The patient pay the doctor every visit, he then collects the document and present them to the third party (the insurance provider) for reimbursement. Managed care is a term used to describe a variety of techniques that aim to reduce the cost and directs the utilization of health benefits. Shortell (2005) defined manage care as any attempt to provide members health care services at the lowest possible cost. This principle aims to limit health care expenditures. Managed care provides patients with several options.
Most people have high deductibles before the employer will even start to pay some of the health insurance coverage. So while you are trying to meet your deductible you are paying way to much out of pocket by the time the insurance kicks in some people cannot pay their bills or having a hard time keep trying to make their appointments because they are spending a lot of their money on deductibles. Soon everyone is going to have to have health coverage in the U.S. Will they make it so that people can afford the coverage? Will it be decent insurance so that it will be worth paying for? The government needs to really look at the people that they want to provide insurance for.
3. Discuss how cost sharing applies to health insurance The purpose of cost sharing is to reduce the misuse of insurance benefits. The main types of cost sharing are utilized in private health insurance: 1) Premium cost sharing in employer-sponsored health insurance, the employee is generally required to share in the total cost of the premium. 2) Deductible which is the amount the insured must first pay before any benefits by the plan are payable. 3) Copayment the amount that the insured has to pay out of pocket each time health services are received after the deductible amount has been paid.
Some of the services that the hospital provides are not covered. Often times, patients still have bills to pay for the treatment they needed even though they have insurance. It is a threat because people think they have insurance, and they don’t have all that they need to meet their health care treatment people will not come into the hospital once they realize how much they have to actually pay for the
With taxes at a breaking point government has little recourse but to try to hold down costs. Government cutting budget for health care sector affects every aspect. Since labour is the main component of health costs, income for health workers and professionals have been brought under tight government controls. This causes brain wash. Health professionals will migrate to other countries were they would compensate for the same services they provide. This causes shortage of labour force in health care sector which in turn causes long patient wait time.
So the government should set aside some finances for the implementation of this bill wisely and carefully by making sure that it does not drive up the taxes as the prices of goods are already high as it is. For the insurance agencies, they should include an all out and fair insurance cover which will not prejudice against the low income earners. As suggested by Blendon, R.J and Benson JM (April 2010). In their article, "Public opinion at the time of the vote on health care reform". His advice to the government and the Medicare experts are simple, they suggested that the government should look into the bill again and revise it allowing for purchases of drugs from Canada and ensuring a limitation of the malpractices and for the government to reduce the qualifying age for Medicare.
Payroll tax imposed on employees and employers enacted by the Federal Insurance Contributions Act and Self Employment Contributions Act of 1954 which set a maximum amount of compensation of which Medicare tax could be imposed each year. Beginning in 1994, maximum limit was removed and a self-employed citizen has to pay the entire 2.9% tax on self-employed net earnings. The Patient Protection and Affordable Care Act of 2010, commonly known as Obama Care, is set up to decrease the number of uninsured United States citizens and reduce the cost of health care. Many believe that with the PPAC, it will reduce premiums, prevent bankruptcy, illness, reduce out of pocket expenses, help pay for early retirees and reduce hidden tax on insured United States citizens. It is estimated that the PPAC will reduce the deficit by $100 billion and trillion dollars in the next decade.
Finally, one of the last reasons for the nursing shortage is the decline in relative earning (Williams &ump; Torrens, page 284). The actual earnings for RNs increased steadily from 1983 to 2000, the amount available after adjusting from inflation has been low since 1991 (Williams &ump; Torrens, page
In a study published in 2013 by the National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers, it was shown that greater than half of the RN workforce is age 50 or older. The consequence of this data is the reality that within the next 15 years a significant portion of the current nursing population will be retiring, or taking their experience and moving into higher paying private sector jobs. Compounding the problems faced by the increasing age of the nursing community is the realization that for a lengthy period of time the government and university leaders underinvested in health worker education. This underinvestment has led to a younger group of nurses who are not well prepared for the personal responsibility of working in the healthcare industry. Along with the underprepared nurses, there is also the lack of youths choosing to enter the healthcare field.
Introduction The national expenditure levels in the United States have more than tripled over the last decade (US Census, 2011). Regardless of inconsistencies in national budgets, health care is still in high demand. Unfortunately, nearly half Americans cannot afford health care and are now forced to rely on Medicare and Medicaid. The generation of Baby Boomers, who was once the back bone for American Capitalism, is living with a growing health care crisis. Considering the age of the boomers, health care is essential.