Title PP - Health Insurance Woes
Slide 1 - Paying for health
- Rise of medical establishment via hospitals
- More people getting access to treatments especially via outpatient department
- Problem of getting $$$ payment for services
Slide 2 - Solution: Hospital Prepayment Plans
- Monthly charge for hospital services
- 1929 A "principal of insurance against the costs of health care." - AHA
- Blue Cross - Covers hospitals charges
- Blue Shield - Covers doctors' charges
Slide 3 - Blue Cross Blue Shield Association image
- BlueCross BlueShield Logo. Digital image. BlueCross BlueShield Association. Accessed 11/23/2016. https://www.bcbs.com.
- 1st Healthcare insurance developed, nonprofit turned private
- Blue Cross and Blue Shield combine in 1982
Slide 4 - Cost Sharing & Cutting Cost
- Deductibles - A specific amount of money the insured must pay out of pocket before coverage kicks in.
- Copayment - A fixed fee that patients covered by health insurance must pay themselves for a given medical service, usually at the time the service is given.
- Experience rating - Statistical factors used to adjust health insurance according to sex, age, race, or other factors.
- Rescission - Canceling insurance coverage, often done in the past to those who hid preexisting health conditions or once an individual hit 65 years old.
- Prior condition exclusion - Insurance coverage is not given to those with already existing health problems.
Slide 5 - Cartoon image about Major medical
- Hoffman, Beatrix. Health Care for Some: Rights and Rationing in the United States since 1930. Chicago: University of Chicago Press, 2012. p. 110.
- Cartoon shows that because of cost sharing, major insurance coverage often feels like minor/no insurance coverage.
Slide 6 - Patient Protection Affordable Care Act (PPACA)
- Previous prior condition exclusion removed
- Coverage expanded to a larger group of people, more $$$ needed
- Cost sharing galore to balance out new costs - deductibles and copay
- ONLY solution is compulsory, everyone must chip in
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