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This current, accurate and detailed industry guide for financial service professionals examines life and health insurance "simultaneously from the viewpoints of the buyer, the advisor, and the insurer"--providing a comprehensive and unbiased treatise on individual and group life; a forthright appraisal of life and health insurance industry products with careful consideration of the environment; and a complete examination of life insurance company operations and regulation. Bases financial treatment of life insured operations on modern financial theory, and devotes entire chapters to the economics of life and health insurance; individual life and health insurance policies; life and health insurance evaluation; the uses of life and health insurance in personal and business planning; government and employee benefit plans; and the management, operation, and regulation of life insurance companies. Offers a strong global orientation, supporting fundamental concepts with an extensive integration of economic and financial theory and international comparisons, and examines how today's health insurance products fit into a broad framework from a contractual, cost, and performance viewpoints. New chapters on the tax treatment of life and health insurance address such areas as estate planning, retirement planning, and the business uses of life and health insurance. For financial planners, salesmen, actuaries, investment managers, attorneys, CPAs, and other financial service professionals.

Why do people buy health insurance? Conventional theory holds that people purchase insurance because they prefer the certainty of paying a small premium to the risk of getting sick and paying a large medical bill. Conventional theory also holds that any additional health care that people purchase when they are insured is of such low value that it is not worth the costs of providing it. As a result, economists have promoted policies, such as cost sharing and managed care, to reduce consumption of this "low-value" care. This book presents a new theory of consumer demand for heath insurance. It holds that people purchase insurance to obtain additional "income" when they become ill. In effect, insurance companies take the premiums paid by those who remain relatively healthy and transfer them to those who come down with a serious disease. This additional income often allows sick persons to obtain medical care that they may not otherwise be able to afford. The value of health insurance, therefore, stems largely from the value of the additional health care that insurance makes possible, and has little, if anything, to do with preferences for certainty. Because its value lies largely in providing access to necessary health care, health insurance is held to be much more valuable under the new theory than the old. The new theory also implies that cost sharing and managed care -- central health policies of the last 30 years -- were largely directed at solving problems that did not exist. Because these policies either reduced the "income" transferred to ill persons or limited access to additional health care, they may have done more harm than good. The new theory suggests that insurancecoverage should be extended to the uninsured. It also provides a solid theoretical justification for implementing some form of national health insurance. The new theory emphasizes three constraints.

Social health insurance - Broadly speaking, health care systems across the world are funded in three different ways: by private contributions, social health insurance contributions or taxes. Social health insurance systems are characterized by the presence of sickness funds which usually receive a proportional contribution of their members' wages.

State Children's Health Insurance Program - The State Children’s Health Insurance Program (SCHIP) is a national program in the United States designed for families who earn too much money to qualify for Medicaid, yet cannot afford to buy private insurance. The program was created to address the growing problem of children in the United States without health insurance.

Ontario Health Insurance Plan - The Ontario Hospital Insurance Plan (OHIP) is the government-run health plan for the Canadian province of Ontario. More recently it has been referred to as the Ontario Health Insurance Plan, but the official name uses the term Hospital rather than Health due to legal questions related to the coverage of prescription drugs.

Health insurance fraud - Health insurance fraud is described as an intentional act of deceiving, concealing, or misrepresenting information that results in health care benefits being paid to an individual or group.

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