Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity.^[1]

Background[link]

A health insurance policy is:

1) a contract between an insurance provider (e.g. an insurance company or a government) and an individual or his 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.

2) Insurance coverage is 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.

The individual insured person's obligations may take several forms:^[2]

• Premium: The amount the policy-holder or his 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 however, 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 maximums. 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 maximums: 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 maximums 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.^[3]
• 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.^[3]

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.^[4]

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.

Comparison[link]

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.^[5] 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.

The Commonwealth Fund completed its thirteenth annual health policy survey in 2010.^[6] A study of the survey "found significant differences in access, cost burdens, and problems with health insurance that are associated with insurance design".^[6] 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.^[6]

Australia[link]

The public health system is called Medicare. It ensures free universal access to hospital treatment and subsidised out-of-hospital medical treatment. It is funded by a 1.5% tax levy on all taxpayers, an extra 1% levy on high income earners, as well as general revenue.

The private health system is funded by a number of private health insurance organisations. The largest of these is Medibank Private, which is government-owned, but operates as a government business enterprise under the same regulatory regime as all other registered private health funds. The Coalition Howard government had announced that Medibank would be privatised if it won the 2007 election, however they were defeated by the Australian Labor Party under Kevin Rudd which had already pledged that it would remain in government ownership.

Some private health insurers are 'for profit' enterprises such as Australian Unity, and some are non-profit organizations such as HCF and the Health Insurance Fund of Australia (HIF). Some 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, iSelect or the decision assistance sites HelpMeChoose and the latest entry 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. ^[7]

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.^[8] The ombudsman publishes an annual report that outlines the number and nature of complaints per health fund compared to their market share ^[9] [ 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.

There are a number of other matters about which funds are not permitted to discriminate between members in terms of premiums, benefits, or membership – they include racial origin, religion, sex, sexual orientation, nature of employment, and leisure activities. Premiums for a fund's product that is sold in more than one state can vary from state to state, but not within the same state.

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

• Lifetime Health Cover: If a person has not taken out private hospital cover by the 1st 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 per cent 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 (currently $70,000 for singles and $140,000 for couples) 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.^[10] 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.^[11]

• Private Health Insurance Rebate: The government subsidises the premiums for all private health insurance cover, including hospital and ancillary (extras), by 30%, 35% or 40%, 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 (which currently combine in Australia to form a minority government) have long been against the rebate, referring to it as "middle-class welfare".^[12]

Canada[link]

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. 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.^[13] Private-sector services not paid for by the government account for nearly 30 percent of total health care spending.^[14]

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.^[15]

China[link]

France[link]

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.

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 reimbursment and benefits.

The government has two responsibilities in this system.

• 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 reimbursment 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.

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.

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.

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.^[16][17]

Germany[link]

Germany has Europe's oldest universal health care system, with origins dating back to Otto von Bismarck's Social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889. As mandatory health insurance, these bills originally applied only to low-income workers and certain government employees; their coverage, and that of subsequent legislation gradually expanded to cover virtually the entire population.^[18]

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^{[citation needed]}, 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.^[19]

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.^[20]

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.

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).^[21][22] 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).^[23]

Insurance systems[link]

Germany has a universal multi-payer system with two main types of health insurance. Germans are offered three mandatory health benefits, which are co-financed by employer and employee: health insurance, accident insurance, and long-term care insurance.

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

Long term care (Pflegeversicherung^[24]) 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.

There are two separate systems of health insurance: public health insurance (Gesetzliche Krankenversicherung) and private insurance (Private Krankenversicherung). 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).^[25] There are many differences between the public health insurance and private insurance. If people change once in private insurance, there is no way back in public health 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´s getting more expensive advanced in years.^[26]

Japan[link]

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.

Netherlands[link]

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%.

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%. 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.

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.

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.

Rwanda[link]

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.^[27][28]

United Kingdom[link]

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)^[29] 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.

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:

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.^[30] († = except in exceptional circumstances)

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

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."^[31] The NHS offers patients a choice of hospitals and consultants and does not charge for its services.

The private sector has been used to increase NHS capacity despite a large proportion of the British public opposing such involvement.^[32] 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%.^[19]

United States[link]

The United States health care system relies heavily on private health insurance, which is the primary source of coverage for most Americans. According to the CDC, approximately 58% of Americans have private health insurance.^[33] 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, 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, and SCHIP, also 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.^[34]

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.^[35] The Medicare and Medicaid programs were estimated to soon account for 50 percent of all national health spending.^[36] 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 included a main provision which the American medical insurance lobby group America's Health Insurance Plans had called for, namely, a mandate that every American must have medical insurance (or pay a fine) as a quid pro quo for "guaranteed issue", i.e. the dropping of unpopular features of America's health insurance system such as premium weightings, exclusions for pre-existing conditions, and the pre-screening of insurance applicants. The Patient Protection and Affordable Care Act is pending review for constitutionality by the United States Supreme Court. During March 26-28, the Supreme Court heard arguments regarding the validity of the Act. By the end of June 2012, a final Supreme Court ruling is expected.

History and evolution[link]

In the late 19th century, "accident insurance" began to be available, which operated much like modern disability insurance.^[37][38] 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.^[39]

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.^[40]

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. 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.

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.^[40] The predecessors of today's Health Maintenance Organizations (HMOs) originated beginning in 1929, through the 1930s and on during World War II.^[41][42]

Health plan vs. health insurance[link]

Historically, HMOs 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).

Comprehensive vs. scheduled[link]

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.^[43]

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 in the USA, 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". Annual benefits maximums for a typical scheduled health insurance plan may range from $1,000 to $25,000.^[44]

Factors affecting insurance prices[link]

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.^[45] 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.^[46] 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.^[45]

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.^[47]

Military[link]

The price of health insurance for retired and active duty military personnel has gone up from $19 billion just a decade ago to $49 billion in the last year. Now, TRICARE, the government health insurance program, makes up nine percent of the total budget for the Pentagon.^[48]

California[link]

In 2007, 87% of Californians had some form of health insurance.^[49] Services in California range from private offerings: HMOs, PPOs to public programs: Medi-Cal, Medicare, and Healthy Families (SCHIP).

California developed a solution to assist people across the State and is one of the only 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^[50] 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.^[51]

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.

Standards of hospitals and clinics used by insurance companies[link]

A key factor in patient safety is that the health care providers should be safe and fit for purpose.

In the USA, 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.^[52]

See also[link]

Notes and references[link]

John Stossel
John Stossel outside Fox Studios after a taping of Stossel, June 9, 2010.
Born	John F. Stossel (1947-03-06) March 6, 1947 (age 65) Chicago Heights, Illinois, U.S.
Education	B.A. in Psychology, Princeton University (1969)
Occupation	Journalist, author, columnist, reporter, TV presenter
Years active	1969–present[1]
Notable credit(s)	20/20 Stossel
Spouse	Ellen Abrams
Website
http://www.johnstossel.com/

John F. Stossel (born March 6, 1947) is an American consumer reporter, investigative journalist, author and libertarian columnist. In October 2009 Stossel left his long time home on ABC News to join the Fox Business Channel and Fox News Channel, both owned and operated by News Corp. He hosts a weekly news show on Fox Business, Stossel, which debuted on December 10, 2009. The show airs in prime time every Thursday, repeating on both Saturdays and Sundays. Stossel also regularly provides signature analysis, appearing on various Fox News shows, including weekly appearances on The O'Reilly Factor, in addition to writing the Fox News Blog, "John Stossel's Take".^[2]

Stossel practices advocacy journalism, often challenging conventional wisdom.^[3] His reporting style, which is a blend of commentary and reporting, reflects a libertarian political philosophy and his views on economics are largely supportive of the free market.^[4]

In his decades as a reporter, Stossel has received numerous honors and awards, including nineteen Emmy awards and has been honored five times for excellence in consumer reporting by the National Press Club.^[5] John Stossel is doctor honoris causa from Universidad Francisco Marroquín.^[6] Stossel has written two books recounting how his experiences in journalism shaped his socioeconomic views, Give Me a Break in 2004 and Myths, Lies, and Downright Stupidity in 2007.

Stossel began his journalism career as a researcher for KGW-TV and later became a consumer reporter at WCBS-TV in New York City, before joining ABC News as a consumer editor and reporter on Good Morning America. Stossel went on to be an ABC News correspondent, joining the weekly news magazine program 20/20, going on to become co-anchor.^[7]

ABC is reported to believe "his reporting goes against the grain of the established media and offers the network something fresh and different...[but] makes him a target of the groups he offends."^[8]

Early life[link]

John Stossel was born in Chicago Heights, Illinois, the younger of two sons,^[9] to a prominent Jewish family, and graduated from New Trier High School in Winnetka. He overcame a stuttering problem so he could become a reporter, and is now a supporter and advocate for the Stuttering Foundation of America. Stossel graduated from Princeton University with a BA in Psychology in 1969 and was a member of Princeton Tower Club while there. He began his journalism career as a researcher for KGW-TV in Portland, Oregon. Stossel later became a consumer reporter at WCBS-TV in New York City before joining ABC News in 1981 as consumer editor and reporter on Good Morning America.

Career[link]

[edit] 20/20

Stossel was named co-anchor of ABC News' 20/20 in May 2003. He joined the weekly news magazine program in 1981, initially as a correspondent. His "Give Me a Break" segments featured a skeptical look at subjects from government regulations and pop culture to censorship and unfounded fear. The series was spun off into a series of one-hour specials (which, Stossel stated in an interview with ReasonTV^[10] cost ABC half a million dollars per special), beginning in 1994, with titles including:

• "Give Me a Break" – regular segment
• You Can't Even Talk About It – 2009^[11]
• Bailouts and Bull (in association with ReasonTV) – 2009
• Age of Consent – 2009
• John Stossel's Politically Incorrect Guide to Politics – 2008
• Sex in America – 2008
• Sick in America, Whose Body Is It Anyway? – 2007
• Cheap In America – 2007
• Myths, Lies and Downright Stupidity – 2007
• Cheap in America – 2006
• Stupid in America: How We Cheat Our Kids – 2006^[12]
• Privilege in America: Who's Shutting You Out? – 2006
• War on Drugs: A War on Ourselves – 2002
• Freeloaders – 2001
• John Stossel Goes to Washington – Spring 2001
• Is America #1? – 1999
• Greed – 1999
• Common Sense – 1995
• Are We Scaring Ourselves to Death?
• Junk Science: What You Know That May Not Be So
• Boys and Girls Are Different
• You Can't Say That!
• The Power of Belief

Fox News Channel and Fox Business Network[link]

In September 2009, it was announced that Stossel was leaving ABC News and joining Fox News Channel and Fox Business Network. In addition to appearing on The O'Reilly Factor every Tuesday night, he now hosts a one-hour weekly program for Fox Business Network and a series of one-hour specials for Fox News Channel, as well as making regular guest appearances on Fox News programs.

The program, entitled Stossel, debuted December 10, 2009, on Fox Business Network. The program looks at consumer-focused topics, such as civil liberties, the business of health care, and free trade. His blog, "Stossel’s Take", is published on both FoxBusiness.com and FoxNews.com.^[13][14][15]

Publications[link]

Stossel has written three books. Give Me a Break: How I Exposed Hucksters, Cheats, and Scam Artists and Became the Scourge of the Liberal Media is a 2005 autobiography from Harper Perennial documenting his career and philosophical transition from liberalism to libertarianism. It describes his opposition to government regulation, his belief in free market and private enterprise, support for tort reform, and advocacy for shifting social services from the government to private charities. It was a New York Times bestseller for 11 weeks.^[3] Myths, Lies, and Downright Stupidity: Get Out the Shovel – Why Everything You Know Is Wrong, which was published in 2007 by Hyperion, questions the validity of various conventional wisdoms, and argues that the belief he is conservative is untrue. On April 10, 2012, Threshold Editions, an imprint of Simon & Schuster, published Stossel's third book No, They Can't: Why Government Fails-But Individuals Succeed. It argues that government policies meant to solve problems instead produce new ones, and that free individuals and the private sector perform tasks more efficiently than the government does.^[16]

With financial support from the libertarian Palmer R. Chitester Fund, Stossel and ABC News launched a series of educational materials for public schools in 1999 entitled "Stossel in the Classroom".^[17][18] It was taken over in 2006 by the Center for Independent Thought and releases a new DVD of teaching materials annually. In 2006, Stossel and ABC released Teaching Tools for Economics, a video series based on the National Council of Economics Education standards.^[19]

Charity and other work[link]

Stossel often makes public appearances and speeches, advocating his brand of libertarian thought.^[20] Stossel explained at the end of the December 30, 2010 episode of Stossel that he gives away his earnings from these engagements to charity; they contribute 25% of his income. The three main groups he supports with his donations are the The Doe Fund, the Central Park Conservancy (on whose board he sits), and Student Sponsor Partners (SSP), which partners low-income high school students with donors who mentor the students and pay tuition for the students to attend private school (usually Catholic schools), which Stossel says have higher graduation rates than public schools.^[21]

Stossel and his former ABC News colleague Chris Cuomo are silent investors in Columbus Tavern, a restaurant on Columbus Avenue at 72nd Street on Manhattan's Upper West Side.^[22][23][24]

Political and personal beliefs[link]

Contrarianism[link]

Stossel's news reports and writings attempt to debunk popular beliefs. His Myths and Lies series of 20/20 specials challenges a range of widely held beliefs. He also hosted The Power of Belief (October 6, 1998), an ABC News Special that focused on assertions of the paranormal and people's desire to believe. Another report outlined the belief that opposition to DDT is misplaced and that the ban on DDT has resulted in the deaths of millions of children,^[25] mostly in poor nations.^[26]

Libertarianism[link]

Stossel speaking at the Free State Project's New Hampshire Liberty Forum.

As a libertarian, Stossel says that he believes in both personal freedom^[27] and the free market. He frequently uses television airtime to advance these views and challenge viewers' distrust of free market capitalism and economic competition. He received an Honoris Causa Doctorate from Francisco Marroquin University, a libertarian university in Guatemala, in 2008. He told The Oregonian, on October 26, 1994:

I started out by viewing the marketplace as a cruel place, where you need intervention by government and lawyers to protect people. But after watching the regulators work, I have come to believe that markets are magical and the best protectors of the consumer. It is my job to explain the beauties of the free market.^[28]

I'm a little embarrassed about how long it took me to see the folly of most government intervention. It was probably 15 years before I really woke up to the fact that almost everything government attempts to do, it makes worse.^[29]

Stossel argues that personal greed creates an incentive to work and to innovate.^[30] He has promoted school choice as a way to improve American schools, because he believes that when people are given a choice, they will choose the better schools for their children.^[31] Referring to educational tests that rank American students lower than others he says:

The people who run the international tests told us, "the biggest predictor of student success is choice." Nations that "attach the money to the kids" and thereby allow parents to choose between different public and private schools have higher test scores. This should be no surprise; competition makes us better.^[32]

Stossel has criticized government programs as inefficient, wasteful, and harmful.^[33] He has also criticized the American legal system, opining that it provides lawyers and vexatious litigators the incentive to file frivolous lawsuits indiscriminately, which Stossel contends often generate more wealth for lawyers than deserving clients, stifle innovation and personal freedoms, and cause harm to private citizens, taxpayers, consumers and businesses.^[34] Although Stossel concedes that some lawsuits are necessary in order to provide justice to people genuinely injured by others with greater economic power,^[35] he advocates the adoption in the U.S. of the English rule as one method to reduce the more abusive or frivolous lawsuits.^[36]

Stossel opposes corporate welfare, bailouts^[37] and the war in Iraq.^[5] He also opposes legal prohibitions against pornography, marijuana, gambling, ticket scalping, prostitution, homosexual activity, and assisted suicide,^[38] and believes most abortions should be legal.^[39] He favors replacing the income tax with the FairTax.^[40]

When President Barack Obama altered federal guidelines in April 2010 governing the employment of unpaid interns under the Fair Labor Standards Act,^[41] Stossel criticized the guidelines, appearing in a police uniform during an appearance on the Fox News program America Live, commenting, "I’ve built my career on unpaid interns, and the interns told me it was great – I learned more from you than I did in college." Asked why he did not pay them if they were so valuable, he said he could not afford to.^[42]

Regarding religion, Stossel identified himself as an agnostic in the December 16, 2010 episode of Stossel, explaining that he had no belief in God, but was open to the possibility.^[43]

Praise and criticism[link]

Awards[link]

Stossel has won 19 Emmy Awards. He was honored five times for excellence in consumer reporting by the National Press Club, and has received the George Polk Award for Outstanding Local Reporting and the Peabody Award. In one year, according to Stossel in his book Give Me A Break, "I got so many Emmys, another winner thanked me in his acceptance speech 'for not having an entry in this category'".^[44] According to Stossel, when he was in favor of government intervention and skeptical of business he was deluged with awards, but in 2006 he stated, "They like me less... Once I started applying the same skepticism to government, I stopped winning awards."^[29] On April 23, 2012, Stossel was awarded the Chapman University Presidential Medal, by the current president, James Doti, and chancellor, Danielle Struppa. The award has only been presented to a handful of people over the past 150 years. ^[45]

Praise[link]

The Nobel Prize–winning Chicago School monetarist economist Milton Friedman lauded Stossel, stating: "Stossel is that rare creature, a TV commentator who understands economics, in all its subtlety."^[46] Steve Forbes, the editor of Forbes Magazine, described Stossel as riveting and "one of America’s ablest and most courageous journalists."^[46] P. J. O'Rourke, best-selling author of Eat the Rich and Parliament of Whores praised Stossel, stating:

... about John Stossel's fact-finding. He seeks the truths that destroy truisms, wields reason against all that's unreasonable, and ... puncture(s) sanctimonious idealism.... He makes the maddening mad. And Stossel’s tales of the outrageous are outrageously amusing.^[46]

An article published by the libertarian group Advocates for Self Government notes praise for Stossel.^[47] Independent Institute Research Analyst Anthony Gregory, writing on the libertarian blog, LewRockwell.com, described Stossel as a "heroic rogue... a media maverick and proponent of freedom in an otherwise statist, conformist mass media."^[48] Libertarian investment analyst Mark Skousen said Stossel is "a true libertarian hero".^[49]

Criticism and controversy[link]

Watchdog groups[link]

Liberal media organizations such as Fairness and Accuracy In Reporting (FAIR) and Media Matters for America (MMfA), have criticized Stossel's work,^[50][51] for what was perceived by those groups as a lack of balance of coverage and distortion of facts. For example, Stossel was criticized for a segment on his October 11, 1999, show during which he argued that AIDS research has received too much funding, "25 times more than on Parkinson's, which kills more people." FAIR responded that, "In fact, AIDS killed more than 16,000 people in the United States in 1999," whereas Parkinson's averaged "a death toll in the United States of less than 4,000 per year."^[52]

However, the Centers for Disease Control National Vital Statistics Reports do not support FAIR's claim. The CDC reported that HIV/AIDS killed 14,802 Americans in 1999, compared to 14,593 who succumbed to Parkinson's.^[53] The following year the order was reversed, with 14,478 dying from HIV/AIDS, and 15,682 from Parkinson's.^[54]

Accusation of conflict of interest[link]

In a February 2000 Salon.com feature on Stossel entitled "Prime-time propagandist", David Mastio wrote that Stossel has a conflict of interest in donating profits from his public speaking engagements to, among others, a non-profit called "Stossel in the Classroom" which includes material for use in schools, some of which uses material made by Stossel.^[55][56]

Galbraith and Stossel[link]

University of Texas economist James K. Galbraith has alleged that Stossel in his September 1999 special, Is America #1?, used an out of context clip of Galbraith to convey the notion that Galbraith advocated the adoption by Europe of the free market economics practiced by the United States, when in fact, Galbraith actually advocated that Europe adopt some of the United States' social benefit transfer mechanisms such as Social Security, which is the economically opposite view. Stossel denied any misrepresentation of Galbraith's views, and stated that it was not his intention to convey that Galbraith agreed with all of the special's ideas, but re-edited that portion of the program for its September 2000 repeat, in which Stossel paraphrased, "Even economists who like Europe's policies, like James Galbraith, now acknowledge America's success."^[57][58][59]

Organic vegetables[link]

A February 2000 story about organic vegetables on 20/20 included statements by Stossel that tests had shown that neither organic nor conventional produce samples contained any pesticide residue, and that organic food was more likely to be contaminated by E. coli bacteria. The Environmental Working Group objected to his report, mainly questioning his statements about bacteria, but also managed to determine that the produce had never been tested for pesticides. They communicated this to Stossel, but after the story's producer backed Stossel's recollection that the test results had been as described, the story was rebroadcast months later, uncorrected, and with a postscript in which Stossel reiterated his claim. Later, after a report in The New York Times confirmed the Environmental Working Group's claims, ABC News suspended the producer of the segment for a month and reprimanded Stossel. Stossel apologized, saying that he had thought the tests had been conducted as reported. However, he asserted that the gist of his report had been accurate.^{[60][61][62][63][64]}

Frederick K. Price[link]

In a March 2007 segment about finances and lifestyles of televangelists, 20/20 aired a clip of Rev. Frederick K. Price, a TV minister, that was originally broadcast by the Lifetime Network in 1997. Price alleged that the clip portrayed him describing his wealth in extravagant terms, when he was actually telling a parable about a rich man. ABC News twice aired a retraction and apologized for the error.^[65][66] In August 2010, a lower court's dismissal of the minister's defamation suit against ABC, Price v. Stossel, was overturned by the U.S. 9th Circuit Court of Appeals.^[67]

"Sick Sob Stories"[link]

In an opinion piece published in The Wall Street Journal in September 2007 called "Sick Sob Stories", Stossel described the case of Tracy and Julie Pierce that was explored in Michael Moore's film, Sicko.^[68] Julie Pierce criticized Stossel, saying her husband would have been saved by the Canadian health care system, and she thought Stossel should have interviewed her and her doctor before writing about them.^[69] Stossel expressed sympathy, but said she had been misled to believe the treatment was routinely available in Canada. He said that the treatment is also considered "experimental" in Canada, and is provided there even more rarely than in the U.S.^[70]

Global warming[link]

He challenges the notion that man-made global warming would have net negative consequences, pointing to assertedly warmer periods in human history.^[71] Central to his argument is the idea that groups and individuals get much more public attention, donations, and government funding when they proclaim "this will be terrible" than groups that say "this is nothing to worry about." He points to groups like the World Wildlife Fund, Greenpeace, the Environmental Defense Fund, the Natural Resources Defense Council, and to activists such as Rachel Carson and former U.S. Vice President Al Gore as examples of environmental scaremongers.^[72]

In 2001, the media watchdog organization Fairness and Accuracy in Reporting criticized Stossel's reportage of global warming in his documentary, Tampering with Nature, for using "highly selective...information" that gave "center stage to three dissenters from among the 2,000 members of the UN's Intergovernmental Panel on Climate Change, which recently released a report stating that global temperatures are rising almost twice as fast as previously thought."^[73]

In a 2006 discussion hosted by the Fraser Institute, Stossel stated that he accepts that global warming has occurred in the past century, that it has been about one degree Celsius, and that man-made emissions "may be part of the cause." Nevertheless he groups environmental groups with astrologers and psychics in his second book, Myths, Lies and Downright Stupidity. He stated that the "myths" come in with the debate about proposed solutions to reduce global warming, which he argues will not solve the problem at all and will restrict people's freedom.^[5]

David Schultz incident[link]

On December 28, 1984, during an interview for 20/20 on professional wrestling, wrestler David Schultz struck Stossel after Stossel stated that he thought professional wrestling was "fake". Stossel stated that he suffered from pain and buzzing in his ears eight weeks after the assault.^[74] Stossel sued and obtained a settlement of $425,000 from the World Wrestling Federation (WWF). In his book, Myths, Lies, and Downright Stupidity, he writes that he has come to regret doing so, having adopted the belief that lawsuits harm hundreds of innocent people.^[75][76] Schultz maintains that he attacked Stossel on orders from Vince McMahon, the head of the then-WWF.^[77]

Personal life[link]

Stossel lives in New York City with his wife, Ellen Abrams. They have two grown children.^[78]

Stossel's older brother, Thomas P. Stossel,^[9] is a hematologist at Brigham and Women's Hospital,^[79] and a professor at Harvard Medical School. He has served on the advisory boards of Merck, Biogen Idec and Dyax,^[80] as a senior fellow at the free-market Manhattan Institute,^[81] and as a trustee of the American Council on Science and Health.^[82]

Stossel's nephew is the journalist and magazine editor Scott Stossel.^[83]

See also[link]

• List of newspaper columnists

References[link]

Further reading[link]

External links[link]

Wikiquote has a collection of quotations related to: John Stossel

• Official website
• John Stossel at the Internet Movie Database
• Harper Collins (Publisher) – Biography at Publisher's website
• American Justice Partnership (December 12, 2005). "Special Interview...Steve Hantler (of) John Stossel" (17 minute MP3 audio). http://www.legalreforminthenews.com/Interviews/Stossel_Hantler_Interview.html. Retrieved October 14, 2007. 

Biographies and articles about Stossel[link]

• ABC News Biography
• Johnson, Peter. "Stossel's evolution from activist to contrarian angers some of his fans", USA Today, April 30, 2006
• "John Stossel: Myth-Buster", FrontPageMag.com
• Sullum, Jacob. "Risky Journalism: ABC's John Stossel bucks a fearful establishment" Reason, April 1997.

Articles by Stossel[link]

• John Stossel's 20/20 Web Page
• John Stossel's Newspaper Columns
• John Stossel's contributions to Reason Magazine
• "Confessions of a Welfare Queen: How rich bastards like me rip off taxpayers for millions of dollars" is an excerpt from his first book.
• John Stossel's Column on Creators.com

Julianne Moore
At the 66th Venice International Film Festival, September 2009
Born	Julie Anne Smith (1960-12-03) December 3, 1960 (age 51) Fayetteville, North Carolina, U.S.
Occupation	Actress
Years active	1983–present
Spouse	John Gould Rubin (m. 1986–1995) «start: (1986)–end+1: (1996)»"Marriage: John Gould Rubin to Julianne Moore" Location: (linkback:http://en-wiki.pop.wn.com/index.php/Julianne_Moore) Bart Freundlich (m. 2003) «start: (2003)»"Marriage: Bart Freundlich to Julianne Moore" Location: (linkback:http://en-wiki.pop.wn.com/index.php/Julianne_Moore)
Children	2

Julianne Moore (born Julie Anne Smith on December 3, 1960) is a British-American actress and a children's book author. She has been nominated for four Oscars, six Golden Globes, three BAFTAs and nine Screen Actors Guild Awards.

Moore began her acting career in 1983 in minor roles, before joining the cast of the soap opera As the World Turns, for which she won a Daytime Emmy Award in 1988. She began to appear in supporting roles in films during the early 1990s, in films such as The Hand That Rocks the Cradle and The Fugitive. Her performance in Short Cuts (1993) won her and the rest of the cast a Golden Globe for their ensemble performance, and her performance in Boogie Nights (1997) brought her widespread attention and nominations for several major acting awards.

Her success continued with films such as The Big Lebowski (1998), The End of the Affair (1999) and Magnolia (1999). She received particular acclaim for her portrayal of a betrayed wife in Far from Heaven (2002), winning several critic awards as best actress of the year, in addition to several other nominations, including the Academy Award, Golden Globe, and Screen Actors Guild Award. The same year, she was also nominated for several awards as best supporting actress for her work in The Hours. In 2010, Moore starred in the comedy drama The Kids Are All Right, for which she received a Golden Globe and BAFTA nomination.

Early life[link]

Moore was born Julie Anne Smith at Fort Bragg, near Fayetteville, North Carolina.^[1] Her mother, the late Anne McNeil McLean (née Love), was a psychiatric social worker who emigrated from Greenock, Scotland, and her father, Peter Moore Smith, a New Jersey native, was a military lawyer, judge, helicopter pilot, and army colonel.^[2][3][4][5] She has a younger sister, Valerie, and a younger brother, novelist Peter Moore Smith III.^[6] Growing up as an "army brat", she moved 23 times and attended 9 different schools before she was 18.^[7][8] She lived in several places across the United States and Germany.^[1] Moore attended J.E.B. Stuart High School in Falls Church, Virginia and Frankfurt American High School in Frankfurt, Germany, graduating in 1979.^[1] She received her bachelor's degree at the College of Fine Arts at Boston University in Drama.^[9]

Career[link]

Acting[link]

Moore moved to New York City in 1983, working as a waitress and performing in bit parts before being cast in the dual roles of Frannie Hughes and Sabrina Hughes on the soap opera As the World Turns, for which she won a Daytime Emmy Award; she played the roles from 1985 to 1988.^[1] In 1987, she was part of the junior company in the New York premiere of Caryl Churchill's Serious Money at The Public Theater. Because of Screen Actors Guild rules, she had to change her name, since there were already actresses named "Julie Smith" and "Julianne Smith".^[1] She chose her father's middle name, "Moore", but because there was already another actress named "Julie Moore", she finally settled on "Julianne Moore."

Moore at the premiere of Savage Grace, April 2008.

Moore began starring in feature films in the early 1990s, mostly appearing in supporting roles in films like The Hand That Rocks the Cradle, Benny & Joon, and The Fugitive. Her part in 1993's Short Cuts gained her critical acclaim and recognition, and she was cast in several high-profile Hollywood films, including 1995's romantic comedy Nine Months, and 1997's summer blockbuster The Lost World: Jurassic Park. Her first role as the central lead, Carol White, in the well-reviewed independent film Safe also attracted critical attention. The role was called the ancestor of one of Moore's best-praised roles, Cathy Whitaker, in another Haynes film, Far from Heaven.^[1][10] Critics noted the importance of this role in establishing her as an actress to take seriously.^[11] In addition, her performance on Vanya on 42nd Street, a filmed version of Anton Chekhov's play Uncle Vanya, earned her critical recognition, with film critic Kenneth Turan calling her work in the film "a revelation".^[12] For this role, Moore won Best Actress from the Boston Society of Film Critics.

During the late 1990s and early 2000s, Moore appeared in a series of films that received Oscar recognition, including her roles in Boogie Nights (1997, Best Supporting Actress nomination), The End of the Affair (1999, Best Actress nomination), and her two 2002 films, The Hours (Best Supporting Actress nomination) and Far from Heaven (Best Actress nomination), for which she also won "Best Actress" from no less than 16 critics groups, more than any other actress that year^[13] (see below for a list), and from the Venice Film Festival.^[1] In the Los Angeles Times review of "The Hours," critic Manohla Dargis wrote: "The film's three leads are extraordinary, but what Moore does with her role is so beyond the parameters of what we call great acting that it nearly defies categorization." During this period, she also appeared in the commercial successes Hannibal (replacing Jodie Foster as Clarice Starling) and The Forgotten, in Paul Thomas Anderson's follow-up to Boogie Nights, Magnolia, and in the Coen brothers cult hit The Big Lebowski. Entertainment Weekly has chosen her one of The 25 Greatest Actresses of the '90s.^[14] In 2003, The Guardian called her "the most talented actress of her generation".^[15]

In November 2006, Moore made her Broadway debut in the world premiere of David Hare's new play The Vertical Hour, directed by Sam Mendes.^[16] 2006 also saw the releasing of three of her films: Freedomland, which opened in February to mixed reviews,^[17] followed by Trust the Man, directed by her husband Bart Freundlich, and the critically acclaimed science fiction feature Children of Men.^[18] The following year she appeared opposite Nicolas Cage and Jessica Biel in Next, a science fiction action film based on The Golden Man, a short story by Philip K. Dick; and the controversial film Savage Grace, the story of a high-society mother and son whose Oedipal relationship ends in tragedy. In 2008, she starred alongside Mark Ruffalo in Blindness, a thriller from director Fernando Meirelles. In her review of the film, Stephanie Zacharek of Salon.com called Moore "an apparition of generosity and compassion who seems in danger of disappearing at any moment. Moore takes the movie's stiff, signpost dialogue and delivers it in a way that's consistently believable. [...] She's a miracle worker, and whatever Meirelles paid her, it isn't nearly enough",^[19] while The Austin Chronicle commented that Moore "masterfully characterizes the devoted wife’s metamorphosis into a heroicism both unwanted and unheralded. It’s a rattling, heartrending performance in, yes, a long, hard slough of a film – one that is well worth the journey, if not a repeat trip."^[20]

The next year, Moore appeared opposite Colin Firth in the well-received American drama A Single Man,^[21] for which she received her fifth Golden Globe nomination, with Peter Travers of Rolling Stone calling her performance "explosively good".^[22] When the cancellation of As the World Turns was announced in late 2009, Moore decided to honor the soap that brought her fame and temporarily returned for a few days as Frannie Hughes.^[23] During the 2009–2010 season of 30 Rock, she had a guest role as Nancy Donovan, a love interest for Alec Baldwin's character, Jack Donaghy.^[24]

In 2010, Moore starred in the erotic thriller Chloe, theatrically released by Sony Pictures Classics and had since became director Atom Egoyan's biggest moneymaker ever.^[25] In his review of the film, David Edelstein of the New York magazine called Moore's performance "extraordinarily raw and affecting."^[26] Moore next appeared in the comedy-drama The Kids Are All Right, co-starring Annette Bening and Mark Ruffalo; Moore was instrumental in getting the film made and in getting Bening involved.^[27] The film was both a critical and commercial success,^[28][29] garnering acting and production nominations from the Gotham Awards, the Independent Spirit Awards and the Academy Awards, as well as winning the Golden Globe Award for "Best Motion Picture – Musical or Comedy". Roger Ebert of the Chicago Sun-Times commented, "Moore and Bening are superb actors here, evoking a marriage of more than 20 years, and all of its shadings and secrets, idealism and compromise",^[30] and the Los Angeles Times review said, "Moore is fearless" and "plays every note perfectly."^[31] For this role, Moore received her sixth Golden Globe Award nomination and a BAFTA nomination.

In July 2011, Moore appeared in the comedy Crazy, Stupid, Love., co-starring Steve Carell and Ryan Gosling, which was successful commercially and received favorable reviews,^[32] with The Globe and Mail commenting, "some genuinely impressive acting breaks out. The accomplished Moore is an obvious candidate and, even in a confined role, she delivers – here a nervous look, there a tender gesture."^[33] In the HBO drama Game Change, Julianne Moore portrayed 2008 vice-presidential nominee Sarah Palin. The made-for-television movie earned the cable channel its biggest audience for an in-house production in eight years.^[34] Moore received rave reviews for her "flawless performance"^[35], with the San Francisco Chronicle calling her portrayal of Palin "both complex and entirely credible. Yes, the hair, makeup and costumes contribute mightily to transforming Moore, but the nuance she brings to the performance is simply astounding."^[36] Altogether, she has five upcoming projects, amongst others the fantasy film The Seventh Son based on the book series The Wardstone Chronicles, co-starring Jeff Bridges, in which Moore will star as the "most dangerous 1700s witch" Mother Malkin.^[37]

Writing[link]

In October 2007, Moore made her literary debut with the publication of Freckleface Strawberry, a children's book illustrated by LeUyen Pham, based on her experiences as a child. In April 2009, Moore and Pham followed up with a second children's book titled Freckleface Strawberry and the Dodgeball Bully.^[38][39]

Personal life[link]

Moore met her first husband, John Gould Rubin, in 1984. They married in 1986, separated in 1994, and divorced in 1995.^{[citation needed]} In 1996, she began a relationship with director Bart Freundlich, whom she wed on August 23, 2003.^[40] The couple had two children prior to their marriage: a son, Caleb (b. December 4, 1997), and a daughter, Liv Helen (b. April 11, 2002). In an interview, Moore said she picked roles in movies that film in the summer so her family can accompany her: "My husband and I are very fortunate, because we have flexible jobs," she says. "If you talk to parents, that's what they're trying to do — have as much flexibility as possible."^[41] She lives with her family in the West Village neighborhood of Manhattan.^{[citation needed]} By way of her Scottish ancestry, Moore became a British citizen on July 8, 2011.^[42]

Activism[link]

Politics[link]

Moore is a pro-choice activist^[43][44] and, during the 2004 presidential election, donated $2,000 to John Kerry's presidential campaign.^[45]

Charity work[link]

Since 2002,^[46] she has been involved with the TS Alliance^[47] to raise awareness of tuberous sclerosis and is an Artist Ambassador for Save the Children's programs in the United States.^{[citation needed]} In 2012, Moore joined Moms Clean Air Force^[48], to help call on parents to join in the fight against toxic air pollution.

LGBT advocacy[link]

She actively supports same-sex marriage,^[49] and some of her films and roles deal with LGBT topics.

Filmography[link]