Case Study: The Cost Of Medical Coverage

Data show that the number of uninsured Americans has greatly reduced over the past 2-3 years. However, prior to the adoption of various provisions of the Affordable Care Act (ACA), there were over 41 million people uninsured in 2013 (Kaiser Family Foundation, 2014). The number of people without health insurance, especially children, has steadily increased throughout most of the past decade. Children without health insurance are more likely to suffer from preventable and treatable illnesses, including their long lasting related effects, than their insured peers (Majerol et al, 2014). Majerol et al. also demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.

The implementation of the Affordable Care Act (ACA) will only hasten changes that were on the horizon for pharmaceutical and biotechnology firms. Pharmaceutical and biotechnology industries new there was going to be some type of healthcare reform so they began to take the necessary precautions to prepare. There are vital provisions in the ACA related to the pharmaceutical and biotechnology industry affecting Medicare and Medicaid. Legislation in the ACA will provide provision to reduce cost for brand name prescriptions (Rx); this will reduce drug cost for patients, but increase rebates and discounts for pharmaceutical and biotechnology firms, therefore, imposing cost to the firms. The pharmaceutical and biotech industry was instrumental

In the United States, the number of uninsured continue to increase everyday with no solution. "As of today the number of uninsured American remained at 10.9 % in the fourth quarter of 2016"(Holahan, 2017). In today economy where unemployment is at an all time high, millions of peoples are without insurance due to unemployment. There are also a lot of uninsured American that are employed, that can't afford insurance.

As of 2008, the Center for Medicare and Medicaid Services (CMS) identified falls as a Hospital Acquired Condition (HAC). HAC is a complication or comorbidity that occurs as a consequence of hospitalization and is high volume and/or high cost, and be reasonably prevented using evidence-based guidelines (Radey & LaBresh, 2012). The Center for Medicare and Medicaid Services will no longer cover the cost of care as a consequence of an inpatient fall based on the presumption that falls are preventable by the organization (CMS,

Affordable Health Care Act: Should the Federal Government or State Government be in charge of our healthcare.

amount should be cut making health care a more affordable necessity in the United States

The Supreme Court 's favorable ruling on the Affordable Health Care Act allowed for healthcare to be available for many Americans who would otherwise not receive medical benefits. This is because it increases the number of people covered by Medicare/Medicaid, and lowers the cost of insurance through employers. While this idea is good in theory, paying for it is a challenge due to the fact that it will only add to the nation’s already enormous debit of several trillion dollars (Mulvany, 2012). From 2010-2019, the United States is predicted to spend around 400 billion dollars on healthcare. This prediction has prompted lawmakers to reduce spending on Medicare, Medicaid and other welfare programs. The spending cuts will result in less people getting the care they need due to the limited availability of money for care and the increase in the number of beneficiaries receiving

For the last five years of my life I have worked in the healthcare industry. One of the biggest issues plaguing our nation today has been the ever rising cost of health care. If we don't get costs under control, we risk losing the entire system, as well as potentially crippling our economy. For the sake of our future, we must find a way to lower the cost of health care in this nation.

Rising health insurance premiums have made healthcare unaffordable in the United States. Health insurance premiums in this country have undergone a steady rise over the past few years while incomes have remained the same. More than 50% of individuals with low incomes holding private insurance in the United States are unable to afford their healthcare costs (Collins, Gunja, Doty & Buetel, 2015). In addition, costs related to healthcare are equally unaffordable to 25% of working-age individuals who hold private health insurance policies (Collins et al., 2015). According to the Kaiser Family Foundation/Health Research and Educational Trust (Kaiser/HRET) survey on employer health benefits, employer-sponsored health insurance plans have also had moderate rises in premiums in 2013 for both individuals and family coverage (Claxton et al., 2013). While

The chosen policy is the Health Insurance for Former Foster Youth Act (S.1797, 2017). This proposed law at the federal level is intended to secure access to health care for youth who have reached a certain age at which they are no longer eligible for foster care resulting in not having health insurance coverage (S.1797, 2017).

In the England healthcare plan its coverage is universal. All “ordinarily resident” in England are automatically entitled to health care, largely free at the point of use, through the NHS. Nonresidents with a European Health Insurance Card are also entitled to free care. Most private hospital care—largely for elective conditions—is financed through supplementary private voluntary health insurance, which covered 10.9 percent of the U.K. population in 2012. The bulk of this was provided through companies (3.97 million policies) versus individual policies (0.97 million). Whereas the United States it difference, about 64 percent of U.S. residents received health insurance coverage from private voluntary health insurance (VHI): 54 percent received

In 2016 the American population again saw their insurance plans increasing their premiums from 10%-13% across the board. This is much more than expected, and even worse the co-op insurance plans have failed. The government sponsored non-profit plans offering lower rates have not proven sustainability in result of the majority going bankrupt even after receiving 1.2 billion dollars of taxpayer’s money. The Affordable Care Act is already becoming a huge tax expense amongst Americans leading to the U.S. increasing the overall national debt. Starting 2018 all high end health insurance premium plans will come with a 40% excise tax. Also, changes in flexible spending accounts have occurred as over the counter medicines are no longer qualified expenses for flexible spending accounts and health savings accounts. The health care tax deduction threshold account increased to 10% from the previous established 7.5%. All these changes through different avenues account for more reasons we continue to see costs increase through the ObamaCare.

Understandably, physicians and hospitals are concerned about the inability to collect the remaining 40 percent from these patients. Even patients who have insurance are becoming responsible for an enormous portion of their medical fees. Among the Americans who receive health coverage through their employers, more than 40 percent have a deductible of at least $1,000. According to the Kaiser family Foundation, only about 10 percent of Americans had a deductible of this size in 2006.

“The amount people pay for health insurance increased 30 percent from 2001 to 2005, while income for the same period of time only increased 3 percent.” (Source: Robert Wood Johnson Foundation). The rising cost of healthcare is a huge problem in America today. In this paper I will analyze the different issues and causes for the increase in cost.

Under the current healthcare reform bill HR-4872, there are several stipulations that will benefit everyone. The proposed bill eliminates the “Pre-existing Condition” clause that insurance companies have been manipulating around for many years. How many people have been stuck in dead end jobs, unable to further their career for the fear of being denied insurance coverage due to a pre-existing condition. The bill (HR-4872) also makes purchasing health coverage affordable. Under the current American system, the health insurance providers can pass on rate increases to the consumers without regard to the clients ability to pay or their after taxes income. It is estimated that healthcare insurance costs have increased as much as 18 – 25% over just the past three years alone. This dramatic increase in premium expenses has put healthcare insurance out of the reach of millions of Americans.