...Why do we need the health insurance industry? Need for health insurance The health insurance industry (XLV) mainly provides a risk management tool for an individual. People cannot predict the extent and timing of their future healthcare expenses. By paying regularly for health insurance, people can get protection against financial losses resulting from high health care expenses. It also enables them to better manage their cash flows as most health insurance plans specify the maximum amount an individual will need to pay in excess of the charge paid for buying the insurance, in a calendar year. Risk pooling According to study by the Congressional Research Service, the top 5% of the total population accounted for about 50% of the health expenses in 2011 and 2012. This uneven distribution of spending forms the basis of risk pooling, where people contribute an amount of money, at least equal to the per capita cost of medical services, expected to be used by the group of insured people. Risk pooling in insurance is essentially a cross-subsidy paid by low-risk members to high-risk members of the insurance plan. The above diagram shows that the performance of healthcare system or the efficiency of health insurance and effectiveness of risk pooling increases as the size of the group increases. However, the benefit of reduced risk resulting from the increasing size of the insured population reduces as the size increases a certain optimal size, S*. As size increases, the probability...
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...the uses of Life Insurance and explain how you would determine how much life insurance a family would need. Discuss the use of Disability Income Insurance and explain how you would determine how much disability insurance an individual would need. Name a category of individuals who might benefit from Disability Income Insurance. Explain why this category might need Disability Insurance. Discuss the use of Property and Causality Insurance and how this is used by a family or individual. Property and casualty insurance is insurance that protects against property losses to one’s business, home or car and against legal liability that may result from injury or damage to the property of others. This type of insurance can protect a person or a business with an interest in the insured physical property against losses. Auto Insurance policies typically cover you and your spouse, relatives who live in your home and other licensed drivers to whom you give permission to drive your car. The policy provides coverage for both bodily injury and property damage liability as well as physical damage to your vehicle. Auto insurance typically covers personal injury, medical payments, uninsured motorist, underinsured motorist, auto rental, emergency road assistance and other damages to your car not caused by a collision such as flood, fire and vandalism. The other insurance is homeowners’ insurance which is bought to protect the biggest assets one has. Homeowners insurance typically covers the...
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...Connor Pozzi 11/24/14 ECON1116 Asymmetry in Health Insurance: Adverse Selection, Welfare Loss, and the Key to Vanquishing Market Distortion In today’s society, even more than ever before, information is key. With the introduction of such modern marvels as Twitter, mobile notification alerts, and around the clock news coverage, the next generation can be defined as though who want information accessible at all times. Most believe that this accessibility of information is much more efficient, and leads to better outcomes and greater utility for the individual. On the contrary, in the colonial times, information was scarce and often times inaccurate. This caused more frustration, less utility, and poorer outcomes. The accessibility issue of general information has undergone vast improvement over time, but in health insurance markets, information asymmetry has continued to plague the system. This asymmetry causes what is known as adverse selection, in which the market suffers from the “adverse” outcome of only having high risk, costly individuals in the market, as opposed to the lower-risk individuals who could also benefit from insurance. Adverse selection strongly decreases consumer welfare, and leads to an inefficient outcome in which market failure persists in what is known as the adverse selection death spiral. However, in order to solve adversely selected markets, it is imperative that the system allows for the collection of better information (and revert to market...
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...------------------------------------------------- What Would Health Care Reform Mean for Small Businesses and their Workers? ------------------------------------------------- What Would Health Care Reform Mean for Small Businesses and their Workers? HLTH 5120 Health Policy Issues Valerie G. Austin 16 May 2012 HLTH 5120 Health Policy Issues Valerie G. Austin 16 May 2012 Valerie G. Austin Dr. James M. Brasfield HLTH 5120 Health Policy Issues 16 May 2012 What Would Health Care Reform Mean for Small Businesses and their Workers? The Affordable Care Act Increases Choice and Saving Money for Small Businesses. Small businesses are the backbone of our economy, but high health care costs and declining coverage have hindered small business owners and their employees. (Health Reform for Small Businesses/WhiteHouse.Gov) Part I Introduction The creation of the Affordable Care Act has brought many persons into a disagreement and has been in argument thru many administrations. Therefore we as a people should come together and set forth a plan that will be a benefit to All Americans. If we are to fix the economy of America we must repair the healthcare system. By reforming our healthcare system it will allow for you to maintain the coverage you have or seek another, delivering quality of care at a decreasing cost and waste elimination, allowing small businesses to remain competitive and reforming insurance coverage so there would never be a threat of losing coverage...
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...Structuring Health Care Erroll Reese Instructor: HSA 500 – Health Services Organization January 23, 2010 Table of Contents Introduction ……………………………………………………………………………………. 3 Identify and describe the three main types of health insurance in the U.S ……………..…….... 3 Describe the three methods for categorizing health insurance in the U.S……………………….. 5 Identify the three types of managed care plans and provide the pros and cons of each for the health care provider, insurer, and patient……………………………………...............................5 Describe the impact of managed care on both the Medicare and Medicaid programs.…………. 8 Conclusion ……………………………………………….……………………………………… 8 References …………………………………………….………………………….……………… 9 Introduction Our stable outlook on the U.S. health insurance sector reflects our belief that industry risk is moderating, business conditions--including growth and retention opportunities and access to capital--have improved, and health insurers' financial fundamentals are now relatively strong. Offsetting these favorable factors are concerns about slowing economic growth, growing governmental fiscal pressures (particularly at the state and local levels), and health care reform issues. We believe these factors will affect each business and individuals differently and will likely keep the number of rating actions moderate for 2012. Identify and describe the three main types of health insurance in the U.S Individual health insurance...
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...Introduction: Health care expenses are not evenly allocated across the population. About 20% of the U.S population dealing with serious or chronic diseases spends about 80% of the health care dollar. The low incomes, the elderly and the disabled are the high percentage of people using the most health care resources and cannot afford to pay for their health care services. There are serious public health risks with a large uninsured population and not compensating care leads to higher costs when patients avoid care until they are seriously ill. Though “community rating” has become one controversial feature of the health reform bill winding its way through Congress as well as through the economist it should be maintained. Another controversy...
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...changes the non-group insurance markets in the US and each individual should have health insurance which helps significantly to develop the markets of the public insurance and support the private insurance coverages which leads to rise in the revenue from the new taxes and reorganizes the Medicare health insurance plan. According to Gurbers assumption of funding ACA is mainly based on the “Three legged Stool” approach followed to fix the Non employer insurance in the United states and which helps in the increasing the market of the health insurance in the country. The reforms included based on the three legged stool strategy to the non-group insurance market. First to prohibiting exclusions for the pre-existing conditions and charging different prices based on the health status. The second leg of the stool looks in to the individual authority to take the insurance policy. The third leg of the stool deals with the Subsidiary for the low income families to have the insurance plan. ACA finances through following sources for the above are 1) To improve the government Medicare plans for the seniors by reducing befits of the private Medicare Advantage programs which affects the 14% financing share. 2) Decreasing of the Medicare reimbursement through decrease in adjustments provided to the hospitals every year for the Medicare reimbursement due to this 33% of financing share has the impact. 3) Increase in the Medicare tax payroll by 0.9% and to the individual with more than $200...
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...Health Insurance Guide Health Insurance Guide * What is health insurance? * How does health insurance work? * What are the different kinds of health insurance? * Individual mediclaim policy * Floater Policy * Critical illness policy * Overseas mediclaim policy * Student medical insurance * Tax saver * So, what kind of coverage can I get? * Accidental death benefit * Permanent and total disability cover * E opinion rider * Children's education allowance * How much does health insurance cost? * The no of people to be covered * Amount of coverage needed * Age of the oldest family member who is proposed to be covered * Can I get tax benefits with health insurance? * Are there any alternatives to health insurance? * Critical illness benefit * Hospital cash benefit * Things to watch out for What is Health Insurance ? Health Insurance also known as Mediclaim in India provides you the cover against the medical care costs arising from disease or accidental injuries. Health insurance is a crucial financial product that every individual must have irrespective of their age. It allows you to focus on getting the best treatment without bothering about the financial costs of the same. Depending on the terms of the health insurance policy it covers all or part of the medical costs of treating the disease or injury including doctor's...
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...affordable health care under the updated health insurance reform legislation passed by the House. "The Affordable Health Care for America Act or H.R. 3962, blends and updates the three versions of previous bills passed by the House committees. "(Kruger, M. 2010) This bill is expected to ease the out-of-control costs of health insurance, introduce competition into the health care marketplace that will help maintain coverage affordability, protect people’s choices of doctors and health plans, and guarantee all Americans access to quality, consistent , affordable health care. The Association of American Medical Colleges stated in a Mar. 21, 2010 article; "we have taken the first step towards truly transforming health care in this country. This historic vote by the House of Representatives sets into motion long-overdue efforts to cover 32 million uninsured Americans and to assure their access to high-quality care. The nation's medical schools and teaching hospitals have expressed their full support for this bill to President Obama, and now stand ready to work with the administration and Congress to carry out these significant changes to our health care delivery system." (AAMC, 2010) The health care reform bill creates a shared responsibility for health care among individuals, employers and the government to ensure that all Americans have affordable essential health benefits. Two of the key components, and possibly the most debated or criticized of the Affordable Health Care for America...
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...BEO2401: Risk Management and Insurance Major Assignment A historical analysis of health insurance in Australia Due Date: 22/5/13 Class: Wednesday 11pm tute Jeremy Fung 3897865 Kwin Trieu 3795138 Tamimuddin Saadzadah 3854247 Zaker Hussaini 3887002 Executive Summary The aim of this report is to analysis and review the Australian Health Care System, We have had a look at the history of the healthcare system in Australia and how it started out in 1901 after the formation of the commonwealth government and the Constitution and the power sharing of the responsibilities and control of the health sector between the federal and state government. The report also analyses the dual private and public health care system, which is the Medicare and the Private Health Insurance (PHI) options for Australian Citizen. The other are that we have reviewed is the legislations related to the health Insurance sector and why is the government so keen in keeping the Private Health Insurance capacity high and what are the benefits of the PHI for the government and the health industry finance. Table of Contents Introduction 1 Australian Health Care System 2 1.1Health Insurance (History) AND Recent Changes in Private Health Insurance 2 1.2 Medicare and the Decline of Private Health Insurance (PHI) Challenge for the Government 3 1.3The role of Private Health Insurance in Australian Healthcare...
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...Health Care Utilization Danjerell Burks HCS/235 July 16, 2014 Joseph Chiappetta The Affordable Care Act started changing the country’s health-care system almost from the moment it was signed into law in March 2010. It has already expanded coverage of young adults by allowing them to stay on their parents’ plans until they turn 26, outlawed lifetime limits on what insurance will cover, lowered the cost of drugs for seniors on Medicare, caused 13 million consumers to get premium rebates totaling some $1.1 billion, and expanded access to free preventive care for patients of all ages. Last summer it survived a challenge in the U.S. Supreme Court. But all that is prelude to the transformation coming in 2014, when almost all Americans will have access to affordable health insurance that covers essential care. By Oct. 1, 2013, every state will have an insurance exchange—an organized marketplace where individuals and small-business owners can select from among the entire qualified private health plans available in their area. It’s expected that most consumers will shop on their state’s marketplace online, but they can also shop by phone, through brokers, or with the personal assistance of trained helpers called Navigators. There will also be help available for consumers who don't speak English. The health care law was intended to expand the government-run health program for low-income Americans to cover up to 16 million more people with household incomes up to 133 percent...
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...affordable health care under the updated health insurance reform legislation passed by the House. "The Affordable Health Care for America Act or H.R. 3962, blends and updates the three versions of previous bills passed by the House committees. "(Kruger, M. 2010) This bill is expected to ease the out-of-control costs of health insurance, introduce competition into the health care marketplace that will help maintain coverage affordability, protect people’s choices of doctors and health plans, and guarantee all Americans access to quality, consistent , affordable health care. The Association of American Medical Colleges stated in a Mar. 21, 2010 article; "we have taken the first step towards truly transforming health care in this country. This historic vote by the House of Representatives sets into motion long-overdue efforts to cover 32 million uninsured Americans and to assure their access to high-quality care. The nation's medical schools and teaching hospitals have expressed their full support for this bill to President Obama, and now stand ready to work with the administration and Congress to carry out these significant changes to our health care delivery system." (AAMC, 2010) The health care reform bill creates a shared responsibility for health care among individuals, employers and the government to ensure that all Americans have affordable essential health benefits. Two of the key components, and possibly the most debated or criticized of the Affordable Health Care for America...
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...rights, and protections while maintaining a high quality of standard. Examples of such are: preventing discrimination based on gender or pre-existing health conditions, free birth control, and the percentage of cost depends on the income. Despite a greater freedom in choosing the...
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...Introduction A. History/Background II. Quality, Affordable Health Care For All Americas B. Immediate Improvements in Health Care Coverage for All Americans a. Amendments to the Public Health Service b. improving coverage i. Prohibition on rescissions ii. Extension of dependent coverage III. Immediate Actions to Preserve and Expand Coverage a. Immediate access to insurance for uninsured individuals with a preexisting condition. b. Reinsurance for early retirees IV. general reform c. Fair health insurance premiums d. Guaranteed availability of coverage V. Consumer Choices and Insurance Competition Through Health Benefit Exchanges e. Affordable choices of health benefit plans f. Consumer choice VI. The Legislation The Patient Protection and Affordable Care Act Analysis Paper Back on March 30, 2010 president Barrack Obama signed The Patient Protection and Affordable Care Act (PPACA) since it had been approved by the house on March 21, 2010. It was a great step in the direction of safeguarding healthcare for all the individuals and family of the USA regardless of whether they are insured or not. There are several types of classes of people that live in the USA, who doesn’t have access to healthcare insurance. These people range from citizen of the United States to legal immigrants to others who are illegible but see insurance as very expensive and thus opt to stay away. There are many...
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...Congressional Budget Office (CBO) released an updated federal budget outlook for the next 10 year “budget window”, during the week of February 3rd, 2015. Detailed in this report were some revisions to the previous baseline projection for the effects of the Affordable Care Act (ACA). A more defined explanation and history of ACA: Federal health reform uses an approach that starts with the health insurance system we currently have in place in the United States. Health reform builds upon our current health insurance system to provide more people with access to health insurance coverage, establish legal protections for consumers, and set up mechanisms for consumers to shop knowledgeably for insurance. On July 14, 2009, House Democratic leaders introduced a 1,000-page plan for overhauling the US health care system, which Obama wanted Congress to approve by the end of the year. After much public debate during the Congressional summer recess of 2009, Obama delivered a speech to a joint session of Congress where he addressed concerns over his administration's proposals. In March 2010, Obama gave several speeches across the country to argue for the passage of health care reform. After Obama announced an executive order reinforcing the current law against spending federal funds for elective abortion services, the House passed the version of the bill previously passed on December 24, 2009, by a 60-vote supermajority in the Senate. The bill, which includes over 200 Republican amendments, was...
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