Health Care

1945 Words Jun 3rd, 2013 8 Pages
HSA 500 Paper #2

Jennifer M. Smith

Dr. Robert Lindsey

Health Service Organization

February 17, 2013

1. Compare the three (3) main types of health insurance in the U.S. and assess the solvency of each. Make a prediction regarding the longevity of each type over the next 30 years. Indemnity or fee-for-service plans, Health maintenance organizations (HMOhmo), and Preferred provider organizations (ppoPPO) are three types of health insurance in the U.S. According to (Williams and Torrens, 2010), The indemnity plan, reimbursed by fee for service, is the oldest form of health insurance design. Under indemnity insurance, the insurers guarantee payment to any licensed health care provider for all covered
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Don’t start at bottom of page. Start at top of next page PHI began with coverage principally for hospital and physicians’ services. As political debates in the United States continue regarding health insurance, there has been considerable argument and criticism about the overhead generated by the PHI mechanism (Woolhandler & Himmelstein, 1991). From1960 to 2000, the total overhead costs of PHI averaged about 12 percent of premiums, ranging from about 9 to 16 percent. This total includes administrative costs, taxes, profits and other nonbenefit expenses (Lemieux, 2005). The full cost of PHI administration to Americans including insurer’s administrative cost, net additions to reserves, rate credits and policyholder dividends, premium taxes, and carrier’s profits or losses is estimated to be about 15 percent of total national health expenditures. None of this including the formidable “hidden” costs to providers for filing claims, collecting data on quality of care, and submitting various financial reports to insurers. Private health insurance is made up of the three principal entities, which is commercial carriers, the Blues, and HMOs plus self- funded plans. The important of PHI as a source of financing for personal health care expenditures has increased slowly, but steadily (Williams & Torrens, 2010). Although there is no denying that some government health insurance programs such as Medicare deliver benefits at far less administrative cost per dollar of

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