Self-Pay Model For Healthcare

In 2010, the United States created The Affordable Care Act (ACA). The objective was to share the responsibility of costs between the government, individuals, and employers to provide affordable access to quality health insurance. “However, health coverage remains fragmented, with numerous private and public sources, as well as wide gaps in insured rates across the U.S. population.” (“United States: International Health Care System Profiles,” n.d.). Each individual state within the US, generally has control over private insurance.

Anderson, Amy. “The Impact of the Affordable Care Act on the Health Care Workforce.” The Heritage Foundation. N.p., n.d. Web. 14 July 2015. This paper is a through report on the impact of the ACA on the workers in healthcare, particularly on the ratio of worker to patients. It shows that the act will increase the physician shortage, particularly in already underserved areas and specialties. It will also greatly increase the stress on workers, due to the increase demand from each physician or nurse and the increased amount of regulatory paperwork required. Many healthcare providers are merging into larger business to cut costs; others are running cash-only or annual-fee models. The act attempts to transition to paying physicians for performance

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 Patient Protection and Affordable Care Act (Obamacare) had mame dramatic changes in the field of the health care system, especially in Medicare, that will seriously take effect in American seniors. Indeed, much of the health law’s new spending is financed by spending reductions in the Medicare program. In addition to the provider payment reductions, Obamacare significantly reduces payments to Medicare Advantage (MA) plans by an estimated $156 billion from 2013 to 2022.( Elmendorf, letter to Speaker Boehner). About 27 percent of all Medicare beneficiaries are enrolled in MA plans, a system of regulated and private plans competing against each other as an alternative to traditional Medicare. MA plans are attractive to beneficiaries because they offer more generous and comprehensive coverage than traditional Medicare by capping out-of-pocket costs and offering drug coverage to a rasonable

The negative impacts of healthcare reform to health systems are significant in that health systems are preparing their resources on developing Accountable Care Organizations (ACO) for bundled payments and population-based reimbursement. In this economy the impact to health systems may require healthcare systems to figure out ways to continue to keep positive financial performance due to the cost-reduction of healthcare reform. For some time now, health systems have subsidized their losses from the Medicare and Medicaid systems by contracting with commercial payers for their premium rates. As a result of the healthcare reform, cost shifting will shrink. Another negative impact over the next few years will be the large shift in health plan enrollment. Less people will be covered by highly

On March 23, 2010, the President Obama signed the Patient Protection and Affordable Care Act (PPACA) which represents the most significant regulatory that impacts the U.S. healthcare systems. With PPACA, 32 millions of Americans are expected the coverage and expanded access to health care and medical care. Due to the baby boomers and the downfall of the economics, there will be millions of people are seeking for low rates medical care which will create great impact on U.S. healthcare. According to Commonwealth Fund analysis, the U.S. healthcare ranks last on every cost-related. Therefore, healthcare becomes the top social and economic problem that American is dealing with. Like all other well-developed countries, there are both private and public insurers in the U.S. health care system. ‘What is unique about the U.S. healthcare system in the world is the dominance of the private element over the public element’ (Chua, 2006). Healthcare system in the Unites States can be divided into three different groups: Medicare, Medicaid, and Managed Care. Each plan provides different coverages for different groups of people.

This article discusses the progress of the ACA as it enters its sixth year. Jost begins the article by first discussing the success of the act, which include a historical drop in the number uninsured, high levels of satisfaction and a slower growth in health care costs compared to previous years. The paper further discusses how the ACA will roll out in the 2016 year. Individuals and large companies will be taxed for failing to gain and provide access to adequate health insurance. One great idea that Jost poses to increase affordability and access of health care was to make the Marketplace more transparent so that individuals can have a better grasp of provider and drug coverage before they apply. Under the ACA there was also a great push to expand Medicare and Medicaid programs through increasing access and coverage. Although this part of the ACA seemed like a great idea as it provided coverage to more individuals, I wonder how this program and the ACA in general will pan out after the election. The ACA will likely see some changes in the near future. Republican proposals to replace the ACA, which I feel are scarce to being with, might remove the community rating, which will reduce the number of people insured, although ultimately leading to a decrease health care expenditure. On the other hand, Democrats will likely expand the ACA and may also offer additional funding for the program with additional

In 2010 during the term of President Barack Obama something needed to be done due to the rise of healthcare costs and the number of people who were uninsured and unable to pay their healthcare bills (ehealthinsurance 2014). United States spent more on healthcare than any other country but yet was only the 34th in life expectancy. These are some of the many reasons why The Affordable Care Act came about and was signed into a health care law. This landmark law impacted and changed many aspects of the healthcare system, as well as influenced everyone’s healthcare options in the United States. The Affordable Care Act has been just about been one of the most

Recently, there have been various issues being debated in the American healthcare system. While many of these issues have been debated amongst for many years, they have recently been debated and focused on more heavily due to the change of Presidents. One of the most leading problems that is being debated right now is the cost of health insurance. Originally, the Affordable Healthcare Act was supposed to make healthcare insurance affordable and more attainable. A few years after the Affordable Healthcare Act was implemented; it became evident that it was a failure for the most part. In a vast majority of cases, it failed many Americans. The Affordable Healthcare Act in many cases has made healthcare insurance less affordable for the American

Throughout the past few years the healthcare industry has taken some precautions due to the recent bill passed that affect it, that being the healthcare reform or the Affordable Care Act (Kavilanz, 2010). In the past years healthcare has not been a concern of the average American, but this is changing rapidly. Though in 2014 healthcare was not among the top three concerns it did fall at number four (Cook, 2015). While at number four on the list last year it’s surely to increase in concern as the healthcare act becomes in full swing in 2015 (Cook, 2015). As Lindsay cook points out in her U.S News article on health care 2015 will be the year doctors see a pay cut and Americans without insurance see a penalty (Cook, 2015). Just like the rule of supply and demand, when the money supply of hardworking Americans decrease, the demand or concern in this case will increase.

One of the main reasons the single payer model has not been adopted by the U.S. is due to the political obstruction that stands in the way of change. For example, Representative John Conyers every year since 2002 has introduced an act for a single-payer system but neither his bill nor any others succeeded in getting more than 20 percent congressional co-sponsorship (http://www.huffingtonpost.com/entry/its-time-for-a-single-payer-healthcare-system_us_58d6470de4b0f633072b37f8). Such a low percentage demonstrates the stationary political climate associated with health care system reform in the U.S. Additionally, implementing a single payer system would monumentally increase government spending. Although, it has been found that, on a per capita basis the U.S. government health programs alone spend more than Canada, Australia, France and Britain each do on their entire health systems

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

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.

With the implementation of the Patient Affordable Care Act, it is estimated that 32-34 million previously uninsured Americans will have access to health insurance by 2015 (Kovner & Knickman, 2011) (Hemphill, 2013). Additionally, those with preexisting conditions (asthma, diabetes, heart disease) will no longer be denied coverage or dropped from policies if they become sick. As a result, insurers will no longer be able to refuse to pay for otherwise-covered medical care and services due to a pre-existing condition or charge more because of a pre-existing condition in the family (The Henry J. Kaiser Family Foundation, 2012). Although, the Patient Affordable Care Act will have considerable positive impacts in regard to access to health insurance and coverage for those with preexisting conditions, the health workforce supply will be unable to meet the oncoming demand for services.

The soaring cost of healthcare coverage is forcing employers to look for alternative solutions. With its many benefits, partially self-funded healthcare plans are growing in popularity among small and medium size companies as they combat the rising costs.