Ethical Issues Faced By Insurance Companies

"In the past two decades or so, health care has been commercialized as never before, and professionalism in medicine seems to be giving way to entrepreneurialism," commented Arnold S. Relman, professor of medicine and social medicine at Harvard Medical School (Wekesser 66). This statement may have a great deal of bearing on reality. The tangled knot of insurers, physicians, drug companies, and hospitals that we call our health system are not as unselfish and focused on the patients' needs as people would like to think. Pharmaceutical companies are particularly ruthless, many of them spending millions of dollars per year to convince doctors to prescribe their drugs and to convince consumers that their specific brand of drug is needed in

The Affordable Care Act, or, “Obamacare” as it has been dubbed by the media and general public was approved on June 8, 2012 when the “The Supreme Court of the United States upheld most provisions of the Affordable Care Act (ACA) by a 5-4 vote” (James, "Affordable Care Act and Pharmacy: Big Changes Ahead?"). This vote and approval has completely reshaped the landscape of the healthcare field, not only from a provider’s aspect, but from a consumer’s aspect as well. The need for healthcare reform was made apparent due to the growing

Melnick, G., & Fonkycj, K. (2013). Fair pricing law prompts most California hospitals to adopt policies to protect uninsured patients from high charges. Health Affairs, 32(6), 1101-1108. Retrieved from http://ezproxy.nu.edu/login?url=http://search.proquest.com/docview/1372932073?accountid=2532

The Patient Protection and Affordable Care Act (ACA) is the 2010 health reform act that could extend insurance coverage to as many as 32 million Americans, which also included policies that affect the quality of coverage insurers must offer (Knickman & Kovner, 2015). In addition to this, the ACA created a range of programs focused on furthering change in how medical care is organized and delivered, with a goal of reducing costs and improving quality and outcomes (Knickman & Kovner, 2015). However, these goals come at a cost. The purpose of this paper is to analyze the impact the ACA had on the population it affected in the United States as a nation, but specifically in the state of North Carolina; describe the impact of economics of providing care to patients from the organization’s point of view; examine how patients were affected by the ACA in terms of the cost, quality, and access to treatment; and explain the ethical implications of the ACA.

The Affordable Care Act expanded compliance risks for health care providers and other sectors of health care. Compliance programs were put in place to ensure that billing and

The Affordable Care Act was signed into law by President Barack Obama on March 23, 2010. The Affordable Care Act also nicknamed as “ObamaCare” faced huge amounts of adversity and challenges on its way to being ratified and upheld by the Supreme Court. Some of these arguments highlight the disadvantages of free social services, the escalating federal deficit, and the altering the healthcare industry’s landscape completely. Healthcare is generally defined as providing for the wellbeing of a personal through medical services. In America, all services come with a price, and healthcare has become an industry that is nearly only about the money and less about the patient. Needless to say, the quality of care that a patient receives is almost

Critics believe that the present functioning of managed-care is degenerative to health care. Managed-care firms control costs by requiring patients to use a “network” of approved doctors and hospitals, and by reviewing the actions of doctors. Patients have to pay more to visit a doctor who does not participate in the “network.” Managed-care firms second-guess doctors, considering only the costs. Patients are often prevented from visiting specialists to reduce costs. A managed-care company might insist that its doctors prescribe inexpensive generic drugs instead of commercial products. Many patients must, also, receive the insurer’s approval before undergoing treatments or operations. HMOs have been criticized for refusing to pay when a patient goes

In the current U.S. system the free market prevails and companies, in this case, major insurance providers “compete” for business. This competitive business approach should in theory drive costs down. For some reason, however, an argument can be made that it has produced the opposite result in profiteering. The nation’s largest insurer, UnitedHealth, boasted over a 10 percent revenue increase in 2013 according to Forbes (2013). Health insurance affordability contributes to the disparity in access to health care, as evidenced by the fact that there are millions that are still uncovered. A greater majority of certain minorities lack both health insurance and the financial resource to seek out either health care or insurance. While insurance companies reap huge profits the percent of private sector companies offering health insurance has dropped to less than 50 percent (Kaiser, 2013). There is decidedly a lack of coordination of care for this at risk population as well, since treatment is rendered sporadically and with continuously changing providers. The last major challenge is that of improving the quality of health care. According to a 2010 report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), an estimated 13.5 percent of Medicare beneficiaries experienced adverse events during their hospital stay and an additional 13.5 percent experienced a temporary

Through the history of health care, the standard of care changed from protecting our patient from injury and illness to a systemic entity to make money for insurance companies. Access to services and clinical outcomes are dependent on what health insurance providers will “pay” for in a clinical or community setting; as a result, patient safety, care and satisfaction has been negatively impacted.

Affordable Care Act (Obama Care) has serious implications in almost all the sectors of the US healthcare system. The health insurance companies are the greatest losers because of Obama Care. What they believed to be a sound policy that would help them and increase their earnings, has turned out to be a bad policy. I feel that Obama Care is battering the health insurance companies. I agree that the concerns raised by the US healthcare system are valid. It is true that the Obama care policy has not been of great benefit to their businesses. Companies have been suffering significant losses because of Obama Care. It is unfortunate that the advocates of Obama care continue to argue that the Obama care is of great benefit to the insurance companies, yet they do not have a better understanding of what the insurance business entails. While they projected that the policy was going to increase the revenue of the insurance companies due to the many subscribers, they do not consider that companies are making losses. It is very true that Obama Care is impacting healthcare providers negatively. The concerns of the US healthcare system are also supported by other insurance companies who are complaining about the same issues. The US healthcare system should take a step and refrain from taking any other policies related to Obama Care. It is not viable to continue making losses since the same will affect businesses growing concern. Obama Care was expected to support the insurance companies,

The financial liability for the patient is daunting and may keep some from coming to the hospital for treatment and others leaving against medical advice (AMA).

While there has been large media coverage about the insurance impacts of the Affordable Care Act (ACA), there has been a smaller amount discussed of the law’s changes to provider reimbursement policy, reforms to the delivery system, and investments in programs to improve the quality of care and constrain long-run growth in health care costs. And yet, the elements included in the ACA directed at cost and quality is possible to affect the practice of care for nearly every provider across the country. Although cost containment policies and initiatives are largely applied through federal health programs which including Medicare and Medicaid; cost containment in these programs has important cost-saving spillover effects to private health care markets through changes in health care practices and pricing across sectors of care.

Health insurance and the affordable care act is a major topic in the United States today. This being said, there are many questions that run through one’s mind when the topic is discussed. Questions such as, what exactly is health insurance? What is the Aetna-Humana merge, and how beneficial is it? Should healthy citizens help pay for citizens with prior known health issues? Should people with preexisting conditions even have the option to purchase insurance to help cover medical cost? Although the Affordable Care Act has been in effect for a few years now, there are still some problems today the health insurers face because of this law.

One of the most tangible benefits of the Affordable Care Act is that costs associated with procuring healthcare should significantly decrease. This projection is largely due to the act's ramifications throughout the health care insurance industry. Currently, insurance companies substantially increase the rates for health insurance for patients who have previously existing medical conditions. Under the auspices of the Affordable Care Act, this practice

The implementation of the Affordable Care Act (ACA), popularly known as “Obamacare”, has drastically altered healthcare in America. The goal of this act was to give Americans access to affordable, high quality insurance while simultaneously decreasing overall healthcare spending. The ACA had intended to maximize health care coverage throughout the United States, but this lofty ambition resulted in staggeringly huge financial and human costs.