The Health Insurance Industry Of Aetna Inc. And Humana Inc

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.

The concept of providing basic healthcare services to individuals in need has undergone an agonizing transition, from a luxury once only afforded by the affluent to a basic human right granted to citizens of every economic station, and the recently enacted Affordable Care Act (ACA) was designed to finalize this ethical evolution. Reflecting perhaps the bitter political enmity currently consuming the nation's once cherished democratic process, Republican legislatures in states throughout the union have bristled at the ACA's primary provisions, threatening all manner of procedural protestation as they attempt to delay and derail the bill's eventual implementation. One of the most intriguing aspects of the sprawling, thousand page law, however, has been the stipulation that individual states will be given a choice to either accept federal funding to expand their statewide Medicaid roster, or to forfeit all federal funding for that program in perpetuity. The role of government in monitoring and regulating the healthcare industry has been long debated, and the bitterly contested passage of President Obama's ACA, a law aimed at revising the country's health insurance system through the creating of a federal health insurance exchange to facilitate increased competition among insurers, has rekindled the debate over who holds the ultimate responsibility for regulating the care provided by hospitals, community clinics, and private practices.

Health care spending in the United States of America as a percentage of the economy has reached astonishing heights, equating to 17.7 percent. This number is shocking when compared to other counties; in Australia health care is 8.9 percent, in United Kingdom 9.4 percent, in Canada 11.2 percent. If the American health care system were to hypothetically become its own economy, it would be the fifth-largest in the world. While these statistics sound troubling, they lead us to look for answers about the problems surrounding our system. The first health insurance company was created in the 1930s to give all American families an equal opportunity for hospital care and eventually led to a nationwide economic and social controversy that erupted in the 1990s and continued to be shaped by the government, insurance companies, doctors, and American citizens. In this paper, I will go in to detail about the various opinions regarding the controversy, the history behind health insurance companies, and the main dilemmas brought out by the health care crisis. Greedy insurance companies combined with high costs of doctor visits and pharmaceutical drugs or the inefficient hospitals all over America can only describe the beginning to this in depth crisis. Recently, the United States health care industry has become know for the outrageous costs of insurance models, developments of various social and health services programs, and the frequent changes in medicinal technology.

However, when Private insurance companies soon joined the fray thereby creating stiff competition, costs were determined by a number of factors among them was the exclusion of the sick and the selective process of insuring only the healthy which meant more profit for the company because Blue Cross only provided coverage for hospital services. The Blue Shield plans were created in 1939 by employers in lumber and mining. This was done to ease the healthcare burden and bring satisfaction to both the physician and the patient. In 1982, The Blue Shield plan merged with The Blue Cross to form The Blue Cross and Blue Shield Association(4).

Nurse leaders play a vital role in establishing standards and leading organizational change. The effects of the Affordable care Act (ACA) on the healthcare industry is characterized by change (Delmatoff & Lazarus, 2014). Given this ACA paradigm transformation, I believe today’s nursing leaders must adapt quickly and assist new leaders to develop the skills necessary to envision and evaluate new healthcare delivery systems. According to Chism (2009), the roles of the doctor of nursing practice (DNP) prepared nurse graduates may be incorporated to meet the transformation of today’s contemporary healthcare. After reading the assigned material, I gained confidence that the DNP program will prepare me for eligible leadership roles within the healthcare industry.

The depression in the 1930’s brought about the Social Security Act. This, however, omitted health insurance. Blue Cross also started offering people hospital care insurance in several states.

Health insurance began in the 1930’s when the Great Depression hit the United States. After the great depression it became very noticeable that health coverage was needed to protect the people and get them the health care treatment they needed. Too many people were dying of sickness and not able to afford the treatment. It wasn’t until the government tried to create some type of insurance to help with these costs. Medicare was created in 1965 for the elderly citizens. At that time there was also commercial and private insurance for Americans. “For years, clinicians have advocated for health insurance coverage for all Americans. Now, through the Affordable Care Act, the nation is one step closer to this goal. October 1, 2013, marks the

According to the report conducted by Smith and Madelia, ‘the percentage of American with health insurance for all or part of 2013 was 86.6 percent, and the majority of individuals, 64.2 percent, were covered by private health insurance’ (2014). The majority of people who receive health insurance through their

Medicaid and Medicare was created and called the Social Security Act of 1965 to provide coverage for medical treatment for qualified individuals and their families. Medicaid is a program that is jointly funded and managed by the federal and state governments that reimburse hospital and physician for providing care to qualified patients who cannot afford medical expense. To qualify for Medicaid he or she must be a United States or resident citizen which, includes low income adults and their children, people with certain disabilities and senior citizens. “Medicaid and Medicare is overlooked by the Center for Medicare and Medicaid,

The Affordable Care Act was created to assure all Americans have access to affordable insurance, but as stated by Sir Isaac Newton for every action there’s an equal and opposite reaction. As more and more people become insured in this country, the for-profit insurance companies are reaping the benefits from the legislation of the Affordable Care Act.

The first thing to think about is the fact that health care accounts for approximately 8% of the U.S. economy. The Affordable Care Act, better known as Obamacare or other unsavory names is actually in my mind making the medical field and the availability of care for patients more difficult. Regardless of its benefits to some patients, Obamacare is making things much more difficult for doctors, nurses and anyone that is part of the medical profession. It has done nothing but increase paperwork, which is the major priority, and costs have continued to rise. From what I have witnessed has done nothing to increase the quality of care. Government bureaucrats and insurance companies, not doctors, are in charge of our health care. Obamacare is all about saving money, by not spending it on patient care and where the money is spent is being directed by special interest and profit-making organizations. They are dictating the way care is provided. Basically insurance companies are in control of who lives or who dies. The law contains spending cuts to Medicare that amount to $716 billion from 2013 to 2022. The end result of course is that seniors are the group that suffers the most since they are the group that seeks and needs medical care more than any other age group. Money is the priority and not patient care as government and insurance companies have a different agenda than health care providers. Should “for-profit” insurance companies exist, or should there be only “non-profit”

Due to the upcoming presidential election, the two major political parties, and their candidates, have been focusing on the primary problems that the nation will face. Chief among those problems is the future of Medicare, the national health-insurance plan. Medicare was enacted in 1965, under the administration of Lyndon B. Johnson, in order to provide health insurance for retired citizens and the disabled (Ryan). The Medicare program covers most people aged 65 or older, as well as handicapped people who enroll in the program, and consists of two health plans: a hospital insurance plan (part A) and a medical insurance plan (part B) (Marmor 22). Before Medicare, many Americans didn't have health

Humana, Inc. is a health insurance company from Louisville, Kentucky that started in 1961 by Lawyers Wendell Cherry and David A. Jones, Sr. Humana started as a nursing home where it later become the largest nursing home company in the nation. After the nursing homes they soon began to purchase hospitals entirely for expansion. The name of the company changed to Humana, Inc. two years later. Cherry and Jones continued to expand by purchasing other companies. In 1984, the company began focusing on Health Insurance where it remains to focus on even today. Since 2014, Humana has had over 13 million customers and over 52,000, and a revenue of $41.3 billion that was reported in 2013.

Throughout the first part of the 20th century there was little effort to promote health insurance, but in the second half of the 20th century healthcare became a major concern. Once, Medicare and Medicaid were introduced in 1965 the government along with its citizens took a major step in the progression of healthcare. From then, there was a shift in the privatization of healthcare. This forced many of the lower class to be without health insurance. In 1993, President Clinton with the best of in intentions failed at establishing a universal healthcare system in the United States. Finally in 2006, Massachusetts passed a law that would provide healthcare coverage for all of its state residents. In 2010 the

The health sector is among the most important sectors in the United States economy. The government has enacted certain laws that affect the corporation’s activities and the insurance industry in general. The regulation affects competition among the health insurance companies, and the insurance industry in general.