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Related post: is one of the oldest forms of insurance. If sick-
ness insurance is really the solution of the sick-
ness problem which its advocates assert, why is it
that without compulsion, fifty per cent, subsidies,
and various other tonics to help it along, it has not
been able to reach a position of more than three
and one half per cent, usefulness?
There are two chief reasons why sickness in-
surance has never been able to take its place along-
side of fire and life insurance. The first of these
reasons is its excessive costs as measured by the
protection afforded. The other reason is the exces-
sive waste which is inseparable from this form of
insurance, whether it is voluntary or compulsory.
Insurance is purchased for the protection af-
forded, Buy Sevelamer Hydrochloride and is cheap or expensive according to the
amount of protection which can be bought for a
given sum. When one can insure a six thousand
dollar building against loss by fire for ten dollars
a year, there is no question of the advisability of
carrying the insurance. On the 'Other hand, if it
were to cost one thousand five hundred dollars a
year to insure a six thotisand dollar building
against loss by fire, almost no one would carry
fire insurance even though the hazard were such
as to justify the risk. The difference between the
rates mentioned above is, however, approximately
the difference between the cost of fire and sick-
ness insurance. Fire insurance is almost univer- Sevelamer Hydrochloride Tablets
sal and this is because there is no question as to
its economic value. In a city such as Schenectady
the ratio between cost and protection is for the
average risk about one dollar premium per annum
for six hundred dollars' worth of protection. In-
surance against death is another typical example
of insurance of unquestioned economic value. The
death of the head of the family is an irreparable
damage. The chances of this occurring in any
given unit of time are small. For instance, be-
tween the years of twenty and forty-two the risk
for any one year is less than one in one hundred.
If we set aside the investment features of the
average policy, we find that life insurance during
the years of the average man's economic activity
costs only about one dollar a year for each one
hundred dollars of protection.
In sickness insurance we find conditions abso-
lutely different from those encountered in fire and
life insurance. Instead of six hundred dollars and
one hundred dollars, respectively, of protection
purchasable for one dollar premium, we find
ii
February 21, 1920.]
L'jft, Kat, Mse & laroai ufe)i>pua^'
STANTON: COMPULSORY HEALTH INSURANCE.
321
under the best individual type of sickness in-
surance an average protection of below five dollars
for each one dollar paid as premium, while in the
family type of compulsory health insurance, as pro-
posed in the socalled model bills of the American
Association for Labor Legislation, this average
protection for real cases of illness must of neces-
sity sink to but little, if any, over one dollar
average protection for each one dollar paid as
premium.
The reasons for the low insurance value of sick-
ness insurance are not difficult to ascertain. The
economic value of insurance decreases as the oc-
currence against which the insurance is carried be-
comes more frequent and the distribution more
uniform. For illustration, suppose that each indiv-
idual could count upon being sick once a year for
an approximately uniform length of time. Then
it would be the height of folly to attempt to carry
yearly term sickness insurance because from the
very nature of things the returns from this in-
surance could only be the amount of the premium
paid less the overhead costs of conducting the
business. Stripped of superfluous detail this is the
insurance problem actually encountered by the
socalled model bills championed by the compulsory
health insurance advocates. The model bills pro-
vide for the medical care of all members of the.
family. The compulsory health insurance advo-
cates are particularly fond of quoting the Ohio
family statistics, so we will take these studies as
a basis for our illustration.
The U. S. Bureau of Labor Statistics ascer-
tained the costs, in 1918, for medical care in 719
families in Cleveland, Lorain, Toledo and Colum-
bus. Because seven families out of the 719 had
medical expenses amounting to over three hundred
dollars it is argued that the entire group of 719
should have been insured for the purpose of pro-
tecting the seven particularly unfortunate families.
This is typical of the mental attitude which concen-
trates on the one per cent, and overlooks the
ninety-nine per cent. As a matter of fact, 716 of
the 719 families had sickness expenses during the
year, averaging $41.97 to a family. Not only was
there sickness in more than ninety-nine per cent, of
the families, but the distribution of sickness is so
nearly uniform that only five and one half per cent.
of the families had sickness expenses in excess of
one hundred and twenty-five dollars, which is only
three times the average expense for each family.
Only twenty-five families, or three and one third
per cent., had sickness expenses in excess of one
hundred and fifty dollars, and less than one per
cent, had expenses amounting to over three
hundred dollars. In the face of the distri-
bution of illness as shown by these figures, the
family unit type of sickness insurance can only be
justified from an economic viewpoint if it can be
shown that the cost of conducting the insurance
is insignificant as compared with the benefits to
be given to the families having abnormally high
sickness costs. As I will show "later the overhead
costs and economic waste incident to this form of
sickness insurance has never been less than forty
per cent., and from the very nature of things, can
never be much less than this figure. For
purposes of illustration, however, we can assume
that some miracle will take place and that the
waste incident to politically controlled compulsory
health insurance would be only thirty per cent.
Assuming only a thirty per cent, loss, we are still
confronted with the fact that in order to insure
the twenty-five families who had expenses over
one hundred and fifty dollars against an aggregate
loss of less than six thousand six hundred dollars
the remaining 694 families would have had to raise

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