Chapter 14

Abstract:



Chapter 14 mainly focused on the health care system of the United States. The chapter discussed the major issues surrounding health care system and that included the concerns of cost, equality for their people, and access to that health care. They discussed the percentages of those who are uninsured and talked about their health, or disabilities. Such as poverty, elderly, less educated to the point where the job they pertain doesn't include health insurance, nonwhites, and those who are not U.S citizens. They then went into greater detail about the quality of health care that individuals receive. The book stated that to insure a healthy, productive nation, we must transform our health system very soon. Another issue that the book reviewed was the rising issue of how the health care is paid for. The two major means of delivering the health care is fee-for-service and prepaid health plans. The majority of health care is paid by third party payment. This is when the health care provider will ask to see proof of insurance, and then upon signing a couple places to just give them permission to release your information, the health care facility will then bill the insurance company and the insurance company will either pay in full or the patient may have to pay money also. The book then went into the insurance of children. There is an act called The State Children's Health Insurance Program (SCHIP) which insures uninsured children, low income children and minority children. This includes about 11.3 million uninsured children and the percent is even higher for minority or low income children. Following the insurance of children, the book went into key insurance terms. After that, the book explained the different types of health Insurance coverage. The two major health insurance programs are medicare and medicaid. Even with the health insurance of medicare for example, there is also a concept called supplement health insurance. The two major supplement insurances are medigap and long-term care insurance. Both programs are there to help even further with health coverage. Normally these programs are put on top of the benefits people are all ready receiving. Next the chapter reviewed managed care. Managed care is defined as "a set of techniques used by or on behalf of purchasers of health care benefits. To lower costs of health care by influencing the patient care decision making through case-by-case assessments of the appropriateness of care prior to its provision." Today, most of America is covered by some sort of managed care. The types of managed care is PPOs, EPOs, HMOs, POS, and PHOs. Next, the chapter gave some insight to other nations and their health care system. They talked about Canada and their national health plan. The book explained that the United States is the only nation who doesn't have a national health insurance program. The chapter concluded with the explanation of the states own health care programs and alternative ways to provide health care offered by Canada and certain states of the U.S.

Reflection:

The chapter gave our group a lot of insight into the health care programs of the U.S. We thought it was interesting on how intricate our health care system actually is. On one of the figures the book showed, it listed all of the different accesses that certain groups of people have to our health care. It was a little difficult to read and trace were the certain groups actually received their care. We also thought that the book did a good job showing us how health care is paid for. And how many different organizations contributed to the costs of health care. It explained the inequality some minorities receive and even gave us an example of an insurance claim form. The chapter really helped my group understand the variety of our health care system but also the controversy that some health care facilities go through. The chapter really answered all of my groups questions and concerns about our health care system.