Moral Hazards And Health Insurance: Article Analysis

In the United States, smoking cigarettes is the number one preventable cause of morbidity and death (Bergen, 1999), and accounts for $300 Billion in health care costs and economic productivity loss (Jamal, 2015). While the national smoking rate is 16.8% (CDC, 2016), specific demographics are more susceptible to developing smoking habits: people who live below the poverty line (10.9% higher), disabled or with a limitation (6.2% higher), and males (4.7% higher) (Agaku, 2014).

Each state has their own policies for Medicaid eligibility, services and payments. Medicaid plans have three eligibility groups such as categorically needy, medically needy and special groups. Children's Health Insurance Program (CHIP) is a program that offers health insurance coverage for uninsured children under Medicaid. If Medicaid does not cover a service, the patient may be billed if the following conditions have been met such as the physician informed the patient before the service was performed that the procedure was not covered by Medicaid and if the patient has signed an Advance beneficiary Notice form. However, there are also conditions where the patient cannot be billed if necessary preauthorization was not obtained or service

The ethical considerations of this issue, is the responsibility of the hospital to provide all the relevant information concerning access to emergency contraceptives, for rape and sexual assault victims. Brownfield’s defense supports the idea that emergency contraceptives, Plan B, and oral synthetic hormones are the most common form of emergency contraceptives, and this information must be given to the victim upon her request. These contraceptives are called the “morning after pill or plan B”.

Tobacco use; despite efforts to curb it, have remained unsatisfactory high. The ACA aims to improve this by making smoking cessation programs affordable or free in health care policies; by funding local communities sponsoring outreach programs aimed at at-risk populations, and media campaigns graphically illustrating the dangers tobacco use [3].

Smoking-related illnesses like emphysema and lung cancer place an enormous drain on the system, and are mostly preventable.” (Livestrong.com Par 1) People do not want to pay taxes for those that will abuse

Children’s Health Insurance Program (CHIP) varies from state to state. [CHIP is a collaboration between federal and state governments. The programs are run by the individual states according to requirements set-up by the federal Centers for Medicare and Medicaid Services. States may organize CHIP programs as an independent program separate from Medicaid, such as separate child health programs, use CHIP funds to expand their Medicaid programs like SCHIP Medicaid expansion programs, or can combine these] put in quotes with the source advancements into a CHIP combination program (NAHSP,2017). States receive federal funds for CHIP programs at a rate above the typical Medicaid match. States with separate child health programs follow the

“To summarize these results, failure to risk-rate health insurance policy results in three types of market failure. First, moral hazard will affect the medical care purchase market. Second, consumers will fail to achieve the optimal allocation of income among states of the world; more specifically,low-risks consumers will systematically subsidize the insurance purchases of high risks. Third, the conditions for optimal spending on health promotion activities will not be met”. (O'Malley, 1989, p. 304).

In the article “Insured, but Not Covered,” Rosenthal points out that, despite being insured through Empire Blue Cross, Karen Pineman had to pay hundreds of dollars out of pocket for a physical therapist when she broke her ankle while playing tennis, simply because her insurer refused to cover it. There are many more cases such as Pineman’s, where patients are forced to pay out of pocket since their insurance policy does not cover their specific treatments. The expenses can amount to thousands and even hundreds of thousands of dollars for treatments of more serious illnesses such as cancer. This is a severe flaw in our current healthcare system, one that could devastate individuals such as Pineman, sinking them deeply in debt and forcing them into

History has proven that government penalties, in the form of taxes, deter smoking. The 2000 U.S. Surgeon General’s Report, Reducing Tobacco Use, found that raising tobacco-product prices decreases the prevalence of tobacco use, and tobacco tax increases produce significant long-term improvements in health. From its review of existing research, the report concluded that raising tobacco taxes is one of the most effective tobacco prevention and control strategies (7). Along with price increases, mass-media campaigns and smoking bans have made cigarette smoking pretty much unacceptable in today’s society. “Today, approximately 22 percent of adults age twenty-two and older are smokers, compared with 33 percent in 1979” (Thorpe 1440). It is clear, from these examples, the use of penalties to deter the unhealthy behavior of smoking is a successful intervention.

Health insurance functions to reduce financial barriers to needed care and to protect against financial hardship from medical bills. Research shows that uninsured individuals are likely to obtain preventive care and management of their chronic conditions, and more likely to suffer negative health consequences. (Remler)

Then John gets desperate. He realizes that he will not raise the money in time before his son’s condition gets to serve to be saved. Unsure what to do, he starts thinking of different ways to come up with the money, but none seem good enough. John receives a phone call from his wife, Denise, who is crazed and grief-stricken. She is at the hospital and reveals to John that the hospital is going to release their son, who is going to die shortly after being released. John, says that he will talk to the hospital again, and he is trying his best. His wife states, “But it’s never good enough, is it? Now, you need to do something! Do you hear me? Do something!” This statement is what pushed John over the edge. It was the final push that made John commit the crime that he did.

Tobacco has been the center of much controversy in America since the late twentieth century. Increasing numbers of studies showing the harmful side effects of tobacco has also caused many insurance companies to increase coverage costs to those who use the product. Insurance rates have a directly proportional relationship with risk factors, so the increase in coverage costs of tobacco users means that they have a higher risk of health complications. The raising of insurance rates is a safety net for the company to protect their stock. On average, individuals who use tobacco products in Florida often pay twenty dollars more per month than individuals who do not

The Affordable Care Act contains various exemptions and drawbacks. One big exception to this rule is for companies that “self-insure,” where they pay for their employees’ medical care (often buying “stop loss” insurance policy plan to secure the business from very high costs) rather than buying health insurance policy plan coverage for their workers. Self-insured plans do not have to offer the “essential health and fitness benefits” that each condition has described, they are exempt from the annually insurance policy plan fee that protected little groups must pay, and they will not enhance (or receive) state-based risk developments for protected little groups and individuals.

Smoking is an expensive habit. People who smoke cigarettes can spend as much as $2,500 a year on them. Smokers’ claim that it helps relax them and it releases stress but the negative aspects of smoking outweigh the positive. Smoking is a health hazard for smokers and non-smokers. Smokers should have the right to choose what to do with their own health but they should respect non-smokers. Many people believe that there are good and bad outcomes from smoking. I believe that smoking is bad and that it should be banned.

The inherently antagonistic relationship between insurance companies and consumers is the “core problem” with insurance, but there is more. Imagine a retail organization that could somehow force every single person within the selling area to buy their product. With insurance, on the other hand, certain kinds of insurance are mandatory. It is against the law to own and operate a car without insurance. If the mortgage is greater than a certain percentage of the value of the house, so is Private Mortgage Insurance. Aside from the fundamental unfairness of mandatory insurance, when purchase becomes mandatory rather than voluntary, costs are likely to become inflated. Furthermore, when something is covered by mandated insurance, the costs of repair and replacement become inflated. People charge more because it is covered by insurance. How many people who have suffered fender bender auto accidents haven’t noticed overpriced estimates from body shops when the work is covered by insurance? In other words, most purchase decisions are based upon perceived value – the trade-off between the quality of the most desirable benefits and the price paid for those