Economic Issues Simulation Paper
HCS/440
January 23, 2012
Charles Sigmund
Health care economics studies such issues as demand for medical care, pharmaceutical prices, competition among health care providers and insurers, and financing of health care services. Castor Collins has put together a plan which will help solve many issues facing the organization. The plan is built to maximize profit for the company and minimize the risk of poor choices provided to individuals who will cause the organization to fall.
Castro Collins Health Plan Castro Collins Health Plan was founded in 1999 as a regional HMO, which provides health care services and health insurance to their enrollees which consist of 100,000 peoples.
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Ninety five percent of them do sedentary activities, which has led to several instances of obesity in this group.
Health Care Risk Factors According to the profile of constructit, their enrollees do great physical activities; however, 43 percent of them do sedentary activities. Obesity affects 39 percent of the group, therefore, Castro Collins has to consider the risk of obesity- related diseases such as; high blood pressure, diabetes, hyperlipidemia and cardiovascular diseases. There are 170 men and 210 women who has not been diagnosed with having no major health risk at all. Seven hundred and twenty of the people of E-editors are obese, which indicates risk of hypertension, diabetes, cardiovascular diseases and high cholesterol
Plan Details Castor standard and Castro Enhanced are individual plans, Castro standard does not cover preexisting medical conditions. Castro Enhance does cover preexisting medical conditions. Castro Collins must now look at the risk, cost and profitability the company will incur in providing insurance to both groups. Castro Collins also provides detail of service for both groups. Coverage for the following services is provided under the terms and conditions and at the co-payment each company list for chemical dependency, treatment, durable medical equipment, emergency services, family planning, hospitalization services, maternity care, and mental health care services,
Throughout the history of the United States, the economics of the health care system has experienced many changes. There are many factors to consider that has been the drive behind many of the changes within the health care system. Medical and surgical technologies are some factors that relate to the changes in health care. Besides these factors, allocating sources to fund health care services has always been the most critical factor. One might consider the economic term supply and demand when looking at the history of health care economics and the primary funding source. Health care funding
When contemplating health care policy changes, several economic issues in health care must be considered. These include the financial issues affecting the health sector and have an impact on health policies. Policy makers face unending challenges due to the health sector revenues that are always rising. Another challenge is decreased funding and failure of the health insurance services.
Within the last half century, the obesity rate in America has increased by twenty one percent from thirteen percent to thirty four percent of adults; while the percent of the population considered overweight has remained stagnate at thirty-four percent. Unfortunately, the increase in the obese population poses a large threat to the health and well-being of United States citizens. Obesity is not only an accumulation of fat mass, but has been linked to many diseases such as cancer, cardiovascular disease, and diabetes. The strain that each of these respective diseases contributes onto the United States healthcare system is great, but how exactly does obesity contribute to the occurrence of these three diseases? What health factors are affected by obesity and lead to the development of chronic illness?
Obesity presents numerous health risks, both physical and mental. Obesity has been linked to or is a risk factor for many non-communicable diseases such as cardiovascular disease (including stroke and heart) type two diabetes, many cancers (including breast, colorectal….), musculoskeletal conditions such as osteoarthritis, depression and mental health disorders. Obesity along with all of the alarming health implications have the ability to
After the collapse of Health Republic, thousands of New York residents were left without insurance. Of these consumers, 200,000 have yet to enroll in another plan. To mitigate this issue, the NY State of Health decided to auto-enroll consumers into Fidelis Care insurance company. Fidelis, which is catholic owned, is the next most popular insurer with premiums close in cost to premiums offered under Health Republic. Fidelis does not cover abortions and family planning services are administered through a separate company called Unified Life, LLC. With this change, many women will have to find new providers of family planning services because their current providers will no longer accept their coverage. Raising Women’s
This section also addresses the health risks associated with obesity including type 2 diabetes and heart problems. Additionally, it is based on fact and is made directly from the government.
Cuba In the recent years, Cuba has emerged as a world-class powerhouse of medicine in spite of having limited amount of resources, while the United States consumes over 10 to 20 times of what is essential for a beneficial and affordable healthcare system. Therefore, Cuba has been successful in achieving infant mortality rate lesser than that of the US, especially less than 50 percent of US Blacks. The existing debate over US healthcare system is not relevant to representing a path for poorer countries, such as Cuba, as over 30 percent of the country’s spending is an overhead by various private insurance companies. Such over budget includes a huge amount of over-treatment, which makes the poor sick by rejecting them treatment, creating illness and exposing them to contagious diseases through excess hospitalization and research based on disease rather than prevention.
Where do we go from here? What are the policies or laws that need to be made or regulated in order to function properly? Which are the problems that need to be addressed if we want to grow as a company? These are some of the questions that governs health care administrators daily. Understanding the market and predict it outcomes are some of the benefits of understanding economics. When we understand how is the market operating, we could be prepared for changes that occurs or even create them. Understanding economics open a window of opportunity and challenges to administrators.
Our family insurance coverage is a PPO insurance product. The insurance is offered through our employer. However, things have changed drastically. In years past healthcare coverage through your employer was 100% coverage with minimal employee contribution. Today the employee contribution is close to half the premium cost. This contribution is usually done bi-weekly with payroll deductions. With our coverage we have co-payments for prescription costs, dental, and vision care. If the prescription is not written as dispensed, (DAW) then we can use a generic equivalent at a cheaper co-pay cost. Other out-of-pocket costs are the deductible guidelines you must meet before your insurance is activated to the 100%
James, W. P. (2008). The epidemiology of obesity: the size of the problem. Journal of Internal Medicine, 336-352. Retrieved from http://eds.a.ebscohost.com.library.gcu.edu:2048/ehost/pdfviewer/pdfviewer?sid=9ede2d6d-4d02-42e9-aff7-dd9b2486a3c3%40sessionmgr4004&vid=8&h
Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. One way to measure of obesity is the body mass index, a person’s weight divided by the square of his or her height. For most adults a BMI 18.5-24.9 is consider normal, 25-29.9 is consider overweight and 30-39.9 is obese. Some of the factors that contributes to the development of obesity include genetic, hereditary, environment, metabolism, and behavior. Those that are morbidly obese are at greater risk for an illness which includes; High blood pressure Diabetes, Heart disease, sleep apnea, High cholesterol, joint disease, esophageal reflux, loss of bladder control, infertility and reduced life expectancy. According to World’s Health Organization latest projections, shows that worldwide obesity has more than doubled since 1980 and in 2015 approximately more than 1.9 billion adults, were overweight and the of these 600 million were obese.1 Also, more about 350 million people worldwide are pre-diabetic or diabetic and the number is likely to grow more than double in the next 20 years and is projected to the top 10 leading cause of death in 2030.4 Several studies indicate that obesity and weight gin are associated with an increased risk of diabetes. According to the obesity society almost 90% of people living with type 2 diabetes are
There are various sides of healthcare: business, health, and wellness. (Dayaranta, 2013) believed that healthcare is incompetent to function like other competitive industries because of its unique business patterns. However, with constant academic research, healthcare has the potential to act a in a manner of other industries (Dayaranta, 2013). One advantage of thinking of healthcare as an industry is the basic accounting equation: assets + liability = owner’s equity. With that said, using this equation helps lawmakers and economists figure out how to reduce costs. Just like many other businesses, when there is an input, there is an output in the healthcare industry. When it comes to providing insurance to consumers, Dayaranta (2013) thought
With the known risks of long-term consequences including hypertension, diabetes, respiratory problems, orthopedic issues, adolescent and adult obesity, and psychosocial disorders, this is a very disturbing trend (Gutin et al., 1990; Hannon et al., 2005; Murugan & Sharma, 2008; Taylor et al., 2006; Dietz, 1998). A causal relationship was established between obesity and insulin resistance (Weiss et al., 2004; Caprio, 2002), and an association between obesity and dyslipidemia, type 2 diabetes, and long-term vascular complications has been suggested (Weiss et al., 2004, p. 2363).
The topic of obesity and its increasing prevalence has captured much attention in the course of several decades. With over 36 percent of the American adult population considered obese between 2011-2014, speculations about its cause, contribution to chronic health conditions, and economic burdens have received considerable awareness (Ogden, Carroll, Fryar and Flegal, 2015). Commonly in research, obesity levels are measured through the Body Mass Index (BMI) scale. A BMI of 25-30 is considered overweight, and a BMI of greater than 30 is considered obese (Stommel and Schoenborn, 2009). The risk of death increases with higher BMI (due to obesity related comorbidities) accounting for nearly 300,000 deaths annually. These trends have been observed across all age groups, both genders, all educational levels, races, and smoking statuses (Aronne, 2001). While diet and energy intake have been on the forerunner when explaining weight gain, another recent trend which has been gaining notice is the shift towards a sedentary lifestyle among the US population (Blair & Brodney, 1999). In 2000, the CDC approximated that less than 30 percent of the American population gets the adequate amount of physical activity (Caballero, 2007). Physical inactivity was associated with 54% higher odds of obesity, while socioeconomic status and societal conditions further influenced its prevalence (Singh, Siahpush, Hiatt, and Timsina, 2011). As a result, in addition to weight-related diseases, obesity
For many patients trying to get good health care from a provider and good health care insurance is very difficult because they do not understand all of the policies. In these hard times