 months on benefits
for any medical condition the signs and symptoms of which existed during
the six months ending on the day the person first took out insurance.
They are also entitled to impose a 12-month waiting period for benefits
for treatment relating to an obstetric condition, and a 2-month waiting
period for all other benefits when a person first takes out private
insurance. Funds have the discretion to reduce or remove such waiting
periods in individual cases.
are also free not to impose them to begin with, but this would place
such a fund at risk of "adverse selection", attracting a
disproportionate number of members from other funds, or from the pool of
intending members who might otherwise have joined other funds. It would
also attract people with existing medical conditions, who might not
otherwise have taken out insurance at all because of the denial of
benefits for 12 months due to the PEA Rule.
benefits paid out for these conditions would create pressure on
premiums for all the fund's members, causing some to drop their
membership, which would lead to further rises, and a vicious cycle would
ensue. There are a number of other matters about which funds are not
permitted to discriminate between members in terms of premiums, benefits
or membership - these include racial origin, religion, sex, sexual
orientation, nature of employment, and leisure activities.
for a fund's product that is sold in more than one state can vary from
state to state, but not within the same state. The Australian government
has introduced a number of incentives to encourage adults to take out
private hospital insurance. These include: Lifetime Health Cover : If a
person has not taken out private hospital cover by the 1st July after
their 30th birthday, then when (and if) they do so after this time,
their premiums must include a loading of 2% per annum.
a person taking out private cover for the first time at age 40 will pay
a 20 per cent loading. The loading continues for 10 years. The loading
applies only to premiums for hospital cover, not to ancillary (extras)
cover. Medicare Levy Surcharge : People whose taxable income is greater
than a specified amount (currently $70,000 for singles and $140,000 for
couples) and who do not have an adequate level of private hospital cover
must pay a 1% surcharge on top of the standard 1.5% Medicare Levy.
rationale is that if the people in this income group are forced to pay
more money one way or another, most would choose to purchase hospital
insurance with it, with the possibility of a benefit in the event that
they need private hospital treatment - rather than pay it in the form of
extra tax as well as having to meet their own private hospital costs.
The Australian government announced in May 2008 that it proposes to
increase the thresholds, to $100,000 for singles and $150,000 for
families. These changes require legislative approval.
bill to change the law has been introduced but was not passed by the
Senate. A changed version was passed on 16 October 2008. There have been
criticisms that the changes will cause many people to drop their
private health insurance, causing a further burden on the public
hospital system, and a rise in premiums for those who stay with the
private system. Other commentators believe the effect will be minimal.
Private Health Insurance Rebate:
government subsidises the premiums for all private health insurance
cover, including hospital and ancillary (extras), by 30%, 35% or 40%.
Canada Health care in Canada Most health insurance in Canada is
administered by each province, under the Canada Health Act, which
requires all people to have free access to basic health services.
Collectively, the public provincial health insurance systems in Canada
are frequently referred to as Medicare.
health insurance is allowed, but the provincial governments allow it
only for services that the public health plans do not cover; for
example, semi-private or private rooms in hospitals and prescription
drug plans. Canadians are free to use private insurance for elective
medical services such as laser vision correction surgery, cosmetic
surgery, and other non-basic medical procedures.
65% of Canadians have some form of supplementary private health
insurance; many of them receive it through their employers.
Private-sector services not paid for by the government account for
nearly 30 percent of total health care spending. In 2005, the Supreme
Court of Quebec ruled, in Chaoulli v. Quebec, that the province's
prohibition on private insurance for health care already insured by the
provincial plan could constitute an infringement of the right to life
and security if there were long wait times for treatment as happened in
other provinces have legislation which financially discourages but does
not forbid private health insurance in areas covered by the public
plans. The ruling has not changed the overall pattern of health
insurance across Canada but has spurred on attempts to tackle the core
issues of supply and demand and the impact of wait times.
France Health care in France
French model of health insurance has been ranked by the World Health
Organization as the best in the world, because it permits a high quality
of care and nearly total patient freedom. The national system of health
insurance was instituted in 1945, just after the end of the Second
World War. It was a compromise between Gaullist and Communist
representatives in the French parliament.
Conservative Gaullists were opposed to a state-run healthcare system,
while the Communists were supportive of a complete nationalisation of
health care along a British Beveridge model. The resulting programme was
profession-based : all people working were required to pay a portion of
their income to a health insurance fund, which mutualised the risk of
illness, and which reimbursed medical expenses at varying rates.
and spouses of insured people were eligible for benefits, as well. Each
fund was free to manage its own budget and reimburse medical expenses
at the rate it saw fit. The government has two responsibilities in this
system. The first government responsibility is the fixing of the rate at
which medical expenses should be negotiated, and it does this in two
ways: The Ministry of Health directly negotiates prices of medicine with
the manufacturers, based on the average price of sale observed in
board of doctors and experts decides if the medicine provides a
valuable enough medical benefit to be reimbursed (note that most
medicine is reimbursed, including homeopathy). In parallel, the
government fixes the reimbursment rate for medical services : this means
that a doctor is free to charge the fee that he wishes for a
consultation or an examination, but the social security system will only
reimburse it at a pre-set rate. These tariffs are set annually through
negotiation with doctors' representative organisations.
second government responsibility is oversight of the health-insurance
funds, to ensure that they are correctly managing the sums they receive,
and to ensure oversight of the public hospital network. Today, this
system is more-or-less intact. All citizens and legal foreign residents
of France are covered by one of these mandatory programs, which continue
to be funded by worker participation. However, since 1945, a number of
major changes have been introduced. Firstly, the different health-care
funds (there are five : General, Independent, Agricultural, Student,
Public Servants) now all reimburse at the same rate.
since 2000, the government now provides health care to those who are
not covered by a mandatory regime (those who have never worked and who
are not students, meaning the very rich or the very poor). This regime,
unlike the worker-financed ones, is financed via general taxation and
reimburses at a higher rate than the profession-based system for those
who cannot afford to make up the difference. Finally, to counter the
rise in health-care costs, the government has installed two plans, (in
2004 and 2006), which require insured people to declare a referring
doctor in order to be fully reimbursed for specalist visits, and which
installed a mandatory co-pay of 1 € (about $1.45) for a doctor visit,
0,50 € (about 80 ¢) for each box of medicine prescribed, and a fee of
16-18 € (20-25 $) per day for hospital stays and for expensive
important element of the French insurance system is solidarity : the
more ill a person becomes, the less they pay. This means that for people
with serious or chronic illnesses, the insurance system reimburses them
100 % of expenses, and waives their co-pay charges. Finally, for fees
that the mandatory system does not cover, there is a large range of
private complementary insurance plans available. The market for these
programs is very competitive, and often subsidised by the employer,
which means that premiums are usually modest. 85% of French people
benefit from complementary private health insurance.
Health care in the Netherlands In 2006, a new system of health
insurance came into force in the Netherlands. This new system avoids the
two pitfalls of adverse selection and moral hazard associated with
traditional forms of health insurance by using a combination of
regulation and an insurance equalization pool. Moral hazard is avoided
by mandating that insurance companies provide at least one policy which
meets a government set minimum standard level of coverage, and all adult
residents are obliged by law to purchase this coverage from an
insurance company of their choice.
insurance companies receive funds from the equalization pool to help
cover the cost of this government-mandated coverage. This pool is run by
a regulator which collects salary-based contributions from employers,
which make up about 50% of all health care funding, and funding from the
government to cover people who cannot afford health care, which makes
up an additional 5%. The remaining 45% of health care funding comes from
insurance premiums paid by the public, for which companies compete on
price, though the variation between the various competing insurers is
only about 5%. However, insurance companies are free to sell additional
policies to provide coverage beyond the national minimum.
policies do not receive funding from the equalization pool, but cover
additional treatments, such as dental procedures and physiotherapy,
which are not paid for by the mandatory policy. Funding from the
equalization pool is distributed to insurance companies for each person
they insure under the required policy. However, high-risk individuals
get more from the pool, and low-income persons and children under 18
have their insurance paid for entirely.
of this, insurance companies no longer find insuring high risk
individuals an unappealing proposition, avoiding the potential problem
of adverse selection. Insurance companies are not allowed to have
co-payments, caps, or deductibles, or to deny coverage to any person
applying for a policy, or to charge anything other than their nationally
set and published standard premiums. Therefore, every person buying
insurance will pay the same price as everyone else buying the same
policy, and every person will get at least the minimum level of
Kingdom National Health Service The UK's National Health Service (NHS)
is a publicly funded healthcare system that provides coverage to
everyone normally resident in the UK. It is not strictly an insurance
system because (a) there are no premiums collected, (b) costs are not
charged at the patient level and (c) costs are not pre-paid from a pool.
However, it does achieve the main aim of insurance which is to spread
financial risk arising from ill-health. The costs of running the NHS
(est. £104 billion in 2007-8) are met directly from general taxation.
NHS provides the majority of health care in the UK, including primary
care, in-patient care, long-term health care, ophthalmology and
dentistry. Private health care has continued parallel to the NHS, paid
for largely by private insurance, but it is used by less than 8% of the
population, and generally as a top-up to NHS services. There are many
treatments that the private sector does not provide.
example, health insurance on pregnancy is generally not covered or
covered with restricting clauses. One of the major insurers, BUPA,
excludes many forms of treatment and care that most people will need
during their lifetime or specialist care most of which are freely
available from the NHS.
include: ageing, menopause and puberty; AIDS/HIV; allergies or allergic
disorders; birth control, conception, sexual problems and sex changes;
chronic conditions; complications from excluded or restricted
conditions/ treatment; convalescence, rehabilitation and general nursing
care ; cosmetic, reconstructive or weight loss treatment; deafness;
dental/oral treatment (such as fillings, gum disease, jaw shrinkage,
etc); dialysis; drugs and dressings for out-patient or take-home use† ;
experimental drugs and treatment; eyesight; HRT and bone densitometry;
learning difficulties, behavioural and developmental problems; overseas
treatment and repatriation; physical aids and devices; pre-existing or
special conditions; pregnancy and childbirth; screening and preventive
treatment; sleep problems and disorders; speech disorders; temporary
relief of symptoms († = except in exceptional circumstances) BUPA's
competitors include, among others, AXA, Aviva, Groupama Healthcare and
the private sector has been used to increase NHS capacity despite a
large proportion of the British public opposing such involvement. .
According to the World Health Organization, government funding covered
86% of overall health care expenditures in the UK as of 2004, with
private expenditures covering the remaining 14%. United States Health
insurance in the United States and Health care in the United States The
US market-based health care system relies heavily on private and
not-for-profit health insurance, which is the primary source of coverage
for most Americans.
to the United States Census Bureau, approximately 84% of Americans have
health insurance; some 60% obtain it through an employer, while about
9% purchase it directly. Various government agencies provide coverage to
about 27% of Americans (there is some overlap in these figures). Public
programs provide the primary source of coverage for most seniors and
for low-income children and families who meet certain eligibility
primary public programs are Medicare, a federal social insurance
program for seniors and certain disabled individuals, Medicaid, funded
jointly by the federal government and states but administered at the
state level, which covers certain very low income children and their
families, and SCHIP, also a federal-state partnership that serves
certain children and families who do not qualify for Medicaid but who
cannot afford private coverage.
public programs include military health benefits provided through
TRICARE and the Veterans Health Administration and benefits provided
through the Indian Health Service. Some states have additional programs
for low-income individuals. In 2006, there were 47 million people in the
United States (16% of the population) who were without health insurance
for at least part of that year.
37% of the uninsured live in households with an income over $50,000. In
2004, US health insurers directly employed almost 470,000 people at an
average salary of $61,409. (As of the fourth quarter of 2007, the total
US labor force stood at 153.6 million, of whom 146.3 million were
employed. Employment related to all forms of insurance totaled 2.3
annual earnings for full-time civilian workers as of June 2006 were
$41,231; median earnings were $33,634.) The insurance industry also
represents a significant lobbying group in the US. For 2008 insurance
was the 8th among industries in political contributions to members of
Congress, giving $28,654,121, of which 51% was given to Democrats and
49% to Republicans, with the top recipient of insurance industry
contributions being Senator John McCain (R-AZ).
leading contributor from the insurance industry — as measured by total
political contributions — was AFLAC, Inc., which contributed $907,150 in
2007. Health Insurance 2019.