Monday, October 21, 2019
Different types of healthcare options in America Essays
Different types of healthcare options in America Essays Different types of healthcare options in America Paper Different types of healthcare options in America Paper Medicare and Medicaid programs were enacted in Americaââ¬â¢s constitution around 44years ago with an aim of setting aside a fund that would provide medical care for all American citizens. However, even with the presence of government programs, the public healthcare system is in a terrible state. (Anne O. James A. 564). In 2004 for instance, 45 millions of Americans were uninsured and ââ¬Å"turned to hospital emergency rooms for even routine careâ⬠numbers of uninsured, it is projected that Medicare program will run out of funds if no suitable remedial action is taken. The reason why a lot of Americans are not insured is because they can nit afford the exorbitant medical care is attributed to the highly fragmented medical care system every medical care provider attempt ââ¬Å"to get the biggest cut of health care dollar they can.â⬠The industry reports that it is forced to charge high medical bills because they need to finance research and development. . (Anne O. James A. 564) As a result of the unaffordable charges, the number of people who have put off medical care is increasing leading to serious health conditions. There are different types of insurance for health care option and are categorized into: à Employed based health insurance coverage Under this we have: Small employer group This insurance option applies to employers who have 2-50 employees. The federal health insurance portability and accountability Act of1996 requires that health insurance contracts for small health groups be on guarantee issue basis and also guarantee renewable unless the employer has failed to pay premiums, committed fraud, intentionally misrepresented or has failed to comply with the terms of the health insurance contract. (Harry A. S 222) à This particular scheme is advantageous especially to smaller companies. Some small health group insurance programs provide additional benefits like free dental care. There is a large network of medical care providers who participate in these programs. There is benefit of economies of scale, making the charges per person lower than individual programs. The contributions of employers and in some cases the workers are not taxed. (Harry A. S 240) However, this scheme is not flexible whereby some organizations allows medical care from specified physicians. The employees in such cases are denied the opportunity of getting medical care from their favorite physicians or the physician of their choice. (Harry A. S 254) Large employer group This program is applicable for employers who have from 51 or more employees. The average charges are lower than both small groups and individual health insurance opting due to economics of scale. The contributions of both employers and employees in most cases are not taxable. Many employers allow their employees to temporary continue their health insurance under specified conditions for a specified period of time. (Ben Irvine) Individuals who have other insurance coverage or have not exhausted COBRA coverage are not provided with this benefit. This option also precludes individuals who did not previously belong to any health insurance coverage as well as those who have not stayed for 18 months prior to the previous creditable coverage. (Applicable to Washington State) Individual health insurance coverage This is the common plan that is in most cases entered by the self-employed and unemployed people. The person intending to secure this kind of plan is medically examined and his/her financial status evaluated by the insurance provider to determine whether the person is financially capable of sustaining the premium payments. (Ben Irvine) à This particular program has several advantages one of which is that a person can choose the benefits that she/he would like provided in the insurance package. If a person under an individual health insurance is unable to pay the monthly dues other insurance organizations that a person has entered can share the medical expenses incase the person becomes ill. (Ben Irvine) On the other hand it is a little bit more expensive than the group insurance schemes and for a person to be eligible to this plan; he/she must have been previously covered. Coverage for medically uninsurable persons
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