Paying for Health Care-health
The cost of health care in the United States is expensive and is escalating. A majority of Americans cannot afford the cost of medicines, physicians’ fees, or hospitalization without some form of health insurance. Health insurance is a contract between an insurance company and an individual or group for the payment of medical care costs. After the individual or group pays a premium to an insurance company, the insurance company pays for part or all of the medical costs depending on the type of insurance and benefits provided. The type of insurance policy purchased greatly influences where you go for health care, who provides the health care, and what medical procedures can be performed. The three basic health insurance plans include a private, fee-for-service plan; a prepaid group plan; and a government-financed public plan.
Private Fee-For-Service Insurance Plan
Until recently, private, fee-for-service insurance was the principal form of health insurance coverage. In this plan an individual pays a monthly premium, usually through an employer, which ensures health care on a fee-far-service basis. On incurring medical costs, the patient files a claim to have a portion of these costs paid by the insurance company. There is usually a deductible, an amount paid by the patient before being eligible for benefits from the insurance company. For example, if your expenses are $1000, you may have to pay $200 before the insurance company will pay the other $800. Usually the lower the deductible, the higher the premiums will be. After the deductible is met the insurance provider pays a percentage of the remaining balance.
Typically there are fixed indemnity benefits, specified amounts that are paid for particular procedures. If your policy pays $500 for a tonsilectomy and the actual cost was $1000, you owe the health care provider $500. There are often exclusions, certain services that are not covered by the policy. Common examples include elective surgery, dental care, vision care, and coverage for preexisting illnesses and injuries. Some insurance plans provide options for adding dental and vision care. Other common options include life insurance, which pays a death benefit, and disability insurance, which pays for income lost because of the inability to work as a result of an illness or injury. The more options added to the insurance plan, the more expensive the insurance will be.
One strategy insurance companies are using to lower insurance premiums and out-of-pocket costs to the consumer is the formation of preferred providers organization (PPO). A PPO is a group of private practitioners who sell their services at reduced rates to insurance companies. When a patient chooses a provider that is in that company’s PPO, the insurance company pays a higher percentage of the fee. When a non-PPO provider is used, a much lower portion of the fee is paid.
A major advantage of a fee-for-service plan is that the patient has options in selecting health-care providers. Several disadvantages are that patients may not routinely receive comprehensive, preventive health care; health-care costs to the patient may be high if unexpected illnesses or injuries occur; and it may place heavy demands on time in keeping track of medical records, invoices, and insurance reimbursement forms.
Prepaid Group Insurance
In prepaid group insurance, health care is provided by a group of physicians organized into a health maintenance organization (HMO). HMOs are managed health-care plans that provide a full range of medical services for a prepaid amount of money. For a fixed monthly fee, usually paid through pay roll deductions by an employer, and often a small deductible, enrollees receive care from physicians, specialists, allied health professionals, and educators who are hired or contractually retained by the HMO. HMOs provide an advantage in that they provide comprehensive care including preventive care at a lower cost than private insurance over a long period of coverage. One drawback is that patients are limited in their choice of providers to those who belong to an HMO.
Government Insurance
In a government insurance plan the government at the federal, state, or local level pays for the health-care costs of elgible participants. Two prominent examples of this plan are Medicare and Medicaid. Medicare is financed by social security taxes and is designed to provide health care for individuals 65 years of age and older, the blind, the severely disabled, and those requiring certain treatments such as kidney dialysis. Medicaid is subsidized by federal and state taxes. It provides limited health care, generally for individuals who are eligible for benefits and assistance from two programs: Aid to Families with Dependent Children and Supplementary Security Income.
Here this nice Video about health care
Live interview from America’s Future Now in Washington DC. Watch more at www.theyoungturks.com.
Find your answer for your own question related to health care
Tags: 08, candidates, care, companies, face, health, HR676, Insurance, mccain, obama, payer, single, the, youchoose
Dear Democratic Friends! Please write your President Obama and demand that the “public option” plan is the ONLY plan we will accept. Do NOT believe the scare tactics the GOP are spouting! Private insurance companies have had plenty of time to lower costs and all they have done is compete with each other to raise prices while people are DYING! We elected President Obama and we must hold him to the fire on this issue! Our majority depends on it! God Bless & Have A Great Day!
If you saw SICKO, then you realise that government-paid doctors in the U.K. make a good buck for their services. And they don’t have to worry about getting paid by their patients. If you become a doctor in order to make more than 100k a year, then maybe you should do something else.
nothings perfect.
Being from Canada I have to say that this whole “waiting lists” thing is overblown.
Its been a deliberate act of federal govs in the past 2 decades to try to dismantle public healthcare by withholding proper funding levels and propaganda similar to anti soviet crap.
We in canada are cursed with a small segment of rich people who want a private market to exploit and benefit from.
I say ship those traitors to the US! lol!
I didn’t read the title carefully and watched it for about 5 minutes before I realized that it wasn’t”Car insurance companies grant health care for all”, but rather “Can insurance companies…”Anyway the Canadaian health care system is great and anyone who says it is inferior to the American one simply doesn’t know what they’re talking about.
I don’t understand why we need to use the Medicare model as the most efficient method in which we should dole out medical care when it is currently on the verge of bankruptcy. If the French model is currently the best and most cost effective method of giving out health care in the world why don’t we use that model? Perhaps there’s a profit agenda behind this California Nurses Asso. idea? It needs to be further investigated.
You make a good case for government healthcare….except when has the government EVER given us a domestic program that is actually adequate. Just one will do really.
Greed and selfishness is the underlying problem.
Socialism kicks ass. The countries that have universal health care spend far less than we do on health services, and have a higher standard of living than America.
because it has been demonized by Republicans and Big Biz boys club. THEY want ALL our money… They have zero interest about the actual well being of the public. We are just the cash cow for them .
Actually the Taiwan Healthcare system is considered the best. They somehow have managed to take the best of all solutions and made it the best in the world. No waiting and everyone gets care.
From the previous sentence it is clear that you do not understand either what socialism or hypocrisy mean…
HR 676 is pragmatic.
Rep=stupid ppl
absolutely, i absolutely agree everyone needs health no has a choice in that
Care to elaborate past a single sentence?
And their doctors are moving here because they aren’t making money in the communistic health care countries.
In that sort of system, I would encourage my child to study managing a McDonald’s then become a Doctor.
really
I wouldn’t know the “capitalist” around here don’t have any CAPITOL
What a bunch of crap. Burger is a socialist. The last thing I want to see is another failed gov program. This one preys on health. All you have to give up is your health privacy in exchange for a gov subsidy. This is just another lose lose situation. No matter how you slice the pie, the only winner is the gov.
“Socialism” is a dirty word here…unfortunately…In spite of our having a socialized police and fire force…Americans have trouble with this word….
America and most Americans are very stupid when it comes to this topic. I doubt most of them get it. And I speak from being an American.
global public health system should be a must, a right for the human race!
actually we do need to take over the government.
If you are a conservative, then providing for the health of America appeals to your patriotism and morals, if you are a liberal, then restricting influence and waste of the privatized healthcare appeals, if you are socialist you approve because it improves the workforce. Only corporatists could be against it and corporatism=fascism, a black hole where we talk about it and still screw the people.
yay go socialism…
and a business community that spreads propaganda decrying socialism but which in fact socializes risks and privatizes profits. it’s pure hypocrisy.
you got that right brother!