Health Care Reform Essay
Several years ago, health care reform was a hot political topic with President Bill Clinton's proposals to revolutionize medical health insurance. Even though his proposals didn't become law, sweeping changes are occurring within the health care system, particularly in regards to managed care health insurance and the reengineering of the hospital. The goals of these changes are to cut medical costs, make the delivery of health care more efficient, and to promote preventive medicine, health, and primary care. While these changes are positive in many ways, they are also creating concerns among both the health care consumer and provider. These changes must be managed to insure that high quality care …show more content…
TYPES OF HEALTH INSURANCE PLANS
At least 1,000 health insurance plans exist but they fall into certain categories (Whigham-Desir, 1996). The traditional plan has been the indemnity or fee-for-service plan. Patients visit any doctor at any time and pay directly for their treatment. They can be reimbursed later, usually for 80 percent of the cost (Whigham-Desir, 1996). These plans are the least restrictive, but the most expensive.
Four types of managed care plans exist. They are the health maintenance organization (HMO), preferred provider organization (PPO), point-of-service (POS), and independent practice association (IPA). In an HMO, the member is offered a specific list of doctors and hospitals from whom he or she must receive care in order to be covered. He or she must also choose a primary care physician clled the "gatekeeper" through whom all care is