Kaiser Family Foundation: A Case Study

1. Kaiser Permanente starting in 1945 when Sydney Garfield and Henry Kaiser came together to form the healthcare system still used today. During the Industrial Revolution, many workers were found to have healthcare needs and not all were insured. In collaboration to help these members, Kaiser and Garfield created a system in which employers paid a set monthly premium and physicians joined a prepaid group practice in efforts to ensure care for all employees. This evolved Kaiser Permanente into the healthcare giant it is now.

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 U.S. health care system faces challenges that indicate that the people urgently need to be reform. Attention has rightly focused on the approximately 46 million Americans who are uninsured, and on the many insured Americans who face rapid increases in premiums and out-of-pocket costs. As Congress and the Obama administration consider ways to invest new funds to reduce the number of Americans without insurance coverage, we must simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps even for those with access to insurance coverage.

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

What’s next? Some experts say that if the consumer-directed approach doesn’t succeed, em wash their hands of health care altogether. A recent study by the Employee Benefit Researc showed that the proportion of U.S. residents covered by employment-based health benefits d percent in 2000 to 60 percent in 2004. Decades from now, observers may conclude that a counter- revolution in employer coverage began in these early years of the 21st century. —Terence F. Shea

The cost of health insurance has changed drastically over the years as it has become more expensive. Depending on personal characteristic, the cost of health insurance may vary. For instance, as individuals grow older the more expensive it becomes. In this case, health insurance is more costly because “older individuals require more health care” therefore “the cost of providing health care is rising” (Madura &Atlantic, 2012). Not only does this affect the high cost of health insurance, but the number of individuals uninsured. As stated by Madura and Atlantic (2012), “about one in every five workers is uninsured” and has increased since then because health insurance has become unaffordable. As a result, individuals tend to seek health care elsewhere as they can no longer

Employers are continuing to face rising health benefit costs and are constantly looking for alternatives to control these escalating costs. Health benefit premiums continue to increase at a double digit pace for employers and employees (Poor, Ross & Tollen, 2004). This escalation is putting environmental pressures on all impacted stakeholders. Companies and insurance providers are squeezing this industry to get a handle on cost while still providing an appropriate level of care. This cycle puts the patient front and center as the ultimate stakeholder who incurs changes in health benefits. This mandate of cost control, efficient operations and market share has facilitated a constant analysis of the dynamic health

It has been six years since the Affordable Care Act has been implemented into the United States healthcare system. As the pieces and provisions of this monumental federal statute become understood and executed, it is transforming the demand for care. Prior to the ACA, a significant number of Americans were marginalized and unable to obtain coverage. This system was faced increasing healthcare costs, placing greater financial strain to everyday Americans, businesses, and public health insurance systems. The ACA did not only help ensure health coverage for all (almost

Societal beliefs and values influence the Affordable Care act. The health care budget is under constraint, how to provide the most recent and enhanced health care while saving money has become a major issue. With this new health reform, millions of Americans who could not afford insurance with their employers or are uninsured due to lack of employment have the opportunity to become insured. The major economic change in this society has created enormous challenges for workers, families, as well as employers. The implementation of this act reduced this plague in the health delivery system.

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

The rising healthcare cost is an issue that affects many working class Americans. Experts have tried to come up with different ways to make health care more affordable and easily accessible to all. Despite all the efforts and even after the Affordable Care Act, there are still millions of Americans without health insurance coverage and therefore unable to access the necessary medical care. According to a 2015 report by the U.S Census Bureau, there are over 33 million uninsured Americans. (“Health Insurance Coverage in the United States: 2014 - p60-253.pdf,” n.d.) The Affordable Care Act has unquestionably made healthcare more accessible and reduced the number of uninsured Americans. However, there are still millions of

Health care in the United States is driven by a patchwork of services and financing. Americans access health care services in a variety of ways — from private physicians’ offices, to public hospitals, to safety-net providers. This diverse network of health care providers is supported by an equally diverse set of funding streams. The United States spends almost twice as much on health care as any other country, topping $2 trillion each year. (WHO.INT 2000) However, even with overall spending amounting to more than $7,400 per person, millions of individuals cannot access the health care services they need.(Foundation 2009) So when the Patient Protection and Affordable Care Act (a.k.a the Affordable Care Act or ACA) was passed in the summer

The health insurance market in the United States has been anything but competitive since the dawn of it 's existence. In many states, a single health insurance provider dominates the market, with virtually no competition (Holahan and Blumberg). In the past, before 2010, there has been no “marketplace” to compare prices for health insurance, which has contributed to ignorance in terms of finding competitive, lower prices for health insurance. Essentially, health insurance providers have been “price makers” rather than “price takers” because the demand for health insurance is relatively inelastic (as people will always get sick or get

Health care is a huge benefit beyond the 1900’s. People try and receive healthcare from their job, but for others who may not have a job, or the job does not provide them with sufficient help, they will most likely look into the affordable care act. Which brings up this article named, “With New Health Law, Shopping Around Can Be Crucial” by Amanda Cox. This article encourages the customer to stick

Many employees must designate a health plan through their employer. These days, as HMOs (health maintenance organizations) and managed care plans continue to proliferate, that means a choice between bad and worse. As employees line up in the lunch-room for a process called open enrollment, they may be surprised to learn that managed care rates have gone up — again. The mirage that managed care is cheaper care is finally fading. And, for the first time in years, employees may also have the promise of free choice in medicine in the form of a new method of financing health care. Consumers are already aware of horror stories involving HMOs, but cheap rates persuaded many that managed care is less expensive. Recent