WHAT IF: Social insurance could pay for prescription drugs?
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A social insurance model could achieve universal coverage of prescription drugs in Canada by raising revenues. Social insurance involves mandatory contributions from employers and employees that are collected by an arms-length agency and used to fund health care. This could address equity issues in Canada's current fragmented system and increase political acceptance for funding rising drug costs. Challenges include financial sustainability if only employment income is used and regulating private insurers to ensure universal coverage and benefits.
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What Are the Governmental Alternatives?
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Table 5-1 Illustrative Federal Government Health Policy Options
Access to Care
• Administered systems
• Universal coverage
• Expand or reduce eligibility or benefits
• Mandate coverage and services
• Captive providers
• Control insurance industry practices
• Mandate employer-based insurance coverage
• Consumer-driven competition
• Implement insurance exchanges
• Encourage basic plans with very low premiums for low-income workers and “young invincibles”
• Mandate individual coverage
• Allow states flexibility to reallocate federal funds for vouchers
• Oligopolistic competition
• Expand or contract coverages in entitlement and categorical programs
• Allow states to reallocate federal uncompensated care funds
• Eliminate ERISA constraints on the states
• Expand the capacity of the system
Quality of Care
• Administered system
• Mandate participation in quality improvement efforts in federal plans and programs
• Add more pay-for-performance incentives
• Select providers and programs on the basis of quality excellence
• Consumer-driven competition
• Encourage or mandate transparency of quality reporting in federal plans and programs
• Oversee licensure and credentialing of foreign-trained providers
• Oligopolistic competition
• Work reporting of quality care and adverse events into purchasing specifications for federal programs and disseminate to the public
• Encourage wider use of health information technology
Cost of Care
• Administered system
• Use full bargaining power in negotiation of ...
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Ch. 5 Paying for Health Care
Learning Objectives
After reading this chapter, you should be able to:
Distinguish the benefits and shortcomings of private sources of payment for the care of vulnerable persons.
Identify the benefits and shortcomings of public sources of payment for the care of vulnerable persons.
Recognize the most common public payer options, and understand their eligibility requirements.
Understand how health care is financed for people with no health insurance coverage.
Introduction
Photo of a large group of people protesting in front of a white government building. A woman at the front left of the photo carries a sign that says, "Responsible capitalism, healthcare for all." A man at the front right of the photo holds a sign that says, "Medical bankruptcy has a face."
Courtesy of Jodi Jacobson/iStockphoto
Costly new technologies and the free-market nature of the health care industry have raised the cost of health care.
The cost of health care is rising, in part because of expensive new technologies and procedures, and in part because of the market failure of the health care industry. It has been argued that deregulation of health insurers, combined with a free market health care industry, has changed health care from a service-based structure to a commodity, or a product available for purchase. America's health care delivery system is geared toward the multibillion dollar health insurance industry rather than individual payers, many of whom lack the financial ability to cover health care expenses out of pocket, from general emergency room care to a life-threatening illness. After all, few people have $10,000 in their budgets to cover the cost of an emergency room visit for a broken arm.
Americans purchase health insurance to cover medical bills, but health insurance is too expensive for many families to afford. In 2010, 64% of the American population had private health insurance for all or part of the year. That isn't a very large majority, considering that everybody needs medical attention at some point. In that same year, 31% of the population had government-run public health insurance, and 16.3% had no health insurance at all for all or part of the year (DeNavas-Walt, Proctor, & Smith, 2011). The question across America, from Congress to kitchen tables, is how to insure all, how to tackle rising health care costs, and how to decipher a fair and equitable payee process.
Critical Thinking
What do you think will be the impact if health care costs are not addressed? What future problems do you predict?
5.1 Private Payers
The private payer sector comprises programs that provide financial access to health care, which includes insurance companies, employer-run health coverage programs, and individuals who pay for health care out of pocket. Individuals who pay for all of their health care out of pocket are rare, as the cost of health care is prohibitive. Employer-run health coverage programs are types of i ...
Riportella priester 2013 the affordable care act
This document provides an overview of the Affordable Care Act (ACA). It discusses key provisions of the law including expanding Medicaid eligibility, establishing health insurance marketplaces, mandating individuals have health insurance, and enforcing employer responsibilities. The document outlines how the ACA aims to increase access to health insurance through a combination of public programs, employer coverage, and online marketplace coverage. It also addresses ongoing implementation challenges and debates around the law.
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This document summarizes a presentation on lessons from other countries' single-payer healthcare systems and their relevance for US healthcare reform. It finds that while no system is superior in all aspects, universal healthcare coverage is needed in the US. A hybrid social insurance model with private insurance options maintained through employers and government support for low-income individuals may be a more appropriate model for the US that could achieve universal coverage while balancing political and economic concerns.
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Healthcare
While the health care reform bill is a step in the right direction, medicare for all or single payer is what is really needed to control costs and insure all.
Answer the following questions on Health Care WorkforcePersonnel.docx
Answer the following questions on Health Care Workforce/Personnel:
The majority of schools of medicine, dentistry, nursing, and other professions and their teaching hospitals are heavily subsidized by federal and state funds. Many of those graduates, when they become health practitioners, feel no obligation to society for their publicly supported education. Do health care providers who reap the benefits of high compensation and social position have an ethical responsibility to repay taxpayers by meeting the needs of the medically underserved?
Technical advances in health care have spawned an ever-increasing number of specialty- trained personnel. More recently, however, hospitals and other institutions are promoting the cross-training of personnel so that they can perform multiple tasks and work more flexibly, based on institution needs. What are the implications of cross training, in terms of quality of care, costs, and efficiency?
Men comprise a small segment of the nurse population, although their numbers are increasing. Given the good income potential of the nursing profession and continuing demand, what is your opinion about why nursing does not attract more males?
Answer the following questions on Health Care Financing:
Name one (1) way each of the following has affected the costs of health care in the US?
§
The health insurance industry
§
Advances in medical care technology
§
Changes in U.S. demographics
§
Government support for health care
§
Consumer expectations
If we accept the premises that resources available to meet the costs of health care are finite, and that continuing to increase dollars allocated for health care expenses carries “opportunity costs“ for the nation and society, discuss your position on the following: As a national policy should we allocate a set level of resources and apply them to achieving “the greatest good for the greatest number” (necessarily leaving some out) OR should we adopt the individualist approach of “those who can pay get, those who can’t pay, don’t?”
From the patient perspective, what might be some of the positive and negative aspects of “disease management programs?”
.
Tackling the Tough Topics: The public plan option, employer pay or play, and ...
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Presentation1
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Due Tomorrow At 100 PMDiscussion Board #6HCA 340Discu.docx
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Chapter 7--The Health Care Workforce and Chapter 8—Financing Health
Answer the following questions on Health Care Workforce/Personnel:
The majority of schools of medicine, dentistry, nursing, and other professions and their teaching hospitals are heavily subsidized by federal and state funds. Many of those graduates, when they become health practitioners, feel no obligation to society for their publicly supported education. Do health care providers who reap the benefits of high compensation and social position have an ethical responsibility to repay taxpayers by meeting the needs of the medically underserved?
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Men comprise a small segment of the nurse population, although their numbers are increasing. Given the good income potential of the nursing profession and continuing demand, what is your opinion about why nursing does not attract more males?
Answer the following questions on Health Care Financing:
Name one (1) way each of the following has affected the costs of health care in the US?
The health insurance industry
Advances in medical care technology
Changes in U.S. demographics
Government support for health care
Consumer expectations
If we accept the premises that resources available to meet the costs of health care are finite, and that continuing to increase dollars allocated for health care expenses carries “opportunity costs“ for the nation and society, discuss your position on the following: As a national policy should we allocate a set level of resources and apply them to achieving “the greatest good for the greatest number” (necessarily leaving some out) OR should we adopt the individualist approach of “those who can pay get, those who can’t pay, don’t?”
From the patient perspective, what might be some of the positive and negative aspects of “disease management programs?”
.
Community Health Financing as a Pathway to Universal Health Coverage: Synthes...
Community-based health insurance (CBHI) emerged in West Africa the 1990s as a grassroots response among rural and poor communities to fees charged by private and public clinics and hospitals. Three countries – Ghana, Senegal, and Ethiopia – have leveraged CBHI in different ways to expand publicly funded coverage to the informal sector in rural and urban settings. This paper synthesizes the experiences from these three countries to illustrate the role that CBHI can play in UHC.
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WHAT IF: Social insurance could pay for prescription drugs?
- 1. What if social insurance could pay for prescription drugs? Sara Allin Report co-authors: Mark Stabile andCarolyn Tuohy
- 2. What is the problem? Unlike most high-income countries, prescription drugs are not universally covered under the health care system in Canada Why is a medically necessary form of healthcare publicly insured in hospitals, but not otherwise?
- 3. Possible policy option? Raising revenues through a social insurance model could be a possible way to achieve universal coverage of prescription drugs
- 4. What is social insurance? A method of raising revenue Contributions are usually related to salaried wages (and are always independent of risk) Contributions may be shared between employers and employees Revenue is earmarked for health care Collection agent is usually arms length from government Participation is mandatory (for the population or specified groups)
- 5. What are the potential benefits? A universal system addresses equity concerns arising from the current fragmented financing model Increased transparency with links between revenues and benefits could be more politically acceptable than general tax increases A diversification of the public system’s funding stream may increase public willingness to pay for rising health care costs
- 6. What are the challenges? Concerns with financial sustainability among SI programs that draw only on employment income Unless there is a single collection agent/risk pool, sophisticated risk adjustment mechanisms are needed to reduce incentives to select risks Regulation is vital to ensure universal coverage and standard benefits, and to integrate private (commercial) and not-for-profit insurers