High Risk Pools At One Time A Patients ' Last Hope

Pear, R. (2015, November 14). Many say deductibles make their health law insurance all but useless. The New York Times, p.

Imagine paying $500, $600, $700, or $1,000 monthly for health care insurance only to realize these payments were for naught. The health care insurance provider that received these monthly installments has decided whatever is ailing you will not be covered due to a pre-existing medical condition. What if you couldn’t have the luxury of health care insurance at all due to the basis the health care insurance provider has concluded you have a pre-existing medical condition? These are the dilemmas facing millions of Americans

Health insurance comes as second nature to many of us. We grab that blue and white card and put it in our wallet and forget about it until we are sick or injured. When this happens, there it is, cushioning our fall like the extra padding it provided to cushion our wallets. This is not the case with everyone, however. Many Americans have no cushion to fall back on, no blue and white card to show the emergency room when they have an unexpected health concern. No HMO with a convenient co-pay amount when their son or daughter develops an ear infection.

More and more people with medical insurance are relying on the health care system as new technologies and treatments become available. This leads to a grater number of claims for payment by insurance companies, the costs of which are passed back to health care consumers. The baby-boom generation is entering its peak health-care using period. Over eighty million Americans will turn 50 in the next 10 years. The cost of providing heath care for these individuals will be staggering

The lack of health insurance reached began to become a serious issue in the mid-1990’s reaching a crisis level in the 2000’s. Individuals without insurance turned to emergency rooms across the country to obtain care routine care, turning emergency departments into primary care facilities. In many instances, people who presented at emergency rooms for treatment could not be turned away due to various health and safety regulations; therefore, patients were seen without the ability to pay often leaving the hospitals with millions of dollars in uncollectable debt, subsequently leading to the insolvency of hundreds of hospitals across the United States.

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 Affordable Care Act has made many positive changes for uninsured and underinsured citizens. With the addition of a program called Health Insurance Marketplace, it is now possible for uninsured people in every state to purchase private insurance plans, those making under 400% or less of the Federal Poverty Level will be able to have tax credits making insurance more affordable (Lathrop & Hodnicki, 2014). Insurance companies are no longer allowed to cancel a policy or raise rates when a client gets sick. Insurance companies cannot refuse coverage to individuals with preexisting conditions such as cancer (“Quality Improvement,” 2015). Insurance companies now must cover preventive care and screenings allowing diseases like cancer to be caught early (“Quality Improvement,” 2015). Research has shown that through health screenings

Another reason for the rising cost of healthcare is the cost of physician care, according to the American Hospital Association “the cost of physician care, both to insurance and patients, has risen 1.3% during the past year.” Because of this increase doctors are put in a corner, they are already locked into an agreement with the insurance companies and do not have much ‘wiggle’ room to negotiate fees and rates. So because of this the patients and consumers are forced to pay a much larger sum. Since there are higher costs and the insurers will not cover them, they are distributes to the customers through higher deductibles, co-insurance, and

Half of the uninsured are in families where the head of household has a full-time job. Not only is the number of uninsured growing, so too are the ranks of the underinsured. About 29 million people in this country with private insurance are at risk of financial disaster in the case of serious illness or injury. This number increased by nearly 50% in the last decade. Denial of coverage for pre-existing conditions is a common practice by insurance companies whereby the insurer refuses to provide coverage for already-existing conditions such as asthma, diabetes, heart disease or cancer (if they have been treated and are not currently active). The Affordable Health Care Act has helped prevent this from happening

The rising cost of health care has led companies to stop offering health insurance for employees, and private insurance is often too expensive for people to afford. Many families make too much money to qualify for Medicaid, but are unable to pay for private health insurance. Health care costs in the United States have more than doubled in the last twenty years. Insurance premiums are rising five times faster than wages, and Americans are spending more money on health care than people in any other country. The average amount one person pays per year for health care in the United States is 134 times higher than the average of other industrialized countries (“Health Care Issues”). Even people who have insurance aren’t guaranteed coverage. Many insurance companies find loopholes to avoid paying for expensive medical treatment, leaving people with massive debt from medical bills. Medical bills and illness cause over half of all personal bankruptcies in the United

Our visits to the emergency room, annual physicals, and checkups were often put on hold because of insurance issues, which lead to my family having negative health outcomes in the long run.

For the first time in history, insurance companies will no longer be allowed to simply tell a person “no”. They will be required to offer coverage and accommodate regardless of a person’s health status, and they will not be able to jack up rates or drop any one from coverage when the main person in the insurance packet gets sick.

Healthcare spending growth rate trends show astounding estimates. Since 1960, spending has risen from $27 billion ($143 per capita, 5.1% pf GDP) to amazing $1,678.9 billion ($5,670 per capita, 15.3% of GDP, 2003 data) (HHS, 2005). Recent research estimated that by 2013, healthcare spending will be as high as 18.4% of the Growth Domestic Product. It is important to note that the gradual move from hospital to ambulatory setting has resulted in much higher spending on outpatient hospital services and prescription drugs. The spending growth for these two trends is much higher than the overall healthcare cost growth, which, in fact, increases faster than such important economic indicators as GDP growth, inflation growth, and population growth rates.

One of the greatest changes in healthcare in the past ten years has been the rise of managed care, much to the displeasure of many patients and physicians alike. Managed care arose out of concern about spiraling healthcare costs and was designed to encourage physicians to give patients treatments that were cost-effective out of their own financial interests. "The consumer strategy was directed at imposing some barriers to use by levying various forms of co-insurance. The most common approaches used either deductibles (where the consumer paid the first portion of the bill a technique familiar in other types of insurance) or co-payments (where the consumer paid a portion of the bill and the insurance company the rest) or a combination of both' (Kane et al 1994). Managed care has given health insurance companies an increasingly significant voice in how treatment is administered and allocated. Managed care has proliferated in the past decade despite considerable criticism of the practice of 'nickel and diming' patients as well as the considerable bureaucratic red tape it is has generated. Also, research indicates that healthy, well-insured patients tend to over-consume care without meaningful co-pays but poorer, sicker patients can be deterred even by moderate co-payments and suffer negative health consequences (Kane et al 1994). However, managed care has not gone away and is a reality that all healthcare

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.