Activating the Self-employed, making efforts work for health promotion through medical/health insurance

Work and leisure should be a source of health for people. The way society organizes work should help create a healthy society.
(Ottawa Center for Health Promotion, 1986)

According to a book published by the WHO entitled “Creating supportive environments for health” – In the context of health promotion, health the ability of an individual to achieve his or her potential and to respond positively to the challenges of the environment. It is a source for everyday life and not the object of living; it is a positive concept emphasizing social and personal resources as well as physical capabilities.

Modern concept of health (state of physical, mental and social well being, not merely the absence of disease or infirmity) by the WHO correlates with health promotion in order to achieve human’s optimum level of functioning whether categorized as individuals, families or communities.

The growing concern of health issues roots from an array of changes in Human Ecology. Politics, Behaviour, Heredity/Genetics, Health Care Delivery Systems, Environmental Elements, and Socio-Economic Influences- all inter-related factors in creating major/minor impacts in the achievement of human’s optimum level of functioning.

For the self-employed, health insurance may not be a priority rather it is considered a cost, not an investment. Further, many self-employed cannot afford health insurance but are too rich to qualify for Medicaid.

Classically, self-employment falls on the household sector that historically dominated the peasant society (categories of work activities were: household, private, and public sectors). In early industrial society, the private sector grew in most countries. The public sectors cover the areas: education and health care, including care of children and elderly. Social security system was introduced in order to render services to different groups: age, gender, employment status, wealth, etc because the public and private sectors work in groups rather than the individual. The integration of medical/health insurance in most security systems have a variety of advantage and disadvantages depending on the policies/provisions of the insurance system which vastly influenced by factors directly or indirectly linked to the health care delivery system.

In modern societies, the social security system may be government or privately-controlled. The fast-changing society had drastic shifts to highly industrialized level and globalized communities. Hence, ill-effects to the environment particularly the disregard to the long-term effects of environmental damage posts health risks- that seek great demands for solutions that work in a long-term basis. Studies supporting correlations between health and economic development encourages both the public and private sector to tap the participation of more companies to mobilize resources- gain support for medical/health insurances forcing them to increase contributions in exchange for some privileges that often creates discrepancies in quality that may aggravate Health Crises. Worse, the self-employed shoulders this increase himself in order to augment the still-growing health costs or worse, he does not avail any health insurance at all. Some companies offer medical/health benefits as a strategy to retain employees- only to disappoint the latter due to lack of funds when the time comes that he needs the services. The unending debate on “putting a price on a human being” place policy-makers in conflicting resolutions as to what models of health insurance scheme to adopt and what plans really work. The solution is going back to the basics, look into the participation of the self-employed as part of the team and empower them to take control of their own health in the context of health promotion. The role of the government should not be delimited to the health insurance scheme but to strengthen its teeth on factors that contribute to high cost of health care products and services.

The government is still the prime authority that should spearhead health promotion through integration in the health insurance schemes. Appropriate infrastructure and instruments are needed in order to achieve a comprehensive long-term health promotion. Work place committees for the self-employed should also be created along with appropriate representative so that the health situation will be analyzed via team- set targets, initiate health programs and evaluate results. Forum and seminars facilitates opportunity for participation of the self-employed with the public and private sector. The creation of a database that contains related literature should be available publicly for research, planning, development of concepts and models of health promotion.

Health requires a multi-disciplinary approach that involves participation of all sectors.