Reading 17 H&S - Palmo PDF

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Introduction to Health & Society Dr. Nina Palmo ------------------------------------------------------------------------------------------------------------------------------Reading response paper #17 Models of health care coverage 1. What are the most common types of public and private health insurance? Public health insurance is insurance that is subsidized or in other words, is paid for completely through public government funds. This includes coverage such as Medicaid, Children’s Health Insurance Program (CHIP), state-sponsored or another government-sponsored health plan, Medicare, and military plans. Private health insurance, on the other hand, is paid entirely by the individuals being covered. Private health insurance can be offered through an employer, purchased by the individual directly, or purchased through local or community programs, or purchased through the Health Insurance Marketplace or a state-based exchanged. Private health insurance excludes plans that pay for only one type of services such as accidents or dental care. A minute number of people are covered by both public and private plans

2. Describe the health insurance status of adults in the US today. How many have health insurance? What kind? How many are uninsured? How has this changed during the past decade? In 2016, 12.4% of adult among the ages of eighteen to sixty-four were uninsured, 20% had public coverage, and 69.2% had private health insurance coverage at the time of interview. Those covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges include 4.7% (9.4 million). The percentage of those under the age of 65 with private insurance enrolled in a high-deductible health plan increased from 36.7% in 2015 to 39.4% in 2016. In the past decade, the percentage of adults aged 18-64 that were uninsured when the interview took place has generally increased from 1997 through 2013. The percentage of uninsured adults has decreased from 2013 to 12.4% in 2016. In a mere four years, the corresponding increases were seen in public and private coverage among these adults. More recently, the changes observed in the percentage of adults aged 18–64 who were uninsured at the time of the interview between 2015 and 2016 had no significance. While the decreases in the percentage of adults who were uninsured for more than a year between 2015 at 9.1% and 2016 at 7.6% and for at least part of the year between 2015 at 18.1% and 2016 at 17% were in fact significant. The percentage of adults covered by exchange plans in the fourth quarter of 2015 from 3.9% or about 7.8 million increased to 4.8% or 9.4 million in the fourth quarter of 2016.

3. Describe the health insurance status of children in the US today. How many have health insurance? What kind? How many are uninsured? How has this changed during the past decade? What policy changes drove these changes? In 2016, among children aged 0–17 years, 5.1% were uninsured, 43.0 % had public coverage, and 53.8% had private coverage. The percentage of children who were uninsured in 1997 at 13.9%, decreased to 5.1% in 2016. The percentage of children who had private coverage decreased and the percentage of children with public coverage increased from 1997 to 2012. In recent time, the percentage of children with public or private coverage has leveled off. The public coverage for children from 2011 through 2016 ranged between 41% and 43%. The percentage of children who had private coverage remained stable from 2011 at 53.3% through 2016 at 53.8%. The percentage of children who were enrolled in exchange plans in the fourth quarter of 2015 from 1.9% to 3% in the fourth quarter of 2016. The observed increase in the children that were enrolled in exchange plans during the first quarter of 2016 to the more fourth quarter of 2016 had no significance.

4. For each of the following models: a) the Beveridge model, b) the Bismarck model, c) the National Health Insurance model, and d) the Out-of-pocket model, The Beveridge model, named after William Beveridge is a system in which healthcare is primarily financed through tax payments by the government, similar to the police force or the public library. The Bismark model, named after the Prussian Chancellor Otto von Bismarck, is an insurance system of providing healthcare that is similar to Americans. Where the insurers are called “sickness funds”. The funds are typically jointly financed by employers and employees through payroll deduction. Unlike the insurance industry of the United States, the Bismarck health insurance plans to cover all and don’t profit. Tight regulation gives the government much of the cost control clout that the single-payer Beveridge model. The National Health Insurance model is a system that contains the elements of both Beveridge and Bismarck. Payment comes from a government-run insurance program that every citizen pays into by using private sector providers. Since there's no need for marketing, no financial motive to deny claims and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than America insurance. National Health Insurance plans also control costs by limiting the medical services they will pay for, or by mak patients wait to be treated. The Out-of-pocket model...