Consumer & Provider Costs Assignment

Discussion in 'ObamaCare' started by MimiMHA, Feb 9, 2018.

  1. MimiMHA
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    MimiMHA Rookie

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    I have to chuckle at the term “consumer based”. Consumer based can also be translated to mean consumer friendly but in fact the high deductible health insurance plans along with high individual and family out of pocket maximums per benefit period (traditional calendar year) is certainly not. According to Naseer (2016), “ Several states, policymakers continue to debate whether to expand Medicaid and are weighing alternative approaches, such as using private insurance, increased cost-sharing, or work requirements for beneficiaries” (para. 1)

    Many patients now have access to health coverage however the financial burden is tremendous for some families. Typically the monthly premium is based on the previous year’s tax return (income sliding scale). Many times the premiums are affordable but the deductibles, coinsurance and out of pocket amounts are high and not affordable.

    Yes, speaking positively, these kinds of health care policies benefit consumers who might not have previously had access to “affordable” health care for various reasons such as being unemployed, self-employed and could not afford insurance, made too much for the state Medicaid or pre-existing conditions either prevented you from obtaining a policy or it just was unaffordable. According to Friedman (2017), “The individual mandate endured a challenge at the U.S. Supreme Court, but the ruling gave states the option of refusing to expand Medicaid, mainly with federal dollars, to households with income just above the poverty line - the working poor who earn too much for traditional Medicaid but too little to afford health insurance” (para. 1). Now consumers have insurance coverage for self-care, better health care choices, or pre-existing conditions, since pre-existing conditions no longer apply under the current health care laws associated with Obama Care (ACA Plans).

    Such health care policies benefit patients who are very sick, see physicians often, take multiple medications which cause them to meet their out of pockets requirements however someone who is not really sick and sees the doctors for self-care and annual maintained it is quite expensive.

    Some other impacts are federal and state health care policies are forever being disputed on what is the best and worst and questioning the need for health care reform. According to Friedman (2016), “The law has been the subject of repeal attempts since day one. The individual mandate survived a challenge at the U.S. Supreme Court. But the same ruling gave states the option of expanding the Medicaid program, mainly with federal dollars, to households with income just above the poverty line - the working poor who earn too much for traditional Medicaid but too little to afford health insurance” 9para. 1).

    References:

    Friedman, M. (2017). The trump effect. Arkansas Business, 34(2), 1-1,14. Retrieved from Login

    Friedman, M. (2016). Obama's rx: Is it working in state? Arkansas Business, 33(45), 1-14. Retrieved from Login

    Naseer, R. (2016). Public, private health insurance expansion improves care for low-income adults. Infectious Disease News, 29(9), 61. Retrieved from Login
     

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