Coverage Issues In a just society, everyone would receive the same level of health care coverage.
Healthcare is a fundamental human right, and you should not get more or less depending on your ability to pay for it. Most employers offer health insurance coverage as a benefit with employment. With insurance rates rising consistently, now companies are trying to offset costs by having the employee’s pay a portion of healthcare costs with a guaranteed issue. With the Affordable Care Act, people who have healthcare insurance is experiencing changes in coverage, rate hikes and making them pay more for a plan equivalent to what they had before. Not all employers offer health insurance to their employees, so they must search for health
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The Banes Family and Mrs. Jackson
The Banes’ are an African-American family who lives in the Lawndale neighborhood on the West side of Chicago. One of the poorest and sickest areas in the city. Everyone in the household is recipients of both federal government health insurances, and they receive government assistance. Mrs. Jackson suffers from health issues; her only income is Social Security and Medicare and Medicaid health insurance. Robert is on Medicare and Medicaid due to his diagnosis of renal kidney failure. Jackie and the kids are on Medicaid
Robert’s Sickness
Unfortunately, Robert never had health insurance, due to his choice of employment, and his employers did not offer health benefits. Robert disregarded his health and avoided going to the Doctor for regular check-ups. In his late twenty’s Robert’s high blood pressure escalated to renal kidney failure that could not be a cure. Luckily, for Robert Medicare has an unusual clause in their insurance coverage; End Stage Renal Disease program for anyone who suffers from renal failure qualify for insurance since under the special status his age and income did not affect his eligibility. He received a kidney transplant and continues his health care routine by having dialysis a twice a week at Neomedica Dialysis Center. Robert’s attending physician Dr. Lang is an owner of the for-profit dialysis chain. Payment for his dialysis sessions is cover by Medicare, Medicaid, and a state-sponsored program the
The U.S. healthcare system is remarkably complex, and even healthcare workers struggle to understand it. The U.S. population gets health coverage by government programs, employers, and private insurance. Notably, because of the complexity and fragmentation of the health care system, there is a percentage of the population that remains uninsured. According to CNN Money, the uninsured rate in the U.S. dropped from 18.2% in 2010 to 10.3% in 2016, this drop was under Affordable Care Act(ACA) (). The goal of the ACA was not to give health coverage to all the uninsured population, rather it was to try to decrease the percentage of the population that remained uninsured(). There is a lot of inequality in the distribution of health among the U.S. population
Health care insurance in the U.S. is extremely competitive and not always fair. Recently in 2012, The Affordable Care Act passed by Barack Obama set new regulations regarding insurance. According to this Act, employers of 50+ employees must offer health insurance, public health insurance such as Medicare and Medicaid was made affordable for those that qualify, it is illegal for anyone to be denied insurance due to pre-existing conditions, and everyone must have health insurance or they will endure tax penalties. For Medicare and Medicaid, each state has different qualifications regarding eligibility. Private health insurance is not mandatory, but many of those that can afford it prefer it because it will cover more than any government insurance. Private health insurance also offers family plans along with single plans(varying from company to company), which will definitely attract middle to high income families. Health insurance is an absolute essential in the U.S. as it is up to the citizen to obtain one that works for them.
This book weaves the tale of four generations of the Banes family, who lives in Chicago’s poorest neighborhood called North Lawndale. The author spent a year from May 1989 to April 1990 with this family and observed its struggle with the prevailing health care system. The story rotates in the Banes family, Jackie Bane, her husband Robert Bane, their children Latrice, Demarest , Brianna, Jackie's grandmother Mrs. Cora Jackson and Jackie's father and Mrs. Jackson’s son Tommy Markham.
Health insurance comes as second nature to many of us. We grab that blue and white card and put it in our wallet and forget about it until we are sick or injured. When this happens, there it is, cushioning our fall like the extra padding it provided to cushion our wallets. This is not the case with everyone, however. Many Americans have no cushion to fall back on, no blue and white card to show the emergency room when they have an unexpected health concern. No HMO with a convenient co-pay amount when their son or daughter develops an ear infection.
Rising health insurance premiums have made healthcare unaffordable in the United States. Health insurance premiums in this country have undergone a steady rise over the past few years while incomes have remained the same. More than 50% of individuals with low incomes holding private insurance in the United States are unable to afford their healthcare costs (Collins, Gunja, Doty & Buetel, 2015). In addition, costs related to healthcare are equally unaffordable to 25% of working-age individuals who hold private health insurance policies (Collins et al., 2015). According to the Kaiser Family Foundation/Health Research and Educational Trust (Kaiser/HRET) survey on employer health benefits, employer-sponsored health insurance plans have also had moderate rises in premiums in 2013 for both individuals and family coverage (Claxton et al., 2013). While
Health insurance is provided by Medicaid and Medicare to elderly and disabled people and poor children. People working for large companies receive health insurance through their employer. Unfortunately, people working for small businesses, those self-employed, and the working poor are left without options to purchase health insurance at an affordable cost. This creates a divide between the haves and have-nots in terms of health care. Those who have health insurance will access the care they need, but those who do not have insurance will go without. This may include primary care interventions such as immunizations and regular health screenings. Rising health care costs have a direct effect on the number of uninsured individuals and, therefore, a direct effect the number of individuals that can access care.
Patients with long-term, chronic illnesses like Mr. Davis’s, care can be very costly, especially when the patient is unable to maintain routine medical care or visits and medications. Without routine medical care and maintenance medications, patients like Mr. Davis tend to have more frequent emergency room visits and hospitalizations; increasing costs for state and local government as well as tax payers. Though Mr. Davis is able to receive care during an emergency room visit, the providers are not fully aware of his health history and are only able to provide a temporary fix of his symptoms and not address his health care needs.
I will compare the current health care system with the new Patient Protection and Affordable Care Act (ACA) that became law on March 23, 2010. The current system, which is being phased out between 2011 and 2018 is increasingly inaccessible to many poor and lower-middle-class people. About 47 million Americans lack health insurance, an increase of more than two million people from 2005 (Rover, 2011) the increasingly complex warfare between insurers and hospitals over who pays the bills is gobbling up a great deal of money and the end result is that the United States pays roughly twice as much per
Challenges were evaluated and although the ACA has provisions for healthcare, numerous individuals still remain uninsured and blame the high cost of healthcare insurance as the primary reason they do not have healthcare coverage. In a survey by the Kaiser Foundation in 2014 showed that 48% of uninsured people stated the cost for healthcare was too expensive as the primary reason they were uninsured. Many workers do not have accessibility to healthcare coverage through an employer, and others, predominantly poor working adults from states with no Medicaid expansion, stay ineligible for public healthcare insurance coverage. Furthermore, undocumented immigrants are not eligible for Medicaid or other healthcare from the Marketplace.
Healthcare reform was designed to help people of middle class to below poverty status afford healthcare insurance, in addition to providing quality care for everyone. When the “Affordable Care Act” rolled out, there were a lot of concerns in regards to the cost and mandating that everyone acquire insurance. The objective was to provide access to low cost insurance; unfortunately, some people remained uninsured, as a matter of fact they were unable to afford health insurance due to the amount of wages they earned.
In the current U.S. system the free market prevails and companies, in this case, major insurance providers “compete” for business. This competitive business approach should in theory drive costs down. For some reason, however, an argument can be made that it has produced the opposite result in profiteering. The nation’s largest insurer, UnitedHealth, boasted over a 10 percent revenue increase in 2013 according to Forbes (2013). Health insurance affordability contributes to the disparity in access to health care, as evidenced by the fact that there are millions that are still uncovered. A greater majority of certain minorities lack both health insurance and the financial resource to seek out either health care or insurance. While insurance companies reap huge profits the percent of private sector companies offering health insurance has dropped to less than 50 percent (Kaiser, 2013). There is decidedly a lack of coordination of care for this at risk population as well, since treatment is rendered sporadically and with continuously changing providers. The last major challenge is that of improving the quality of health care. According to a 2010 report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), an estimated 13.5 percent of Medicare beneficiaries experienced adverse events during their hospital stay and an additional 13.5 percent experienced a temporary
Medicare is a health insurance program purposely created for people over sixty five (65) years of age. However the service is open to people with certain disabilities or permanent kidney failures. The process of choosing the right Medicare involves having to weigh different plans on account of benefits of their cover. Different types of Medicare plans are important in: Inpatient hospital care, outpatient services, doctor visits, home health care, prescription drugs, and care in a skilled nursing facility among others. In addition, the program covers the cost of health care but does not cover all medical expenses including cost of long term care. If one ought to choose an original Medicare coverage, one may buy a Medicare supplement policy from a private insurance company to aid in coverage of costs that are not supported by Medicare. Most of these Medicare expenses are covered by a part of the pay role offered to workers by their employer. This paper covers different Medicare plans; A, B, C, D and their influence towards my decision on the best preferred option.
The agency serves inter-city Memphis and aid adults that suffer from kidney failure. Some main factors of kidney disease are diabetes, most common, and high blood pressure, secondary cause. The normal age range of the clients the agency help is between 30 years old and up (Kidney failure/ESRD, 2017). The clients Fresenius experience injustices pertaining to the access of treatment and the ability to pay for treatment. Most individuals that have kidney disease are 50 years old, so that lack transportation to dialysis clinics. Also, since the individuals live in poverty-stricken environments, it is harder to find the necessary aid to pay for health care
Throughout the 20th century and into the 21st century the United States has always had a realization that there was a problem with obtaining affordable health insurance. The Patient Protection and Affordable Care Act (ACA) also known as Obamacare, was signed into law in March 2010. This law enables people who were unable to afford healthcare the ability to obtain a healthcare plan at an affordable rate. In 2009 a survey was taken as to the amount of people in the United States that carried health insurance. In table one below you can see over 50 million people in the United States did not have any type of insurance, which is close to 17 percent of the population (see table 1 below). “According to the Kaiser Family Foundation, “32%
The healthcare system says that if one pays their insurance then they should get coverage. What the healthcare system forgets to tell people is that there are premiums to pay, even when one does not need healthcare at that moment. A premium is how much someone pays a month for their healthcare coverage. Since 2005 premiums has risen to the point that it takes almost takes all of an employer’s check (Clemmitt, Universal Coverage 2). If someone is unemployed or in school they just drop healthcare all together, because it’s