WE 3 Responses

The Uninsured

Q.1 Write reply for this article.

I believe that all of us in our lifetime will be faced with needing medical insurance that won't be for something routine that we can fully pay out of pocket. Many people have gone bankrupt due to medical bills that they have racked up. I believe that a solution to eliminate Americans with no health insurance would be to start putting pressure on businesses to offer healthcare coverage to their workers. The affordable care act is doing a good job in putting pressure on businesses to do so and has been putting penalties on employers who don't follow the rules. I also believe that focus on expanding  existing medical programs that cover low-income adults would go a long way into having every American insured, creating an insurance pool for small businesses and the self employed as well as having premium assistance for the low-wage earners and requiring employers to either provide health benefits or contribute to a fund to finance coverage for working people. These are just a few examples of what can be done to get insurance for all Americans. i found this article that states a few more examples of how Government actions by both the federal and state can achieve health care coverage for all Americans.

https://www.commonwealthfund.org/publications/journal-article/2007/feb/uninsured-america-problems-and-possible-solutions

Q.2 Write a reply/ response for this article.

With almost 30 million Americans living without insurance, that calls for some action. While easier said than done, factors that lead to Americans being uninsured are costs of medical bills, unemployment, and adults that aren’t elderly do not qualify for coverage programs such as Medicare and Medicaid. I would propose loosening the restrictions and qualifications for assistance. I would also have those who are employed with family members they need to support extra help and benefits to provide for their families. I would most importantly, improve the incentives for workers that are in facilities such as county hospitals, and low income areas facilities to make them provide excellent care. They should be practicing preventative care of chronic illnesses.  https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/

The reason United health care won’t work for the United States is the increase of malpractice suits, the already “too bloated” to try and scale back. The costs of healthcare is already too expensive to try and repair. And lastly, doctors and other medical professionals will likely leave the field. Their income will be reduced.   

https://outofyourrut.com/7-reasons-universal-healthcare-wont-work-us/

Q.3 Class evaluate public programs such as Medicare and Medicaid and discuss which program is meeting the needs of the population it is intended to serve.

Private Insurance

Q.4 write a reply /response for this article.

The way that health insurance differs from other kinds of insurance is that with health insurance you have copays, deductible, or co insurance.  There are deductibles and premiums attached to the type of insurance you choose.  Health insurance you have PPO, HMO, or DPO, which they carry different leels of cost based how much coverage you will need.  Also there are not FSA's and HSA's that are attached health isurance which gives you the otpion to have your medical cost reimbursed to you if you pay out of pocket, or you can have the expenses taken directly from the annual amolutn you have chosen for the HSA.  There are different types of health insurance coverage it provides comprehensive coverage for hospital services, ambulance service, accidental and special care, etc. It provides financial protection for health-related expenses. It meets health emergency needs and other expenses.  Mediclaim health insurance provides coverage for hospital service.  Premium plans are for sum insured. insurer age, gender, opted duration, plans and location it will differ.  Claim settlement is a form of reimbursement with cashless treatment. insurance varies on reasonably small channels of loss.  Health insurance for sustainable insurance for wealth, loss and limited loss.  Fee for service for people's autonomy to provide better care with coverage. it is traditional health insurance.   It is a type of health coverage that includes out of pocket expenses.  Managed-care plans include(PPO) preferred provider organization, point of service(POS), Health maintenance organization(HMOs). These plans between the insurer and health care providers for financial incentives to use providers network to assure quality care.

https://www.homeworklib.com/question/858313/how-does-health-insurance-differ-from-other-kinds

Q.5 write a reply/ response for this article

Health insurance covers routine check ups, scans and blood tests. It also covers small sick visits and general healthcare questions that only a provider can confirm. Health insurance is mostly offered through employment, but is also available through private companies.  Other insurances such as car, home, and life insurance guarantee only protection over financial loss and reimbursement of possessions and their value. Life insurance pays a sum of money in the event that a life is lost. So they’re very straight forward and general purposes where health insurance offers more specific coverage.   

Some implications with competent value based care would be managing higher patient volumes, less out of network patients, increase market share, and care for a bigger population of patients with chronic disease.   

https://healthinformatics.uic.edu/blog/shift-from-volume-based-care-to-value-based-care/

Q. 6Write a reply for this articles.

Private health insurance refers to health insurance plans marketed by the private health insurance industry as opposed to government-run insurance programs. Private health insurance includes employer sponsored plans which cover over half the American population. Examples of Private insurance are HMO's where payments are made in advance of services being provided. The Capitation payment entitles the patient to a certain dollar amount of services over a time period. In an HMO the employer pays a flat fee to the HMO and if the employee uses fewer services the provider keeps the difference but if the employee uses More services then the provider absorbs the cost. In a PPO it does not receive premiums or assume financial risk. Instead it acts as the go-between negotiating and managing contracts on the part of the providers. Patient chooses provider and if provider is preferred then services are provided at a lower cost. If the provider is not preferred then the services are provided at a higher rate. Just 2 different payment methodologies on private insurances.

Austin, A., Wetle, V. (2018). The United States Health Care System: Combining Business, Health, and Delivery, 3rd Edition

https://www.healthinsurance.org/glossary/private-health-insurance/