How does ERISA create differences between large and small employer health care coverage? How does it impact regulatory activities by state governments?
The Employee Retirement Income Security Act of 1974 (ERISA) differentiates by setting limits and minimum constraints based on established pension and healthcare plans. This limitation helps in regulating the healthcare coverage depending on the per-individual scenario. This provides an efficient coverage policy.
How does our current system of malpractice litigation contribute to increased healthcare costs? Discuss whether it is an effective means of addressing quality and safety issues in healthcare.
The current system of malpractice litigation is not efficient enough to identify and address the quality and malpractice issues in healthcare facilities. This inefficiency is specifically due to ambiguities that exist within the professional roles and responsibilities of the healthcare system. Therefore, in the case of any malpractice, the burden is automatically laid on the patient, and the cost of health care increases specifically.
What are some of the laws the government can use to challenge financial dealings involving healthcare providers?
Some of the laws that can help in this regard are:
- Affordable Care Act
- HIPAA Privacy Rule
- The Health Information Technology for Economic and Clinical Health (HITECH), etc.
How did the Affordable Care Act promote increased healthcare coverage? What are Essential Health Benefits? What are medical loss ratios?
The affordable Health Care Act in the US was specifically designed for the healthcare coverage of the elderly population of the United States. It was designed to provide financial support regardless of the financial or insurance status of all the elderly citizens of the US.
Identify some of the financial challenges and shortcomings associated with the Medicaid and Medicare programs
ACA has been serving, specifically the poor Older Adults of the US since decades by giving them an easy pathway to the best and the most advanced medical technologies. However, just recently, the high rise ratio of Chronic Diseases in the enhanced older adult population has put the ACA under great stress. The expenditure for treating chronic diseases and their subsets is great along with the exponential growth of the older generation.
It is being argued that the efficiency of the Health Care system in the US is degrading significantly because of mounting insurance claims, budget issues, and financial instability. These arguments are pointing toward the public-finding system of Health Care in the US. US Health Act coined this terminology that also formulated the legislation and regulations for US Healthcare Act. According to US Healthcare Act, legal and permanent residents of US are insured to receive the US Healthcare Act health aid without any co-payment.
The services that will be provided under the insurance will be medically and clinically necessary. According to the surveys and researchers, since it is a public and privately funded program, the pressure and stress on US Healthcare Act are increasing exponentially which can create issues in the sustainability of the Health Care System in the US. As per an estimate, around 70% of the funds are paid by public sources, while 30% is paid by private sources
What are some of the tax and regulatory forces that have shaped resulted in our current employer-based insurance system?
The US Department of Taxation is responsible for shaping up the current insurance system as well.
Identify policy reforms or initiatives at either the state or federal levels that you think might be beneficial in structuring health care coverage, incentivizing or empowering consumers, or in providing data to insurers or the public so as to promote more effective care delivery and financing.
US Healthcare Act has generalized and universal nature to address the needs of virtually all older adults and consider them to be insured, no matter what their real status is.
US Healthcare Act has been serving, specifically the poor Older Adults of US for decades by giving them an easy pathway to the best and the most advanced medical technologies. However, just recently, the high rise ratio of Chronic Diseases in the enhanced older adult population has put the US Healthcare Act under great stress. The expenditure for treating chronic diseases and their subsets is great along with the exponential growth of the older generation.