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Wednesday, November 30, 2016

Health Insurance Woes PP

HIST 3478 - Medicine and Health in US History

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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