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I have to respond to the following statements of my classmates. Please provide 100-150 words to each statement with a reference to each if applicable.

Re: Discussion Starter

posted by WANDA LANE at Jan 13, 2015, 9:11 PM

Last updatedJan 13, 2015, 9:11 PM 

Theoretically, a health care free market provides the following (not all inclusive): the ability of the patient to choose his or her provider, price decreases with an increased demand for services, competition based on price and quantity, and the ability of the patient to know the cost of health care services.  However, the United States health care system is far from a free market.  Patients are at the mercy of their health insurance plans whether those plans are private or government funded. Although monopolies are prohibited by law, managed care organizations (MCOs) are widely accepted.  Smaller insurance plans are unable to compete with individual premiums and provider payments.  One of the biggest challenges facing the free market concept in the United States is the varying costs of health care services.  A surgeon, for example, charges a set fee for his services but the patient gets billed for supplies, operating room usage, anesthesia, medications, and radiology services.  The surgery cost has now more than doubled, and the patient is struggling to pay these additional costs.

Re: Discussion Starter

posted by Shonna at Jan 13, 2015, 8:42 PM

Last updatedJan 13, 2015, 8:42 PM 

The US health care market is referred to as imperfect because it is sometimes difficult to get the services or care that is needed at a price one can afford. The consumer lacks the understanding that the suppliers have over the market. The business or firm that the physician works for wants the consumer to purchase the products at a the listed price so they can cover the costs of the product to make a profit. Sometimes the consumer or patient does not know the cost before they purchase the product. A physician will recommend the patient have multiple tests, procedures and medications, which then the consumer/patient has to pay for after receiving.

Re: Discussion Starter

posted by CARL CAMPBELL at Jan 13, 2015, 10:51 PM

Last updatedJan 13, 2015, 10:51 PM 

The United States governed market (Medicaid, Medicare, and CHIP); is an imperfect market compared to the private health care provided by private health care insurance companies who practice independently within in the free market.

The free market allows patient to choose their providers based on afford ability.

Health care patients who have insurance coverage provided by the imperfect governed markets have fewer choices for health care options and vastly depended on government provided health care service.

This issue limits the care the patients who receive care due to the high cost of provider care hence, they are the majority and usually do not have personal funds to pay for private insurance company benefits. The larger quantity of patients who receive government funded health care for, relative to the lower volume that privately funded insured patients through private institutions is in most cases because of their social economic status (unemployed

Re: Discussion Starter

posted by ERIKA RATERINK at Jan 13, 2015, 2:43 PM

Last updatedJan 13, 2015, 2:43 PM 

Free market health care means that the price can be negotiated by the purchaser, or patient. Currently in the United States we do not have free market health care, the rates of services are negotiated by the insurance company. The rates of services are not transparent and they vary depending on the insurance carrier and the provider. It would seem to make sense that gall bladder surgery should cost about the same no matter what type of insurance the patient has or where the procedure is completed, however, that is not the case. It seems that Medicare is really the only insurance that the allowable amount of a procedure is cut and dry across the board. Most countries at this time have universal health care, not here in The United States, we do not have universal health care and we do not have free market health care either; that is why our health care system is referred to as imperfect, we cannot seem to make up our mind on what it is we want as a country.

Re: DIscussion Starter

posted by WANDA LANE at Jan 14, 2015, 7:02 PM

Last updatedJan 14, 2015, 7:02 PM 

Prior to the passage of the Affordable Care Act, health insurance conglomerates were more concerned with the bottom line, and the corresponding profit margin, than the health of its members.  Executives had high salaries and even larger bonuses.  Patient care was compromised under the guise of controlling costs.  With the advent of the Affordable Care Act, insurance companies were mandated to use the "80/20" or Medical Loss Ratio rule.  Not only are health insurance companies required to show how much money is spent on administrative cost as opposed to health care, but "if an insurance company spends less than 80% of premiums on medical care and quality (or less than 85% in the large group market, which is generally insurance provided through large employers), it must rebate the portion of premium dollars that exceeded this limit" (HHS.gov/HealthCare, 2014).  Insurance companies are now transparent to its members.

Re: DIscussion Starter

posted by ERIKA RATERINK at Jan 13, 2015, 3:03 PM

Last updatedJan 13, 2015, 3:03 PM 

The Affordable Health Care Act (ACA) has allowed people with pre-existing conditions to obtain health insurance that is affordable and obtainable. Prior to the ACA people with pre-existing conditions had difficulty obtaining health insurance and if they did the insurance coverage was inadequate, either not covering anything related to the condition or having very low life time maximums. People with chronic and often very expensive health conditions were at the mercy of the system. 

The United States has tried to create a universal health care system for many many years and was unable to come to an agreement. The ACA came at a time when the United States had a large majority if people out of work and uninsured. They fell through the cracks and we not able to obtain state funded assistance like Medicaid. With the ACA some states expanded their Medicaid program along with providing the health insurance marketplace (affordable coverage). 

The law was intended to end lifetime maximums, make it mandatory for companies to offer health insurance, allow children to stay on their parents policy until 26, and also stop pre-excisting conditon clauses in health insurance poicies.

Re: DIscussion Starter

posted by DAYNERI VALLECILLO at Jan 13, 2015, 7:09 PM

Last updatedJan 13, 2015, 7:09 PM 

How has the Affordable Care Act changed the ability of Americans to get insurance? What were the factors that lead up to the creation of this law? What were the problems in the healthcare system that this law was intended to fix?

The affordable Care Act changed the ability of Americans to get Insurance since it provided more access and cheaper premiums for those Americans that could not previously afford coverage. There are several factors that lead to the creation of the act. Such factors as high medical bills due to lack of coverage that where not paid which in return increased. In addition, the shift to provide care to those individuals that where denied due to preexisting conditions put a strain in programs such as straight Medicare and straight Medicaid. The biggest problem in the health care was that many individuals could not afford to pay for coverage and the Affordable Acts main goal was to fix this issue.

Re: DIscussion Starter

posted by Debbie McKeever at Jan 13, 2015, 6:46 PM

Last updatedJan 13, 2015, 6:46 PM 

The Affordable Care Act has made it easier for American's to afford health insurance. Americans will no longer be discriminated based on their health status or demographic information.

There are many reasons as to why the Affordable Care Act (ACA) was created and passed. One of the main reasons was the millions of Americans that were without health insurance, mainly due to the high costs and access to health care. Insurance companies had the ability to deny consumers coverage due to a preexisting condition or drop the coverage due to consumers reaching their lifetime dollar limit. Insurance companies were also able to raise health insurance premiums to the price they wanted.

The Affordable Care Act was mainly created to expand health care coverage to more Americans and make health insurance more affordable for everyone. The ACA allowed for the expansion of Medicaid and CHIP for millions of people and also requires that preventive health services are covered without out-of-pocket expenses. For insurance companies, this act does not allow them to raise premiums at a startling rate, for it now helps keep the rates down. For companies, the ACA helps small businesses afford health care coverage for employees and also requires large businesses to provide access to health coverage to their employees.