Case Study : Ontario Health Insurance Plan

Under the Act, each provincial health plan is administered at the provincial level and provides comprehensive first dollar coverage of all medically necessary services. With minor exceptions, health coverage is available to most if not all residents with no out of pocket charges. Most physicians are paid on a fee for services and enjoy a great deal of practice autonomy. Private health insurance for covered services are illegal.  Most Canadians have supplemental private insurance for services that are not covered, such as prescription drugs and dental services. Consequently, physicians are forced to participate and each health plan effectively serves all residents in the province (Henderson 487).

(Long Term Care Canada, 2011) All in All for this form of service it would be beneficial for this individual to either have private insurance or for the family to care for them.

Obamacare, Medicare, universal, privatized, public, parallel; these healthcare systems (HCS) may sound a little confusing and scary for a person who values their health and the health of their family. In the United States of America, there are several different options of health coverage to choose from: health insurance for people with disabilities, long term care insurance, traditional-fee-for-service, and preferred provider organization, this is just naming a few (USA.org, 2017). With all these choices, how do you know which one is the best for you and your family? Usa.org emphasizes that several questions must be considered when choosing a healthcare provider: Are there any deductibles? Can I see any doctors or go to any hospital? Will all medications be covered that the doctor prescribes? Again, seems confusing, right! Therefore, Canada's HCS is based on the patients' needs and not what they can afford (Government of Canada, 2012). Although Canada's HCS is widely known for their universal coverage, many Canadian citizens have various concerns; one being excessive wait times.

Cheryl has been diagnosed with Generalized Anxiety Disorder, Major Depressive Disorder, and Alcohol Use Disorder. When asked about her concerns for post discharge she states that she has been heavily reliant on her parents and their health benefits for her treatment and that she is nervous that she may not have coverage to continue therapy. She reports that she felt safe knowing that “Obamacare” would be in place to help her afford the treatment she needs to stay mentally healthy and sober. She states that she is concerned about the possible repeal of the Affordable Care Act because she will need help paying for her mental health expenses. The Affordable Care Act made a giant leap in extending the work of the Mental Health Parity and Addiction Equity Act. These two acts work together to ensure that treatment for mental illness is accessible to many Americans that need treatment. Throughout this paper I

With the Advent of the Affordable Care Act, came many changes throughout the medical industry, changes happened in hospitals, health insurance, and doctors. Doctors, more than any other group seem to be affected in a number of way, from the amount of patients, from the increased number of people with insurance plans. It also changed the way a doctor interacts with other parts of medicine. There are some questions arising from this such as; would doctors approve or disapprove of these changes along with do these changes affect the doctors' ability to practice. For the most part, there is no difference the way doctors practice or to their income, but it does have doctors utilize their abilities towards medicine rather paper pushing which could have doctors prefer the post-ACA medical community rather than before.

HCA is a healthcare provider that was established in 1968. Their main focus is on offering cliental with a number of different services to include: inpatient, intensive care, outpatient, diagnostic and emergency services. To achieve these objectives they operate a variety of facilities such as: outpatient, psychiatric, surgery centers, freestanding emergency care facilities, diagnostic / imaging centers and comprehensive rehabilitation / physical therapy centers. They are structured to create increasing earnings for its policy and shareholders. This is achieved by contracting with private doctors to deliver services to its preferred providers members. At the same time, they receive fees from these entities and they negotiate lower group rates.

Toward the end of the 1920s, in a little town in South Texas named Cotulla, a junior high teacher saw the injustice and poverty among his Mexican-American students (Del Bosque, 2013). After decades passed, that same man became the U.S. President; Lyndon B. Johnson signed the bill that constructed Medicaid in 1965, which is a program that is funded by the state and the federal government to provide health insurance to low-income Americans (2013). Johnson had an idea to create a “Great Society” which he defined as “a society where no child will go unfed, and no youngster will go unschooled” (2013) . Now even in 2015, we see that President Obama is still fighting for this dream of Johnson’s (Ura & Walters, 2014). President Obama’s Affordable Care

Prior to the enactment of the Affordable Care Act, many Americans did not have access to health care. According to Shi and Singh, assess is an individual’s ability to obtain health services when necessary (Shi &Singh, 2010). “After implementation of the ACA, the proportion of the U.S. population that was uninsured dropped from approximately 16% to roughly 12% in 2014 (Shi & Singh, 2010, p 11). More low to middle income American are eligible for health care services through the Affordable Care Act. Advancements in health information technology have helped to improve and streamline medical services and have helped with the lower cost of health care. “Essential insurance benefits required by the ACA include preventative and wellness services,

Four years after President Obama signed the Affordable Care Act into law there is still uncertainty regarding how it will affect small businesses. Because there were delays and exemptions granted by the, Obama administration and challenges that were still pending in courts. The effects on small businesses vary from state to state depending on the company size and the composition of the company's workforces. But the large corporations pay their employees medical bills and hiring insurers to administer health benefits. Most small businesses purchase group health insurance from insurers and face cost increasing regulations as they go through the annual ritual of renewing their coverage. While media has focus their attention on the state and federal health exchanges, employers are responsible for the growth in the

The Canada Healthcare act [R.S. 1985, c. C-6] passed in 1984. It ensures that all residents of Canada have an equal access to necessary physician services, no extra billing from physicians and hospital. The act is on five main principles, Public administration necessary services are to offer on a non-profit basis. Next, accessibility coverage with no extra charges and comprehensiveness coverage for all medically necessary services at all times. Portability coverage is to extend to all residents in all provinces and territories. The fifth principle is universality coverage for all eligible residents of all provinces and territories (SEDAP, 2007).

The Affordable Care Act (ACA) has been the biggest milestone to date in American health care policy (Saldin, 2011). There is nothing more complex or controversial in recent history than the passing of the ACA in 2010 (Davidson, 2016). The United States Supreme Court ratified the constitutionality of the Patient Protection and Affordable Care Act on June 28, 2012. With this, there were certainly challenges facing the full implementation of the provisions of this act by 2014.

The healthcare system underwent reformation in 2010 in the form of The Affordable Care Act. The main goal of the ACA was to extend health care throughout the nation; irrespective of this intention, some people regard the Affordable Care Act as being paternalistic. Chapter 9 covers the issue of how ethical the imposition of new restrictions on people by the ACA is.

Canada 's health care system is a group of socialized health insurance plans that provides coverage to all Canadian citizens. It is publicly funded and administered on a provincial or territorial basis, within guidelines set by the federal government. Under the health care system, individual citizens are provided preventative care and medical treatments from primary care physicians as well as access to hospitals, dental surgery and additional medical services. With a few exceptions, all citizens qualify for health coverage regardless of medical history, personal income, or standard of living. In addition to public health care providers such as primary care doctors and hospitals, many private clinics offering specialized services also operate in Canada.

Blue Cross Blue Shield of Tennessee faced another lawsuit against them filed by the Harrogate Family Practice owned by Amanda Brown. The plaintiffs, Harrogate Family Practice and owner, Amanda Brown, filed a complaint on the grounds of seeking injunctive and declaratory relief under ERISA (Employment Retirement Income Security Act of 1974). The defendant, Blue Cross Blue Shield of Tennessee, had sent five letters over the course of January, February, and March of 2014, notifying the plaintiffs of the overpayments that were discovered during an audit in November 2013 and requested recoupment. The Harrogate Family Practice and Amanda Brown’s counsel responded on April 3, 2013 stating that the recoupments violated ERISA. After a breakdown in

In Canada, healthcare comes from the ‘Single payer system’ (Canadian health care system, 2013). Single payer is known to be quite normal in many other countries, for example, New Zealand. It is basically a publically funded system that is provided by the provincial governments through taxes with guidance and some funds from the federal government (Canadian health care system, 2013). This health system covers Canadian citizens, permanent residents and temporary