HLTH 3400 Quiz 2 Part 2

- lack of universal coverage
- high cost
- no transparency
- limited choice
- rationing of care
- poor quality
- eligibility
- no trust
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Terms in this set (21)
- lack of universal coverage
- high cost
- no transparency
- limited choice
- rationing of care
- poor quality
- eligibility
- no trust
What are the problems with health insurance?
- eligibility
- cost
- choice
- rationing of care
- quality
what are the problems are associated with medicaid expansion?
- **reimbursement for hospitals (hospitals want medicaid expansion)
- covers the previously uninsured
- enhanced matching rates
- decrease in ED
- eligibility
what are the pros of medicaid expansion?
- decline in match rate
- education
- state had option to expand or not
- tax increases
- not universal
- quality issues
- longer waits because more insured
- providers may not accept medicaid
what are the cons of medicaid expansion?
- higher costs
- uninsured (most likely to gain insurance)
what are the problems associated with dependents covered till the age of 26?
- providers get reimbursed
- stay on parents insurance longer (college)
- lowered cost because less uninsured
- access to prevention
what are the pros of dependents covered till age 26?
- fewer individual plans
- dropped at age 26 and may not be financially stable
- more expensive for employees and employers
what are the cons of dependents covered till age 26?
- cost
- eligibility
- coverage
- quality
what are the problems associated with pre-existing conditions?
- cant deny coverage or change more
- patients with pre-exisiting conditions receive better quality care
- decreases amount of uninsured
- reduces cost for patients
what are the pros of pre-existing conditions?
- plans can be grandfathered
- hospitals have rationing of services/physicians
- increase cost to treat patients
- higher premiums for those without pre-existing conditions
what are the cons of pre-existing conditions?
- cost - coverage - eligible - qualitywhat are the problems associated with no annual or life time limit?- not denied access - everyone is covered for all expenses - less out-of-pocket costs for patientswhat are the pros of no annual or life time limit?- overuse/abuse of services - **moral hazard - quality - higher costs; higher premiums the next yearwhat are the cons of no annual or life time limit?- cost - choice - no universal coverage - qualitywhat are the problems associated with individual mandates?- subsidies - healthier population - encourages people to get insurance - prevents financial loss/risk of loss - insurance mandates are stable and functionalwhat are the pros of individual mandates?- tax penalty = have to pay taxes if they dont want to have health insurance - increase debt - penalty is not great enough for people to get health insurance - health insurance is still expensive - differs state to state decisions: can only look within markets within stateswhat are the cons for individual mandates?- eligibility - costwhat are the problems associated with employer mandates?- add competitive advantage - reliable payments - covers more people - another source of coverage - choice of policy/choose insuranceswhat are the pros of employer mandates?- rationing of choice because of providers in network - small businesses cant afford it - reduces start ups - type of coverage - costs - lose revenuewhat are the cons of employer mandates?insurance CEOwho makes the most in healthcare?- submit data on the Medical Loss Ratio (MLR) - issues rebates to enrollees if the percentage does not meet minimum standards - spend at least 80% to 85% of premium dollars on medical carewhat does the ACA require insurance companies to do?