Compulsory accident and sickness insurance was initiated (1883-84) in Germany by Otto von Bismarck; it was adopted by Great Britain, France, Chile, the Soviet Union, and other nations after World War I.

In Britain the National Health Insurance Act of 1946, provided the most comprehensive compulsory medical care plan introduced anywhere at that time. Under the plan the individual obtained free medical attention from any doctor participating in the National Health Service. The cost was met by the national government and local taxation; however, small charges for some services have been instituted since then.

In 1958 the Canadian Hospital and Diagnoses Act provided full hospital service almost free of charge in public wards with comprehensive coverage added ten years later.

The programme is financed by the federal government but administered by the provinces. National health insurance has been widely adopted in Europe and parts of Asia.

Voluntary programmes date from about 1850, when health insurance was provided chiefly by cooperative mutual benefit and fraternal beneficiary associations.

Limited coverage by commercial companies was also introduced during that period, and the carried industries and labour unions. Advocacy of government health insurance in the United States began in the early 1900s when Theodore Roosevelt tried to make it a major theme of the Progressive party during the 1912 presidential campaign.

After 1920, opposition to government-sponsored plans was led by the American Medical Association, said to be motivated by the fear that government participation in medical care might lead to socialized medicine.

Consequently, the United States is the only Western industrial nation without some form of comprehensive national health insurance.

? we tend to take them for granted while we are employed, so much so that it almost seems an inalienable right, not a benefit of the job.

Do you know anyone that does not have some form of health insurance? No? Consider yourself fortunate.

In Bermuda, most employers must provide health insurance to just about all of their employees who fit health benefit guidelines. There is no such mandate in the US where this year the highest number ever without any health insurance, more than 45 million citizens, must routinely trek to emergency rooms, street clinics, or go untreated.

Statistically, on a percentage basis even though there appears to be no information available, if Bermuda had those numbers, based upon 15 percent of our 60,000 population, we?d have more than 9,000 individuals stressing the portals of our local hospital and health care workers.

? are inflating at a rate of more than 15 percent average annually, far more than those every day general living expenses each and every year, both here and abroad.

According to a recent study by human resources consultant US Hewitt Associates, employers are seeking to solve the problem by changing the products they offer, changing insurers, reducing coverage, passing costs on to employees by raising deductibles, co-pay levels, and shifting more of the premium expense.

The goal is to save money by making employees more accountable for their medical expenditures.

How would we feel about ourselves if we were awarded points toward discounted health insurance if we passed ?staying healthy? tests?

Would we be treated differently by being penalized (higher premiums) for not adhering to good health habits? Would these strategies work to help everyone adapt healthier lifestyles?

Or do we feel that it?s a free marketplace where we have the right to shop around for the health care provided with the best prices and that?s it? After all, we live in a democracy. Isn?t it our right to live as we wish?

And speaking of those stay healthy tests, who determines who passes and who does not? If we are in a pool and a few bad apples (literally) refuse to take care of themselves, costing all of us collectively more in premiums, will we be able to take our healthy selves to another healthy citizen pool?

Could any of this happen? As a collective group, do we seriously take responsibility for our health and living habits?

Flawless skin, superb physical strength or beauty, and just plain glowing good health. If only one could preserve this supreme state of being and dole it out carefully as we get older!

In a testament to the powerful design of a supreme being, our bodies can take tremendous physical and mental abuse and appear none the worse for wear. We are sheer resilience as young people, nothing can happen and we can never grow old, infirm, or sick. If only.

Yet lessons are there, such as reformed smoker Peter Jennings with lung cancer, twenty years after he gave up the habit.

While future scenarios may seem like pure conjecture today on my part, when General Motors announces that the cost of health care per worker is more than the cost for car parts, we know there is a serious competitive marketplace imbalance problem for thousands of companies. GM?s costs for health care run $5 billion per year, an average of $6500 per worker. GM competes against foreign automakers whose health-care costs are government-subsidized, yet analysts have stated that ?either GM cuts its health care costs or it goes bankrupt?.

Health care providers and employers may eventually have to ask us all to take more responsibility for our own health.

Nor can we ignore those who have no coverage. Government financial assistance does not grow money; it has to come from somewhere.

Even for those who have prepared, the impact of this four-times-the-rate of inflation annual increases for those who must self-insure is a far too quick erosion of savings meant to last a retirement lifetime.

So, the big questions are, for we Bermuda residents living in one of the greatest average annual income per capita communities on the planet, how much of our health and wellness are we willing to take responsibility for?

And if health costs continue to be hard to control, who is going to foot the bill?

@EDITRULE:

She can be reached at 299-5578 Confidential email can be directed to marthamyronnorthrock.bm

The article expresses the opinion of the author alone. Under no circumstances is the content of this article to be taken as specific individual investment advice, nor as a recommendation to buy/ sell investment products or financial plans.