document_title: V for Vendetta (film)

question_text: who is the actor who plays v for vendetta

text: V for Vendetta (film)

text: Plot[edit]

text: In 2027, the world is in turmoil and warfare, with the United States fractured as a result of prolonged second civil war and a pandemic of the "St. Mary's Virus" ravaging Europe. The United Kingdom is ruled as a Nordic supremacist[7][8][9] and neo-fascist[10] police state by the Norsefire Party, helmed by all-powerful High Chancellor Adam Sutler. Political opponents, immigrants, Jews, Muslims, atheists, homosexuals, and other "undesirables" are imprisoned and executed in concentration camps. The Irish are not exterminated, but are considered inferior compared to people of Nordic and British descent.[7]

text: On November 4, a vigilante in a Guy Fawkes mask identifying himself as "V" rescues Evey Hammond, an employee of the state-run British Television Network, from members of the "Fingermen" secret police while she is out past curfew. From a rooftop, they watch his demolition of London's main criminal court, the Old Bailey, accompanied by fireworks and the "1812 Overture". Inspector Finch of Scotland Yard is asked to investigate V's activities while BTN declares the incident an "emergency demolition". V interrupts the broadcast to claim responsibility, encouraging the people of Britain to rise up against their government and meet him on next year's Guy Fawkes Night outside the Houses of Parliament. During the broadcast, the police attempt to capture V. Evey helps him escape, but is knocked unconscious.

text: V takes Evey to his home, where she is told she must remain for one year. V then kills Lewis Prothero, Norsefire's chief propagandist, and Anthony Lilliman, the Bishop of London. Evey offers to help, and uses the opportunity to escape to the home of her boss, comedian and talk show host Gordon Deitrich. In return for Evey trusting him with her safety, Gordon reveals prohibited materials, including subversive paintings, an antique Quran, and homoerotic photographs. Meanwhile, V confronts Dr. Delia Surridge, who had experimented on him and many other "undesirables" 20 years ago at Larkhill concentration camp; seeing her remorse for her past actions, he kills her painlessly.

text: After Gordon performs a satire of the government on his show, his home is raided and Evey is captured. She is imprisoned and tortured for information about V, with her only solace being a note written by actress Valerie Page, a former prisoner who was tortured and killed for her lesbianism. Evey is told she will be executed unless she reveals V's location. When she says she would rather die, she is inexplicably released, and then finds herself in V's home. It turns out that V was the one who had "captured" her at Gordon's home, and staged her imprisonment and torture to free her from her fears. The note was real, passed from Valerie to V when he was imprisoned. He also informs her that Deitrich had been executed when the Quran was found in his home. While Evey initially hates V for what he did to her, she realises she has become a stronger person. She leaves him, promising to return before November 5.

text: Reading the deceased Surridge's journal, Finch learns V is the result of human experimentation and has been targeting the people who detained him. Despite being stonewalled by the government, Finch searches for the true identity of V, tracing him to a bioweapons program in Larkhill. Finch meets William Rookwood, who tells him that the program, which was directed by Sutler (who was then Undersecretary of Defence), resulted in the creation of the deadly St. Mary's Virus. He further reveals that Creedy, a leader of the Norsefire Party, released the virus onto English soil, killing 100,000 British residents and framing the outbreak as an attack by a terrorist organisation. The Party, which promised security in times of social instability, used the ensuing wave of fear to elevate Sutler to the newly created office of High Chancellor and win an overwhelming majority in Parliament, becoming the elected government. Finch later discovers that Rookwood was V in disguise, and though he initially disbelieves the story, his faith in the Norsefire government is severely shaken.

text: As November 5 nears, V distributes thousands of Guy Fawkes masks, and the population questions party rule as the nation slowly descends into anarchy, ignited when one of the Fingermen makes the mistake of shooting and killing a young girl committing vandalism, only to be killed in turn by a mob of enraged citizens. On the eve of November 5, Evey visits V, who shows her an explosive-laden train in the abandoned London Underground, set to destroy Parliament. He leaves it to Evey to decide whether to use it. V meets Party Leader Creedy, with whom he has made a deal to surrender in exchange for Sutler's execution. After Creedy executes Sutler, V reneges on his deal and kills Creedy and his men. Mortally wounded, he returns to Evey and tells her he loves her before dying.

text: As Evey places V's body aboard the train, she is found by Finch. Disillusioned by the Party's regime, Finch allows Evey to send the train off. On the surface, thousands of unarmed Londoners wearing Guy Fawkes masks march towards Parliament. Since Creedy and Sutler are both dead, the military receives no orders, and allows the crowd to pass. As Parliament is destroyed, Finch asks Evey for V's identity, to which she replies, "He was all of us."

text: Cast[edit]

text: Hugo Weaving as V:

tag: ul

text: Natalie Portman as Evey Hammond:

text: Stephen Rea as Eric Finch:

text: John Hurt as High Chancellor Adam Sutler:

text:
Stephen Fry as Gordon Deitrich, a closeted homosexual and talk/comedy show host. When asked in an interview what he liked about the role, Fry replied "Being beaten up! I hadn't been beaten up in a movie before and I was very excited by the idea of being clubbed to death."[18]
Tim Pigott-Smith as Peter Creedy, Norsefire's Party leader and the head of Britain's secret police (the "Finger").[12]
Rupert Graves as Dominic Stone, Inspector Finch's lieutenant.
Roger Allam as Lewis Prothero, the "Voice of London", a propagandist for Norsefire, and formerly the Commander of Larkhill concentration camp.
John Standing as Anthony James Lilliman, a corrupt bishop at Westminster Abbey.
Eddie Marsan as Brian Etheridge, the head of the government's audio-surveillance division (the "Ear").
Ben Miles as Roger Dascombe, the head of the government's propaganda division (the "Mouth") and chief executive of the British Television Network.
Guy Henry as Conrad Heyer, the head of the government's visual-surveillance department (the "Eye").
Sinéad Cusack as Dr. Delia Surridge, the former head physician at the Larkhill Detention Centre, now a coroner.
Natasha Wightman as Valerie Page, a lesbian imprisoned for her sexuality. Imogen Poots portrays Valerie as a child.

text: Sources[edit]

text: V for Vendetta sets the Gunpowder Plot as V's historical inspiration, contributing to his choice of timing, language, and appearance.[12] For example, the names Rookwood, Percy and Keyes are used in the film, which are also the names of three of the Gunpowder conspirators.[citation needed] The film creates parallels to Alexandre Dumas' The Count of Monte Cristo, by drawing direct comparisons between V and Edmond Dantès. (In both stories, the hero escapes an unjust and traumatic imprisonment and spends decades preparing to take vengeance on his oppressors under a new persona.)[19][20][21] The film is also explicit in portraying V as the embodiment of an idea rather than an individual through V's dialogue and by depicting him without a past, identity or face. According to the official website, "V's use of the Guy Fawkes mask and persona functions as both practical and symbolic elements of the story. He wears the mask to hide his physical scars, and in obscuring his identity – he becomes the idea itself."[12]

text: As noted by several critics and commentators, the film's story and style mirror elements from Gaston Leroux's The Phantom of the Opera.[22][23] V and the Phantom both wear masks to hide their disfigurements, control others through the leverage of their imaginations, have tragic pasts, and are motivated by revenge. V and Evey's relationship also parallels many of the romantic elements of The Phantom of the Opera, where the masked Phantom takes Christine Daaé to his subterranean lair to re-educate her.[22][23][24]

text: As a film about the struggle between freedom and the state, V for Vendetta takes imagery from many classic totalitarian icons both real and fictional, including the Third Reich and George Orwell's Nineteen Eighty-Four.[12][16] For example, Adam Sutler[16] primarily appears on large video screens and on portraits in people's homes, both common features among modern totalitarian regimes and reminiscent of the image of Big Brother. The slogan "Strength through Unity. Unity through Faith" is displayed prominently across London, similar in cadence to "War is Peace. Freedom is Slavery. Ignorance is Strength" in Orwell's book.[25] There is also the state's use of mass surveillance, such as closed-circuit television, on its citizens. Valerie was sent to a detention facility for lesbianism and then had medical experiments performed on her, reminiscent of the persecution of homosexuals in Nazi Germany and the Holocaust.[23]

text: Themes and references[edit]

text:
"We felt the novel was very prescient to how the political climate is at the moment. It really showed what can happen when society is ruled by government, rather than the government being run as a voice of the people. I don't think it's such a big leap to say that things like that can happen when leaders stop listening to the people."

—James McTeigue, Director[12]

tag: div

text: The filmmakers added topical references relevant to a 2006 audience. According to the Los Angeles Times, "With a wealth of new, real-life parallels to draw from in the areas of government surveillance, torture, fear mongering and media manipulation, not to mention corporate corruption and religious hypocrisy, you can't really blame the filmmakers for having a field day referencing current events." There are also references to an avian flu pandemic,[25] as well as pervasive use of biometric identification and signal-intelligence gathering and analysis by the regime.

text: Film critics, political commentators and other members of the media have also noted the film's numerous references to events surrounding the George W. Bush administration in the United States. These include the hoods and sacks worn by the prisoners in Larkhill that have been seen as a reference to the Abu Ghraib torture and prisoner abuse.[26][27] The Homeland Security Advisory System and rendition are also referenced.[28] One of the forbidden items in Gordon's secret basement is a protest poster with a mixed US–UK flag with a swastika and the title "Coalition of the Willing, To Power" which combines the "Coalition of the Willing" with Friedrich Nietzsche's concept of will to power.[29]

text: Despite the America-specific references, the filmmakers have always referred to the film as adding dialogue to a set of issues much broader than the US administration.[16] When James McTeigue was asked whether or not BTN was based on Fox News Channel, McTeigue replied, "Yes. But not just Fox. Everyone is complicit in this kind of stuff. It could just as well been the Britain's Sky News Channel, also a part of News Corp."[16]

text: Production and release[edit]

text: Development[edit]

text: The film was made by many of the same filmmakers involved in The Matrix series. In 1988, producer Joel Silver acquired the rights to two of Alan Moore's works: V for Vendetta and Watchmen.[30] After the release and relative success of Road House, writer Hilary Henkin was brought on to flesh out the project with an initial draft – one that bears little, if any, relation to the finished product, with the inclusion of overtly satirical and surrealistic elements not present in the graphic novel, as well as the removal of much of the novel's ambiguity, especially in regard to V's identity.[31] The Wachowskis were fans of V for Vendetta and in the mid-1990s, before working on The Matrix, wrote a draft screenplay that closely followed the graphic novel. During the post-production of the second and third The Matrix films, they revisited the screenplay and offered the director's role to James McTeigue. All three were intrigued by the original story's themes and found them to be relevant to the current political landscape. Upon revisiting the screenplay, the Wachowskis set about making revisions to condense and modernise the story, while at the same time attempting to preserve its integrity and themes. James McTeigue cites the film The Battle of Algiers as his principal influence in preparing to film V for Vendetta.[12]

text: Moore explicitly disassociated himself from the film due to his lack of involvement in its writing or directing, as well as due to a continuing series of disputes over film adaptations of his work.[13] He ended cooperation with his publisher, DC Comics, after its corporate parent, Warner Bros., failed to retract statements about Moore's supposed endorsement of the film. Moore said that the script contained plot holes[32] and that it ran contrary to the theme of his original work, which was to place two political extremes (fascism and anarchism) against one another. He argues his work had been recast as a story about "current American neo-conservatism vs. current American liberalism".[33] Per his wishes, Moore's name does not appear in the film's closing credits. Co-creator and illustrator David Lloyd supports the film adaptation, commenting that the script is very good but that Moore would only ever be truly happy with a complete book-to-screen adaptation.[30]

text: Filming[edit]

text: V for Vendetta was filmed in London, United Kingdom, and in Potsdam, Germany, at Babelsberg Studios. Much of the film was shot on sound stages and indoor sets, with location work done in Berlin for three scenes: the Norsefire rally flashback, Larkhill, and Bishop Lilliman's bedroom. The scenes that took place in the abandoned London Underground were filmed at the disused Aldwych tube station. Filming began in early March 2005 and principal photography officially wrapped in early June 2005.[30] V for Vendetta is the final film shot by cinematographer Adrian Biddle, who died of a heart attack on December 7, 2005.[34]

text: To film the final scene at Westminster, the area from Trafalgar Square and Whitehall up to Parliament and Big Ben had to be closed for three nights from midnight until 5 am. This was the first time the security-sensitive area (home to 10 Downing Street and the Ministry of Defence) had ever been closed to accommodate filming.[35] Prime Minister (at the time of filming) Tony Blair's son, Euan, worked on the film's production and is said (according to an interview with Stephen Fry) to have helped the filmmakers obtain the unparalleled filming access. This drew criticism of Blair from MP David Davis due to the film's content. However, the filmmakers denied Euan Blair's involvement in the deal,[36] stating that access was acquired through nine months of negotiations with fourteen different government departments and agencies.[35]

text: Post-production[edit]

text: The film was designed to have a future-retro look, with heavy use of grey tones to give a dreary, stagnant feel to totalitarian London. The largest set created for the film was the Shadow Gallery, which was made to feel like a cross between a crypt and an undercroft.[37] The Gallery is V's home as well as the place where he stores various artefacts forbidden by the government. Some of the works of art displayed in the gallery include The Arnolfini Portrait by Jan van Eyck, Bacchus and Ariadne by Titian, a Mildred Pierce poster, St. Sebastian by Andrea Mantegna, The Lady of Shalott by John William Waterhouse and statues by Giacometti. One of the major challenges in the film was how to bring V to life from under an expressionless mask. Thus, considerable effort was made to bring together lighting, acting, and Weaving's voice to create the proper mood for the situation. Since the mask muffled Weaving's voice, his entire dialogue was re-recorded in post-production.[35]

text: Promotion[edit]

text: The cast and filmmakers attended several press conferences that allowed them to address issues surrounding the film, including its authenticity, Alan Moore's reaction to it and its intended political message. The film was intended to be a departure from some of Moore's original themes. In the words of Hugo Weaving: "Alan Moore was writing about something which happened some time ago. It was a response to living in Thatcherite Britain... This is a response to the world in which we live today. So I think that the film and the graphic novel are two separate entities." Regarding the film's controversial political content, the filmmakers have said that the film is intended more to raise questions and add to a dialogue already present in society, rather than provide answers or tell viewers what to think.[16]

text: Release[edit]

text: The film adopts extensive imagery from the 1605 Gunpowder Plot, in which a group of Catholic conspirators plotted to destroy the then Houses of Parliament in order to spark a revolution in England.[30] The film was originally scheduled for release on the weekend of November 5, 2005, the Plot's 400th anniversary, with the tag line "Remember, remember the 5th of November", taken from a traditional British rhyme memorialising the event. However, the marketing angle lost much of its value when the release date was pushed back to March 17, 2006. Many have speculated that the delay was caused by the London tube bombing on the July 7 and the failed July 21 bombing.[38] The filmmakers have denied this, saying that the delays were due to the need for more time to finish the visual effects production.[39] V for Vendetta had its first major premiere on December 11, 2005, at Butt-Numb-A-Thon, followed by a premiere on February 13, 2006 at the Berlin Film Festival.[2][16] It opened for general release on March 17, 2006 in 3,365 cinemas in the United States, the United Kingdom and six other countries.[5]

text: Reception[edit]

text: Commercial[edit]

text: By December 2006, V for Vendetta had grossed $132,511,035, of which $70,511,035 was from the United States. The film led the U.S. box office on its opening day, taking in an estimated $8,742,504, and remained the number one film for the remainder of the weekend, taking in an estimated $25,642,340. Its closest rival, Failure to Launch, took in $15,604,892.[5] The film debuted at number one in the Philippines, Singapore, South Korea, Sweden and Taiwan. V for Vendetta also opened in 56 IMAX cinemas in North America, grossing $1.36 million during the opening three days.[40]

text: Critical[edit]

text: Ebert and Roeper gave the film a "two thumbs up" rating. Roger Ebert stated that V for Vendetta "almost always has something going on that is actually interesting, inviting us to decode the character and plot and apply the message where we will". Margaret Pomeranz and David Stratton from At the Movies stated that despite the problem of never seeing Weaving's face, there was good acting and an interesting plot, adding that the film is also disturbing, with scenes reminiscent of Nazi Germany.[41] Jonathan Ross from the BBC blasted the film, calling it a "woeful, depressing failure" and stating that the "cast of notable and familiar talents such as John Hurt and Stephen Rea stand little chance amid the wreckage of the Wachowski siblings' dismal script and its particularly poor dialogue."[42] Sean Burns of Philadelphia Weekly gave the film a 'D', criticizing the film's treatment of its political message as being "fairly dim, adolescent stuff,"[43] as well as expressing dislike for the "barely decorated sets with television-standard overlit shadow-free cinematography by the late Adrian Biddle. The film is a visual insult."[43] On Alan Moore removing his name from the project, Burns says "it's not hard to see why,"[43] as well as criticising Portman's performance: "Portman still seems to believe that standing around with your mouth hanging open constitutes a performance."[43] Harry Guerin from the Irish TV network RTÉ states the film "works as a political thriller, adventure and social commentary and it deserves to be seen by audiences who would otherwise avoid any/all of the three". He added that the film will become "a cult favourite whose reputation will only be enhanced with age."[44] Andy Jacobs for the BBC gave the film two stars out of five, remarking that it is "a bit of a mess... it rarely thrills or engages as a story."[45]

text: V for Vendetta received few awards, although at the 2007 Saturn Awards Natalie Portman won the Best Actress award.[46] On review aggregator website Rotten Tomatoes, the film received an approval rating of 73% based on 244 reviews, with an average rating of 6.8/10. The site's critical consensus reads, "Visually stunning and thought-provoking, V For Vendetta's political pronouncements may rile some, but its story and impressive set pieces will nevertheless entertain."[47] On Metacritic, the film has a weighted average score of 62 out of 100 based on 39 critics, indicating "generally favorable reviews".[48] The film was nominated for the Hugo Award for Best Dramatic Presentation, Long Form in 2007.[49] V was included on Fandomania's list of The 100 Greatest Fictional Characters.[50] Empire magazine (in 2008) named the film the 418th greatest movie of all time.[51]

text: Political[edit]

text: V for Vendetta deals with issues of homosexuality (and its complement homophobia), criticism of religion, totalitarianism, Islamophobia, and terrorism. Its controversial story line and themes have been the target of both criticism and praise from sociopolitical groups.

text: On April 17, 2006, the New York Metro Alliance of Anarchists organised a protest against DC Comics and Time Warner, accusing it of watering down the story's original message in favor of violence and special effects.[52][53] David Graeber, an anarchist scholar and former professor at Yale University, was not upset by the film. "I thought the message of anarchy got out in spite of Hollywood." However, Graeber went on to state: "Anarchy is about creating communities and democratic decision making. That's what is absent from Hollywood's interpretation."[52]

text: Film critic Richard Roeper dismissed right-wing Christian criticism of the film on the television show Ebert and Roeper, saying that V's "terrorist" label is applied in the film "by someone who's essentially Hitler, a dictator."[54]

text: LGBT commentators have praised the film for its positive depiction of homosexuals. Sarah Warn of AfterEllen.com called the film "one of the most pro-gay ever". Warn went on to praise the central role of the character Valerie "not just because it is beautifully acted and well-written, but because it is so utterly unexpected [in a Hollywood film]."[55]

text: David Walsh of the World Socialist Web Site criticized V's actions as "antidemocratic," calling the film an example of "the bankruptcy of anarcho-terrorist ideology;" Walsh writes that because the people have not played any part in the revolution, they will be unable to produce a "new, liberated society."[56]

text: The film was broadcast on China's national TV station, China Central Television (CCTV) on December 16, 2012 completely uncensored,[57] surprising many viewers. While many believed that the government had banned the film, the State Administration of Radio, Film and Television stated that it was not aware of a ban; CCTV makes its own decisions on whether to censor foreign films. Liu Shanying, a political scientist at the Chinese Academy of Social Sciences who used to work for CCTV, speculated that the showing indicated that Chinese film censorship might be being loosened.[58]

text: Differences between the film and graphic novel[edit]

text: The film's story was adapted from Alan Moore and David Lloyd's graphic novel V for Vendetta; this was originally published between 1982 and 1985 in the British comic anthology Warrior, and then reprinted and completed by DC. Moore's comics were later compiled into a graphic novel and published again in the United States under DC's Vertigo imprint and in the United Kingdom under Titan Books.[59]

text: There are several fundamental differences between the film and the original source material. For example, the comic is set in the 1990s, while the film is set sometime between 2028 and 2038: Alan Moore's original story was created as a response to British Thatcherism in the early 1980s and was set as a conflict between a fascist state and anarchism, while the film's story has been changed by the Wachowski Brothers to fit a modern US political context. Alan Moore, however, charged that, in doing so, the story has turned into an American-centric conflict between liberalism and neo-conservatism, and abandons the original anarchist–fascist themes. Moore states that "[t]here wasn't a mention of anarchy as far as I could see. The fascism had been completely defanged. I mean, I think that any references to racial purity had been excised, whereas actually, fascists are quite big on racial purity." Furthermore, in the original story, Moore attempted to maintain moral ambiguity, and not to portray the fascists as caricatures, but as realistic, rounded characters. The time limitations of a film meant that the story had to omit or streamline some of the characters, details, and plotlines from the original story.[12] Chiefly, the original graphic novel has the fascists elected legally and kept in power through the general apathy of the public, whereas the film introduces the "St. Mary's virus", a biological weapon engineered and released by the Norsefire Party as a means of clandestinely gaining control over their own country.[citation needed]

text: Many of the characters from the graphic novel underwent significant changes for the film. V is characterized in the film as a romantic freedom fighter who shows concern over the loss of innocent life.[60] However, in the graphic novel, he is portrayed as ruthless, willing to kill anyone who gets in his way. Evey Hammond's transformation as V's protégée is also much more drastic in the novel than in the film. At the beginning of the film, she is already a confident woman with a hint of rebellion in her; in the graphic novel, she starts off as an insecure, desperate young woman forced into prostitution. V and Evey's relationship, though not as obvious in the book, ends in the film with pledges of love. In the graphic novel's finale, she not only carries out V's plans as she does in the film, but also clearly takes on V's identity.[13] In the film, Inspector Finch sympathizes with V, but, in the graphic novel, he is determined to stop V and goes as far as taking LSD to enter into a criminal's state of mind. Gordon, a very minor character in both adaptations, is also drastically changed. In the novel, Gordon is a small-time criminal who takes Evey into his home after V abandons her on the street. The two share a brief romance before Gordon is killed by a Scottish gang. In the film, however, Gordon is a well-mannered colleague of Evey's, and is later revealed to be gay. He is arrested by fingermen for broadcasting a political parody on his TV program, and is later executed when a Quran is found in his possession.[13]

text: Marketing[edit]

text: Home media[edit]

text: V for Vendetta was released on DVD in the US on August 1, 2006,[61] in three formats: a single-disc wide-screen version, a single-disc full-screen version, and a two-disc wide-screen special edition.[62] DVD sales were successful, selling 1,412,865 DVD units in the first week of release which translated to $27,683,818 in revenue. By the end of 2006, 3,086,073 DVD units had been sold, bringing in slightly more than its production cost of $58,342,597.[63] The single disc versions contain a short (15:56) behind-the-scenes featurette titled "Freedom! Forever![64] Making V for Vendetta" and the film's theatrical trailer, whereas the two-disc special edition contains three additional documentaries, and several extra features for collectors. On the second disc of the special edition, a short Easter egg clip of Natalie Portman on Saturday Night Live can be viewed by selecting the picture of wings on the second page of the menu. The film has also been released on the HD DVD high definition format, which features a unique 'in-film experience' created exclusively for the disc. Warner Bros. later released the video on Blu-Ray, on May 20, 2008.[65] The film also saw release on Sony's PSP UMD format.[66]

text: Soundtrack[edit]

text: The V for Vendetta soundtrack was released by Astralwerks Records on March 21, 2006.[67] The original scores from the film's composer, Dario Marianelli, make up most of the tracks on the album.[68] The soundtrack also features three vocals played during the film: "Cry Me a River" by Julie London, a cover of The Velvet Underground song "I Found a Reason" by Cat Power and "Bird Gerhl" by Antony and the Johnsons.[68] As mentioned in the film, these songs are samples of the 872 blacklisted tracks on V's Wurlitzer jukebox that V "reclaimed" from the Ministry of Objectionable Materials. The climax of Tchaikovsky's 1812 Overture appears at the end of the track "Knives and Bullets (and Cannons too)". The Overture's finale is played at key parts at the beginning and end of the film.

text: Three songs were played during the ending credits which were not included on the V for Vendetta soundtrack.[68] The first was "Street Fighting Man" by the Rolling Stones. The second was a special version of Ethan Stoller's "BKAB". In keeping with revolutionary tone of the film, excerpts from "On Black Power" (also in "A Declaration of Independence") by black nationalist leader Malcolm X, and from "Address to the Women of America" by feminist writer Gloria Steinem were added to the song. Gloria Steinem can be heard saying: "This is no simple reform... It really is a revolution. Sex and race, because they are easy and visible differences, have been the primary ways of organising human beings into superior and inferior groups and into the cheap labour on which this system still depends." The final song was "Out of Sight" by Spiritualized.

text: Also in the film were segments from two of Antonio Carlos Jobim's classic bossa nova songs, "The Girl From Ipanema" and "Quiet Nights of Quiet Stars". These songs were played during the "breakfast scenes" with V and Deitrich and were one of the ways used to tie the two characters together. Beethoven's Symphony No.5 also plays an important role in the film, with the first four notes of the first movement signifying the letter "V" in Morse code.[69][70] Gordon Deitrich's Benny Hill-styled comedy sketch of Chancellor Sutler includes the "Yakety Sax" theme. Inspector Finch's alarm clock begins the morning of November 4 with the song "Long Black Train" by Richard Hawley, which contains the foreshadowing lyrics "Ride the long black train... take me home black train."

text: Books[edit]

text: The original graphic novel by Moore and Lloyd was re-released as a hardback collection in October 2005 to tie into the film's original release date of November 5, 2005.[71] The film renewed interest in Alan Moore's original story, and sales of the original graphic novel rose dramatically in the United States.[72]

text: A novelisation of the film, written by Steve Moore and based on the Wachowski Brothers' script, was published by Pocket Star on January 31, 2006.[73] Spencer Lamm, who has worked with the Wachowskis, created a "behind-the-scenes" book. Titled V for Vendetta: From Script to Film, it was published by Universe on August 22, 2006.[74]

text: Television series[edit]

text: In October 2017, it was announced that Channel 4 was developing a television series based on the comic book.[75]


document_title: Health insurance

question_text: who pays the premium for private healthcare insurance

question_tokens: who pays the premium for private healthcare insurance

root

text: Health insurance

text: Background[edit]

text: A health insurance policy is:

tag: p

text:
A contract between an insurance provider (e.g. an insurance company or a government) and an individual or his/her sponsor (e.g. an employer or a community organization). The contract can be renewable (e.g. annually, monthly) or lifelong in the case of private insurance, or be mandatory for all citizens in the case of national plans. The type and amount of health care costs that will be covered by the health insurance provider are specified in writing, in a member contract or "Evidence of Coverage" booklet for private insurance, or in a national health policy for public insurance.
(US specific) Provided by an employer-sponsored self-funded ERISA plan. The company generally advertises that they have one of the big insurance companies. However, in an ERISA case, that insurance company "doesn't engage in the act of insurance", they just administer it. Therefore, ERISA plans are not subject to state laws. ERISA plans are governed by federal law under the jurisdiction of the US Department of Labor (USDOL). The specific benefits or coverage details are found in the Summary Plan Description (SPD). An appeal must go through the insurance company, then to the Employer's Plan Fiduciary. If still required, the Fiduciary's decision can be brought to the USDOL to review for ERISA compliance, and then file a lawsuit in federal court.

tag: ol

text: The individual insured person's obligations may take several forms:[3]

text:
Premium: The amount the policy-holder or their sponsor (e.g. an employer) pays to the health plan to purchase health coverage.
Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. For example, policy-holders might have to pay a $500 deductible per year, before any of their health care is covered by the health insurer. It may take several doctor's visits or prescription refills before the insured person reaches the deductible and the insurance company starts to pay for care. Furthermore, most policies do not apply co-pays for doctor's visits or prescriptions against your deductible.
Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service. For example, an insured person might pay a $45 co-payment for a doctor's visit, or to obtain a prescription. A co-payment must be paid each time a particular service is obtained.
Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that insured person may also pay. For example, the member might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80%. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain.
Exclusions: Not all services are covered. The insured are generally expected to pay the full cost of non-covered services out of their own pockets.
Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maxima. In 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 maxima: Similar to coverage limits, except that in this case, the insured person's payment obligation ends when they reach the out-of-pocket maximum, and health insurance pays all further covered costs. Out-of-pocket maxima can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.
Capitation: 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: (U.S. term) A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider. Generally, 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 occurring. Obtaining an authorization means that the insurer is obligated to pay for the service, assuming it matches what was authorized. Many smaller, routine services do not require authorization.[4]
Explanation of Benefits: A document that may be sent by an insurer to a patient explaining what was covered for a medical service, and how payment amount and patient responsibility amount were determined.[4]

text: Prescription drug plans are a form of insurance offered through some health insurance plans. In the U.S., the patient usually pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan. Such plans are routinely part of national health insurance programs. For example, in the province of Quebec, Canada, prescription drug insurance is universally required as part of the public health insurance plan, but may be purchased and administered either through private or group plans, or through the public plan.[5]

text: 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. The 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.

text: Comparisons[edit]

text: 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.[7] 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 coverage.

text: The Commonwealth Fund completed its thirteenth annual health policy survey in 2010.[9] A study of the survey "found significant differences in access, cost burdens, and problems with health insurance that are associated with insurance design".[9] Of the countries surveyed, the results indicated that people in the United States had more out-of-pocket expenses, more disputes with insurance companies than other countries, and more insurance payments denied; paperwork was also higher although Germany had similarly high levels of paperwork.[9]

text: Australia[edit]

text: The Australian public health system is called Medicare, which provides free universal access to hospital treatment and subsidised out-of-hospital medical treatment. It is funded by a 2% tax levy on all taxpayers, an extra 1% levy on high income earners, as well as general revenue.

text: The private health system is funded by a number of private health insurance organizations. The largest of these is Medibank Private Limited, which was, until 2014, a government-owned entity, when it was privatized and listed on the Australian Stock Exchange.

text: Some private health insurers are 'for profit' enterprises such as Australian Unity, and some are non-profit organizations such as HCF and the HBF Health Fund (HBF). Some, such as Police Health, have membership restricted to particular groups, but the majority have open membership. Membership to most health funds is now also available through comparison websites like moneytime, Compare the Market, iSelect Ltd., Choosi, ComparingExpert and YouCompare. These comparison sites operate on a commission-basis by agreement with their participating health funds. The Private Health Insurance Ombudsman also operates a free website which allows consumers to search for and compare private health insurers' products, which includes information on price and level of cover.[10]

text: Most aspects of private health insurance in Australia are regulated by the Private Health Insurance Act 2007. Complaints and reporting of the private health industry is carried out by an independent government agency, the Private Health Insurance Ombudsman. The ombudsman publishes an annual report that outlines the number and nature of complaints per health fund compared to their market share [11]

text: 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"). Funds 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. They 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. The 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 in premiums, and a vicious cycle of higher premiums-leaving members would ensue.

text: The Australian government has introduced a number of incentives to encourage adults to take out private hospital insurance. These include:

text:
Lifetime Health Cover: If a person has not taken out private hospital cover by 1 July after their 31st birthday, then when (and if) they do so after this time, their premiums must include a loading of 2% per annum for each year they were without hospital cover. Thus, a person taking out private cover for the first time at age 40 will pay a 20 percent loading. The loading is removed after 10 years of continuous hospital cover. 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 (in the 2011/12 financial year $80,000 for singles and $168,000 for couples[12]) 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. The 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. A bill to change the law has been introduced but was not passed by the Senate.[13] An amended 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.[14]

Private Health Insurance Rebate: The government subsidises the premiums for all private health insurance cover, including hospital and ancillary (extras), by 10%, 20% or 30%, depending on age. The Rudd Government announced in May 2009 that as of July 2010, the Rebate would become means-tested, and offered on a sliding scale. While this move (which would have required legislation) was defeated in the Senate at the time, in early 2011 the Gillard Government announced plans to reintroduce the legislation after the Opposition loses the balance of power in the Senate. The ALP and Greens have long been against the rebate, referring to it as "middle-class welfare".[15]

text: Canada[edit]

text: Health care is mainly a constitutional, provincial government responsibility in Canada (the main exceptions being federal government responsibility for services provided to aboriginal peoples covered by treaties, the Royal Canadian Mounted Police, the armed forces, and members of parliament). Consequently, each province administers its own health insurance program. The federal government influences health insurance by virtue of its fiscal powers – it transfers cash and tax points to the provinces to help cover the costs of the universal health insurance programs. Under the Canada Health Act, the federal government mandates and enforces the requirement that all people have free access to what are termed "medically necessary services," defined primarily as care delivered by physicians or in hospitals, and the nursing component of long term residential care. If provinces allow doctors or institutions to charge patients for medically necessary services, the federal government reduces its payments to the provinces by the amount of the prohibited charges. Collectively, the public provincial health insurance systems in Canada are frequently referred to as Medicare.[16] This public insurance is tax-funded out of general government revenues, although British Columbia and Ontario levy a mandatory premium with flat rates for individuals and families to generate additional revenues – in essence a surtax. Private health insurance is allowed, but in six provincial governments only for services that the public health plans do not cover, for example, semi-private or private rooms in hospitals and prescription drug plans. Four provinces allow insurance for services also mandated by the Canada Health Act, but in practice there is no market for it. All 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. Some 65% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers.[17] Private-sector services not paid for by the government account for nearly 30 percent of total health care spending.[18]

text: In 2005, the Supreme Court of Canada ruled, in Chaoulli v. Quebec, that the province's prohibition on private insurance for health care already insured by the provincial plan violated the Quebec Charter of Rights and Freedoms, and in particular the sections dealing with the right to life and security, if there were unacceptably long wait times for treatment, as was alleged in this case. 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.[19]

text: China[edit]

text: France[edit]

text: 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. The 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.

text: The resulting programme is profession-based: all people working are required to pay a portion of their income to a not-for-profit health insurance fund, which mutualises the risk of illness, and which reimburses medical expenses at varying rates. Children and spouses of insured people are eligible for benefits, as well. Each fund is free to manage its own budget, and used to reimburse medical expenses at the rate it saw fit, however following a number of reforms in recent years, the majority of funds provide the same level of reimbursement and benefits.

text: The government has two responsibilities in this system.

text:
The first government responsibility is the fixing of the rate at which medical expenses should be negotiated, and it does so in two ways: The Ministry of Health directly negotiates prices of medicine with the manufacturers, based on the average price of sale observed in neighboring countries. A 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 reimbursement 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.
The 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.

text: 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. Secondly, 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 specialist 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 procedures.

text: An important element of the French insurance system is solidarity: the more ill a person becomes, the less the person pays. This means that for people with serious or chronic illnesses, the insurance system reimburses them 100% of expenses, and waives their co-pay charges.

text: 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.[20]

text: Germany[edit]

text: Germany has the world's oldest national social health insurance system,[21] with origins dating back to Otto von Bismarck's Sickness Insurance Law of 1883.[22][23]

text: Currently 85% of the population is covered by a basic health insurance plan provided by statute, which provides a standard level of coverage. The remainder opt for private health insurance,[24] which frequently offers additional benefits. According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004.[25]

text: The government partially reimburses the costs for low-wage workers, whose premiums are capped at a predetermined value. Higher wage workers pay a premium based on their salary. They may also opt for private insurance, which is generally more expensive, but whose price may vary based on the individual's health status.[26]

text: Reimbursement is on a fee-for-service basis, but the number of physicians allowed to accept Statutory Health Insurance in a given locale is regulated by the government and professional societies.

text: Co payments were introduced in the 1980s in an attempt to prevent over utilization. The average length of hospital stay in Germany has decreased in recent years from 14 days to 9 days, still considerably longer than average stays in the United States (5 to 6 days).[27][28] Part of the difference is that the chief consideration for hospital reimbursement is the number of hospital days as opposed to procedures or diagnosis. Drug costs have increased substantially, rising nearly 60% from 1991 through 2005. Despite attempts to contain costs, overall health care expenditures rose to 10.7% of GDP in 2005, comparable to other western European nations, but substantially less than that spent in the U.S. (nearly 16% of GDP).[29]

text: Insurance systems[edit]

text: Germans are offered three kinds of social security insurance dealing with the physical status of a person and which are co-financed by employer and employee: health insurance, accident insurance, and long-term care insurance.

text: Germany has a universal multi-payer system with two main types of health insurance: law enforced health insurance (or public health insurance) (Gesetzliche Krankenversicherung (GKV)) and private insurance (Private Krankenversicherung (PKV)). Both systems struggle with the increasing cost of medical treatment and the changing demography. About 87.5% of the persons with health insurance are members of the public system, while 12.5% are covered by private insurance (as of 2006).[30] There are many differences between the public health insurance and private insurance. In general the benefits and costs in the private insurance are better for young people without family. There are hard salary requirements to join the private insurance because it is getting more expensive advanced in years.[31]

text: Statutory health insurance/Gesetzliche Krankenversicherung (GKV)[edit]

text: The statutory health insurance (est. in 1883) is part of the German social insurance system, together with the statutory accident insurance (est. 1883), the statutory old age and disability insurance (est. in 1889), the unemployment insurance (est. in 1927) and the long term care insurance (est. in 1995).[citation needed]

text: Since 2009, health insurance is mandatory for anyone living in Germany.[32]

text: The statutory health insurance is a compulsory insurance for employees with a yearly income below €54.900 (in 2015, adjusted annually) and others.

text: History[edit]

text: With the 'Imperial Bill of 15 June 1883' and its update from 10 April 1892 the health insurance bill was created, which introduced compulsory health insurance for workers. Austria followed Germany in 1888, Hungary in 1891 and Switzerland in 1911.

text: On 29 April 1869 the county health insurance ill[clarification needed] in Bavaria created the first law that introduced and regulated health insurance for low income earners. It was limited to individuals with an income less than 2000 Mark per year and guaranteed the insured person a 60% minimum income during sickness.[citation needed]

text: Function[edit]

text: Function of the statutory health insurance according to § 1 SGB V is to preserve, recreate or improve health of the insured person. According to § 27 SGB V this includes to "subdue the afflictions of illness".[33]

text: All insured fundamentally have the same entitlement for benefits. The scope of benefits is regulated in SGB V ("social insurance bill five") and limited by § 1 SGB V. Benefits have to be adequate, appropriate and economic and shall not exceed the necessary for the insured.[34]

text: Additional benefits can only be granted based on particular regulations based on formal law. These are e.g. additional service for the prevention of sickness, care at home, household support, rehabilitation etc.[citation needed]

text: Based on the principle of solidarity and compulsory membership, the calculation of fees differs from private health insurance in that it does not depend on personal health or health criteria like age or sex, but is connected to one's personal income by a fixed percentage. The aim is to cover the risk of high cost from illness that an individual can not bear alone.[citation needed]

text: Organization[edit]

text: The German legislature has reduced the number of public health insurance organisations from 1209 in 1991 down to 123 in 2015.[35]

text: The public health insurance organisations (Krankenkassen) are the Ersatzkassen (EK), Allgemeine Ortskrankenkassen (AOK), Betriebskrankenkassen (BKK), Innungskrankenkassen (IKK), Knappschaft (KBS), and Landwirtschaftliche Krankenkasse (LKK).[36]

text: As long as a person has the right to choose his or her health insurance, he or she can join any insurance that is willing to include the individual.

text:
public health insurance organisations in February 2012[37]
Numbers
number of members including retired persons
open on federal level
open on state level
not open

all public insurance organisations
146
69,6 Mio.
43
60
43

Betriebskrankenkassen
112
11,6 Mio.
33
45
34

Allgemeine Ortskrankenkassen
12
24,3 Mio.
0
12
0

Landwirtschaftliche Krankenkassen
9
0,8 Mio.
0
0
9

Ersatzkassen
6
25,7 Mio.
6
0
0

Innungskrankenkassen
6
5,4 Mio.
3
3
0

Knappschaft
1
1,8 Mio.
1
0
0

tag: table

text: Private health insurance/Private Krankenversicherung (PKV)[edit]

text: Law enforced accident insurance/gesetzliche Unfallversicherung[edit]

text: Accident insurance (Unfallversicherung) is covered by the employer and basically covers all risks for commuting to work and at the workplace.

text: Law enforced long term care insurance/Gesetzliche Pflegeversicherung[edit]

text: Long-term care (Pflegeversicherung[38]) is covered half and half by employer and employee and covers cases in which a person is not able to manage his or her daily routine (provision of food, cleaning of apartment, personal hygiene, etc.). It is about 2% of a yearly salaried income or pension, with employers matching the contribution of the employee.

text: In 2013 a state funded private care insurance was introduced ("Private Pflegeversicherung").[39] Insurance contracts that fit certain criteria are subsidised with 60 Euro per year. It is expected that the number of contracts will grow from 400,000 by end of 2013 to over a million within the next few years.[40] These contracts have been criticized by consumer rights foundations.[41]

text: Japan[edit]

text: There are two major types of insurance programs available in Japan – Employees Health Insurance (健康保険 Kenkō-Hoken), and National Health Insurance (国民健康保険 Kokumin-Kenkō-Hoken). National Health insurance is designed for people who are not eligible to be members of any employment-based health insurance program. Although private health insurance is also available, all Japanese citizens, permanent residents, and non-Japanese with a visa lasting one year or longer are required to be enrolled in either National Health Insurance or Employees Health Insurance.

text: Netherlands[edit]

text: 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. All 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%.[citation needed]

text: 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%.[citation needed] However, insurance companies are free to sell additional policies to provide coverage beyond the national minimum. These 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.

text: 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. Because of this, insurance companies no longer find insuring high risk individuals an unappealing proposition, avoiding the potential problem of adverse selection.

text: 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 coverage.

text: New Zealand[edit]

text: Since 1974, New Zealand has had a system of universal no-fault health insurance for personal injuries through the Accident Compensation Corporation (ACC). The ACC scheme covers most of the costs of related to treatment of injuries acquired in New Zealand (including overseas visitors) regardless of how the injury occurred, and also covers lost income (at 80 percent of the employee's pre-injury income) and costs related to long-term rehabilitation, such as home and vehicle modifications for those seriously injured. Funding from the scheme comes from a combination of levies on employers' payroll (for work injuries), levies on an employee's taxable income (for non-work injuries to salary earners), levies on vehicle licensing fees and petrol (for motor vehicle accidents), and funds from the general taxation pool (for non-work injuries to children, senior citizens, unemployed people, overseas visitors, etc.)

text: Rwanda[edit]

text: Rwanda is one of a handful of low income countries that has implemented community-based health insurance schemes in order to reduce the financial barriers that prevent poor people from seeking and receiving needed health services. This scheme has helped reach 90% of the country's population with health care coverage.[42][43]

text: Switzerland[edit]

text: Healthcare in Switzerland is universal[44] and is regulated by the Swiss Federal Law on Health Insurance. Health insurance is compulsory for all persons residing in Switzerland (within three months of taking up residence or being born in the country).[45][46] It is therefore the same throughout the country and avoids double standards in healthcare. Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition. They are not allowed to make a profit off this basic insurance, but can on supplemental plans.[44]

text: The universal compulsory coverage provides for treatment in case of illness or accident and pregnancy. Health insurance covers the costs of medical treatment, medication and hospitalization of the insured. However, the insured person pays part of the costs up to a maximum, which can vary based on the individually chosen plan, premiums are then adjusted accordingly. The whole healthcare system is geared towards to the general goals of enhancing general public health and reducing costs while encouraging individual responsibility.

text: The Swiss healthcare system is a combination of public, subsidised private and totally private systems. Insurance premiums vary from insurance company to company, the excess level individually chosen (franchise), the place of residence of the insured person and the degree of supplementary benefit coverage chosen (complementary medicine, routine dental care, semi-private or private ward hospitalisation, etc.).

text: The insured person has full freedom of choice among the approximately 60 recognised healthcare providers competent to treat their condition (in his region) on the understanding that the costs are covered by the insurance up to the level of the official tariff. There is freedom of choice when selecting an insurance company to which one pays a premium, usually on a monthly basis. The insured person pays the insurance premium for the basic plan up to 8% of their personal income. If a premium is higher than this, the government gives the insured person a cash subsidy to pay for any additional premium.

text: The compulsory insurance can be supplemented by private "complementary" insurance policies that allow for coverage of some of the treatment categories not covered by the basic insurance or to improve the standard of room and service in case of hospitalisation. This can include complementary medicine, routine dental treatment and private ward hospitalisation, which are not covered by the compulsory insurance.

text: As far as the compulsory health insurance is concerned, the insurance companies cannot set any conditions relating to age, sex or state of health for coverage. Although the level of premium can vary from one company to another, they must be identical within the same company for all insured persons of the same age group and region, regardless of sex or state of health. This does not apply to complementary insurance, where premiums are risk-based.

text: Switzerland has an infant mortality rate of about 3.6 out of 1,000. The general life expectancy in 2012 was for men 80.5 years compared to 84.7 years for women.[47] These are the world's best figures.[48]

text: United Kingdom[edit]

text: 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)[49] are met directly from general taxation. The NHS provides the majority of health care in the UK, including primary care, in-patient care, long-term health care, ophthalmology, and dentistry.

text: 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. For example, health insurance on pregnancy is generally not covered or covered with restricting clauses. Typical exclusions for Bupa schemes (and many other insurers) include:

text: 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.[50] († = except in exceptional circumstances)

text: There are a number of other companies in the United Kingdom which include, among others, ACE Limited, AXA, Aviva, Bupa, Groupama Healthcare, WPA and PruHealth. Similar exclusions apply, depending on the policy which is purchased.

text: Recently (2009) the main representative body of British Medical physicians, the British Medical Association, adopted a policy statement expressing concerns about developments in the health insurance market in the UK. In its Annual Representative Meeting which had been agreed earlier by the Consultants Policy Group (i.e. Senior physicians) stating that the BMA was "extremely concerned that the policies of some private healthcare insurance companies are preventing or restricting patients exercising choice about (i) the consultants who treat them; (ii) the hospital at which they are treated; (iii) making top up payments to cover any gap between the funding provided by their insurance company and the cost of their chosen private treatment." It went in to "call on the BMA to publicise these concerns so that patients are fully informed when making choices about private healthcare insurance."[51] The practice of insurance companies deciding which consultant a patient may see as opposed to GPs or patients is referred to as Open Referral.[52] The NHS offers patients a choice of hospitals and consultants and does not charge for its services.

text: The private sector has been used to increase NHS capacity despite a large proportion of the British public opposing such involvement.[53] 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%.[25]

text: Nearly one in three patients receiving NHS hospital treatment is privately insured and could have the cost paid for by their insurer. Some private schemes provide cash payments to patients who opt for NHS treatment, to deter use of private facilities. A report, by private health analysts Laing and Buisson, in November 2012, estimated that more than 250,000 operations were performed on patients with private medical insurance each year at a cost of £359 million. In addition, £609 million was spent on emergency medical or surgical treatment. Private medical insurance does not normally cover emergency treatment but subsequent recovery could be paid for if the patient were moved into a private patient unit.[54]

text: United States[edit]

text: The United States health care system relies heavily on private health insurance, which is the primary source of coverage for most Americans. As of 2012[update] about 61% of Americans had private health insurance according to the Centers for Disease Control and Prevention.[55][56] The Agency for Healthcare Research and Quality (AHRQ) found that in 2011, private insurance was billed for 12.2 million U.S. inpatient hospital stays and incurred approximately $112.5 billion in aggregate inpatient hospital costs (29% of the total national aggregate costs).[57] Public programs provide the primary source of coverage for most senior citizens and for low-income children and families who meet certain eligibility requirements. The primary public programs are Medicare, a federal social insurance program for seniors and certain disabled individuals; and 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. Together, Medicare and Medicaid accounted for approximately 63 percent of the national inpatient hospital costs in 2011.[57] SCHIP is a federal-state partnership that serves certain children and families who do not qualify for Medicaid but who cannot afford private coverage. Other 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.[58]

text: In the late 1990s and early 2000s, health advocacy companies began to appear to help patients deal with the complexities of the healthcare system. The complexity of the healthcare system has resulted in a variety of problems for the American public. A study found that 62 percent of persons declaring bankruptcy in 2007 had unpaid medical expenses of $1000 or more, and in 92% of these cases the medical debts exceeded $5000. Nearly 80 percent who filed for bankruptcy had health insurance.[59] The Medicare and Medicaid programs were estimated to soon account for 50 percent of all national health spending.[60] These factors and many others fueled interest in an overhaul of the health care system in the United States. In 2010 President Obama signed into law the Patient Protection and Affordable Care Act. This Act includes an 'individual mandate' that every American must have medical insurance (or pay a fine). Health policy experts such as David Cutler and Jonathan Gruber, as well as the American medical insurance lobby group America's Health Insurance Plans, argued this provision was required in order to provide "guaranteed issue" and a "community rating," which address unpopular features of America's health insurance system such as premium weightings, exclusions for pre-existing conditions, and the pre-screening of insurance applicants. During 26–28 March, the Supreme Court heard arguments regarding the validity of the Act. The Patient Protection and Affordable Care Act was determined to be constitutional on 28 June 2012. SCOTUS determined that Congress had the authority to apply the individual mandate within its taxing powers.[61]

text: History and evolution[edit]

text: In the late 19th century, "accident insurance" began to be available, which operated much like modern disability insurance.[62][63] 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.[64]

text: Accident insurance was first offered in the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850, offered insurance against injuries arising from railroad and steamboat accidents. Sixty organizations were offering accident insurance in the U.S. by 1866, but the industry consolidated rapidly soon thereafter. While there were earlier experiments, the origins of sickness coverage in the U.S. effectively date from 1890. The first employer-sponsored group disability policy was issued in 1911.[65]

text: Before the development of medical expense insurance, patients were expected to pay 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. One major obstacle to this development was that early forms of comprehensive health insurance were enjoined by courts for violating the traditional ban on corporate practice of the professions by for-profit corporations.[66] State legislatures had to intervene and expressly legalize health insurance as an exception to that traditional rule. Today, most comprehensive private health insurance programs cover the cost of routine, preventive, and emergency health care procedures, and most prescription drugs (but this is not always the case).

text: Hospital 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.[65] The predecessors of today's Health Maintenance Organizations (HMOs) originated beginning in 1929, through the 1930s and on during World War II.[67][68]

text: The Employee Retirement Income Security Act of 1974 (ERISA) regulated the operation of a health benefit plan if an employer chooses to establish one, which is not required. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) gives an ex-employee the right to continue coverage under an employer-sponsored group health benefit plan.

text: Health plan vs. health insurance[edit]

text: This section does not cite any sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (December 2014) (Learn how and when to remove this template message)

text: Historically, Health maintenance organizations (HMO) tended to use the term "health plan", while commercial insurance companies used the term "health insurance". A 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.). The 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).

text: There are different options available to both employers and employees. There are different types of plans, including health savings accounts and plans with a high or low deductible. The plans that have the high deductibles typically cost the employee less for the monthly premiums, but the part they pay for each time they use their insurance, as well as the overall deductible before the insurance covers anything is much higher. These types of plans are good for the people who rarely go to the doctor and need little health care. The lower deductible plans are typically more expensive, however, they save the employee from having to spend a lot of money out of pocket for services and treatment. The recent trend for employers is to offer the high deductible plans, called consumer-driven healthcare plans, because it costs them less overall for the care their employees need, but it is a lower monthly premium for the employees.[69]

text: Comprehensive vs. scheduled[edit]

text: 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. These 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.[70]

text: 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. In recent years[when?], these plans have taken the name "mini-med plans" or association plans. The term "association" is often used to describe them because they require membership in an association that must exist for some other purpose than to sell insurance. Examples include the Health Care Credit Union Association. 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". As of 2005[update], "annual benefit maxima for a typical mini scheduled health insurance plan may range from $1,000 to $25,000".[71]

text: Factors affecting insurance prices[edit]

text: A recent study by PricewaterhouseCoopers examining the drivers of rising health care costs in the U.S. pointed to increased utilization created by increased consumer demand, new treatments, and more intensive diagnostic testing, as the most significant.[72] However, Wendell Potter, a long-time PR representative for the health insurance industry, has noted that the group which sponsored this study, AHIP, is a front-group funded by various insurance companies.[73] People in developed countries are living longer. The 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. Other 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.[72]

text: Other researchers note that doctors and other healthcare providers are rewarded for merely treating patients rather than curing them and that patients insured through employer group policies have incentives to go to the absolute best HCPs rather than the most cost-effective ones.[74]

text: Military[edit]

text: The price of health insurance for retired and active duty military personnel has gone up from $19 billion a decade ago to $52 billion in 2012. TRICARE, the government veteran's health insurance program, makes up nine percent of the total budget for the Department of Defense.[75]

text: California[edit]

text: In 2007, 87% of Californians had some form of health insurance.[76] Services in California range from private offerings: HMOs, PPOs to public programs: Medi-Cal, Medicare, and Healthy Families (SCHIP).

text: California developed a solution to assist people across the state and is one of the few states to have an office devoted to giving people tips and resources to get the best care possible. California's Office of the Patient Advocate was established July 2000 to publish a yearly Health Care Quality Report Card[77] on the top HMOs, PPOs, and Medical Groups and to create and distribute helpful tips and resources to give Californians the tools needed to get the best care.[78]

text: Additionally, California has a Help Center that assists Californians when they have problems with their health insurance. The Help Center is run by the Department of Managed Health Care, the government department that oversees and regulates HMOs and some PPOs.

text: Massachusetts[edit]

text: The state passed healthcare reform in 2006 in order to greater decrease the uninsured rate among its citizens. The federal Patient Protection and Affordable Care Act (colloquially known as "Obamacare") is largely based on Massachusetts' health reform.[79] Due to that colloquialism, the Massachusetts reform has been nicknamed as "Romneycare" after then-Governor Mitt Romney.[80]

text: As of 2017, Massachusetts has the highest rate of insured citizens in the United States at 97%.[81] [82]

text: Standards of hospitals and clinics used by insurance companies[edit]

text: In the US, insurers will often only make use of health care providers that are independently surveyed by a recognized quality assurance program, such as being accredited by accreditation schemes such as the Joint Commission and the American Accreditation Healthcare Commission.[83]