Pocket Issue Of Pocket Medical Costs

Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.

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

After the Affordable Care Act (ACA) was enacted in 2010, much of the uninsured population in the United States were finally given the access to health insurance (Shi & Singh, 2015). Prior to the passing of the Act, those who did not have insurance still managed to seek medical attention, whether paying for medical care out of their own pockets or seeking the assistance of government programs. As reported by the U.S. Census Bureau, in 2013, 13.4% of the population in the U.S. were uninsured during the entire year (Smith & Medalia, 2014). Still, a great number of uninsured who sought medical care were unable to pay for those services, this is referred as uncompensated care. In 2013 the cost incurred from

25% or more of one’s income going toward health care is too much for today’s economy this

The single most important impetus for healthcare reform throughout recent history has been rising costs (Sultz, 2006). In the book called The healing of America: a global quest for better, cheaper, and fairer health care, Reid wrote that the nation’s health care system has become excessively expensive, ineffective, and unjust. Among the world’s developed nations, the US ranks near the bottom for healthcare access and quality. However, the US ranks at the top for health expenditure as a percentage of the Gross Domestic Product (GDP) and average of $7,400 per person (Reid, 2010). Therefore, Americans are spending

For those Americans not covered or find their work coverage too expensive, there is a new way for them to buy insurance on their own called Health Insurance Marketplaces. Some states have named these marketplaces something else. The Health Insurance Marketplace is like a virtual insurance megamall where private insurers compete for American’s business. Americans can pick out how much coverage they want, how much they want to pay for it, from cheaper high deductible plans to more expensive plans. Regardless what plan is chosen, all plans will cover a complete set of services like hospital visits, doctor visits,

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

With 50 million uninsured Americans in 2010, the Affordable Care Act (ACA) aimed to insure nearly everyone with “minimum essential” health insurance coverage. The ACA provides that all Americans and individuals lawfully present in the United States be provided health insurance regardless of their health or financial situation. It strengthens existing forms of health insurance coverage, while building a new health insurance market for individuals and families who do not have employer coverage or another form of “minimum essential coverage” such as Medicare or Medicaid. In addition, the ACA imposes fees or assessments on health insurance providers. The fees meant to be absorbed by insurance providers will impact premiums for all individuals covered under fully insured or self-funded plans and policies.

Most working class Americans get healthcare insurance through their employer and or purchase their coverage through a private insurance. What most of us don’t know is how the premiums we pay for our coverage are calculated. Cost of premiums area a direct reflection of the costs associated with our consumption of medical services. Cost of medical services includes doctor visits, hospital stays, and medical devices as our consumption of these services increase premiums also increase. (“America’s Health Insurance Plans - Premiums 101 – How Are Health Insurance Premiums Determined?,” n.d.)

The ever rising cost of healthcare has made access to healthcare almost impossible to many households in the United States. That these households have stagnant incomes has further complicated issues (Collins, 2008). Many working families without insurance cover have been forced to pay for their own medical expenses that consume lion share of their incomes. Individuals have been forced to forfeit healthcare because of its inherent costs. The lower-income and middle-income families are a very vulnerable lot because they are either uninsured or underinsured (Collins, 2008).

“But insurers in many counties are offering such a dizzying array of health insurance plans with so many subtle differences that consumers have struggled to determine which plan is best for them” (Pear, 2015). One of the attractive features of affordable coverage is the low monthly premium. With these attractive numbers, some people might even choose to give up their employer coverage to save the extra money. Naturally, consumers would most likely be fond with the low premiums rather than the quality of the plan. However, low premium is only worth the price that is paid for. The high deductibles lie within these low cost plans could cost the patients a fortune when they receiving the care. As this happen, the Affordable Care Act is no longer serve its purpose in helping to increase the quality and affordability of health insurance as well as reducing the cost of healthcare. Instead, the Obama Care only succeeds in reducing uninsured rate of the population. The lack of understanding about the healthcare coverage could become financially burden to the consumers’ family if they choose to use the plan.

Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster

Problem: The Patient Protection and Affordable Care Act (ACA) leaves coverage gaps for millions of Americans. The ACA focuses on individuals without insurance, but in the meantime, increases the spread in those underinsured. Before the ACA the number of adults underinsured age 19-64 in 2010 was, 16 percent, or 29 million (The New Health Care). New estimates in 2014 indicate that 23 percent of adults 19-64 who were insured, or 31 million, had such high out-of-pocket costs or deductibles relative to their incomes that they were underinsured (The Problem of Underinsurance). “The share of continuously insured adults with high deductibles has tripled, rising from 3 percent in 2003 to 11 percent in 2014. Half (51%) of underinsured adults reported problems with medical bills or debt and more than two of five (44%) reported not getting needed care because of cost” (The Problem of Underinsurance). The goals of the ACA are accessibility and affordability to healthcare coverage and treatment, so why has the number of underinsured increased?

All health plans now must offer a wide variety of in network preventive services and treatments for adults and children, with no out of pocket costs, for example; copays, co-insurance or need to meet a deductible.” Americans used to spend more than $8,200 per person on health care annually, more than twice as much as other developed nations and amount approaching 18 percent of gross domestic product” (Welcome to Bankrate) But now with the ACA, they fight administrative profit-taking by making sure insurers submit any proposed rate increases, and when insurers spend less than 80% of individual plan premiums, the law now requires them to refund the difference to policy

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