A short guide to health insurance online quotes in Virginia (12/10/2011)
(...) The plans may have different amounts of medical care coverage with various prices. If you aren't sure what budget you can manage to buy medical health insurance, you won't have the ability to compare the quotes competitively. 2. (...)

Standards of value of the American health care system (01/03/2011)
(...) It's also true that the science of scanning is constantly improving, and the likelihood is high that scans will, at some point, replace even more instances of invasive cutting, probing, and testing. That isn't the point of this example. The point is that for the heart scans being done, there was no in-place body of evidence showing that they added value. (...)

Health Care Cost Inflation and its consequences (01/02/2011)
(...) Many other industries have a surplus of available workers. Health care does not. Health care currently hires its work force from a shrinking and increasingly inadequate pool of skilled health care workers. (...)

What to know about health insurance policies and managed care plans (10/07/2010)
(...) Most persons in the United States no longer have health insurance per se, but rather, are members of, or subscribe to, a service plan under which they receive health-care services from a health maintenance organization (HMO) or some other form of managed care plan. Traditional health indemnity policies, under which an insured paid his or her health-care provider, executed an assignment of benefits form in the provider's favor, was billed for, and paid the doctor for the difference, are no longer in existence for all intents and purposes. Managed care organizations include health maintenance organizations (HMOs), preferred provider organizations (PPOs), and other hybrid forms, including point of service plans (POSs). (...)

Limitations on preexisting conditions included in health insurance policies (10/07/2010)
(...) Experimental or Investigative Treatment Exclusion Many health insurance policies and managed care plans exclude coverage for treatments that are not recognized as accepted medical practice or that have not received governmental approval. Often, policies and managed care plans put the determination whether a given treatment is considered experimental or investigative in the sole discretion of the plan's medical director. This is an exclusion that in many ways is a variant of the medical necessity requirement discussed previously. (...)

Medical care costs can bring an American family to financial collapse (05/12/2010)
(...) More than six hundred million workdays are lost annually for those reasons. Our data suggest that the loss of income and employment is even more devastating financially than the direct cost of medical care. In combination, medical costs and lost income are frequently lethal to the financial survival of previously secure members of the American middle class. (...)

Medical costs and health insurance are central health care issues in America (05/12/2010)
(...) They reported that the number-one reason for taking out personal loans other than for durable goods was to pay medical costs. Those consumers reported that the loans they took for medical reasons constituted more than a quarter of the loans taken for any specified purpose. Medical debts generally were by far the most important single type of debt reported. (...)

What is medical debt and how can you avoid it (05/12/2010)
(...) Many providers now require payment at the time of service, so that many patients put their medical bills on an all-purpose credit card. As a result, a listing for credit card debt today may conceal ambulance costs, physicians' bills, pharmaceuticals, home health care costs, medical appliance and equipment fees, and hospital charges. Nor will a home equity line of credit or a finance company loan on a bankruptcy schedule show a connection to earlier, substantial medical debts. (...)

The legislation of Medicare and health providers (03/30/2010)
(...) At one point, Medicare opponents proposed an increase in Social Security cash payments to retirees. Medicare proponents were opposed to these higher cash payments because they believed the increase in Social Security taxes to fund the cash payment would prevent later passage of Medicare, which would also have necessitated a similar tax increase. To understand the reasons for the conflict, why it lasted so long, and the final form of the legislation, one must know who the major interest groups were and how they perceived the proposed legislation would affect their economic interests. (...)

Redistributive Effects of Medicare and Medicaid on their direct beneficiaries (03/30/2010)
(...) A universal program that treats persons of different incomes alike will not result in equal use of services. Medicare uses deductibles and copayments. The aged also have to pay a premium to participate in Part B of Medicare. (...)

How the working class should pay for Medicare and Medicaid (03/30/2010)
(...) Employer-purchased health insurance is considered a nontaxable fringe benefit to employees. Had the employee received the fringe benefit in cash, for those higher-income employees in higher marginal tax brackets, a greater portion of it would have been taxed away. As the employer paid increased premiums for health insurance to keep up with rising medical health care prices, this was not as great a loss to higher-income employees receiving tax-free benefits. (...)

National health insurance means different things to different groups (03/30/2010)
(...) Universal Coverage According to the public interest theory, the motivation underlying national health insurance is to increase access to medical health care by the uninsured and those with low incomes. The poor either have no health insurance and must fall back on Medicaid if they become ill, or their health insurance is less comprehensive than the health insurance purchased by (or on behalf) of those with higher incomes. In support of the goal of universal access are the numerous studies that document the size of the uninsured population (approximately 15. (...)

Major groups with a high interest in health reform (03/30/2010)
(...) Similarly, Medicaid and Medicare Part B (which pays for nonhospital services) and Part C (the newly enacted prescription drug benefit) contribute to the federal deficit. These programs are subsidized from general tax revenues. Controlling the federal deficit is a goal that has a large amount of political support. (...)

Health care reform rises interests of additional groups (03/30/2010)
(...) The effect of budget-neutrality was to lessen the political influence of the AHA, because the AHA could only favor revenue increases to all hospitals - not to specific groups of hospitals. Each group of hospitals then developed their own lobbying organization to try and receive more Medicare funding and to protect themselves against the lobbying efforts of other hospital associations. Hospitals no longer spoke to legislators with one voice. (...)

Tax policies and the demand for health insurance (03/30/2010)
(...) Do you want to buy the policy? Would any reasonable person in your situation choose to buy this policy? It does not make much sense to purchase a policy to cover $500 in medical expenses when that policy costs $600. It makes more sense to politely refuse the insurance agent's offer and to pay the expenses directly, thus saving the $100 you would otherwise have to pay to cover overhead and profit for the insurance company. For people without a known medical condition, it makes even less sense to buy the additional policy. (...)

What are the conditions to be eligible for Medicaid (03/30/2010)
(...) 5 million low-income adults. 2. Elderly people who meet certain income requirements People over 65 whose income is below a level established by the federal government (typically about 75% of the poverty level) qualify for supplemental cash payments under the Supplemental Security Income (SSI) program. (...)

Medicare Physician Payment Policy facts and explanations (03/09/2010)
(...) (Participating physicians are those who agree to accept Medicare's reasonable fees as payment in full for all services they furnish to Medicare beneficiaries during the year.) In 1987 the freeze was lifted for all physicians, but nonparticipating physicians were subjected to limits on their maximum allowable charges for four more years. Against this background, Congress created the Physician Payment Review Commission (PPRC) in 1986, with a broad mandate to advise Congress on "basic reform needed in physician payment". (...)

Medicare fee shedule implementation and physician payment policy (03/09/2010)
(...) Given these problems, a large increase in demand for the services of a particular specialty may not cause the supply of that service to increase. Hence, the prices of services provided by that specialty will increase. On the demand side, lack of information, insurance coverage, and "the special nature of medical care" mean that consumer demand is not fully informed, voluntary, or rational. (...)

Medicare payment system and so called reforms that failed (03/09/2010)
(...) This capacity can be measured by differences in the physicians' marginal cost functions. At first glance, it might seem that all physicians will serve more Medicare patients when they can balance-bill. The ability to balancebill, however, makes absolutely no difference in the total quantity of Medicare services supplied by high-capacity physicians. (...)

Medicare expenditures and payment incentives for physicians (03/09/2010)
(...) Budget These global budget proposals appear to be a logical extension of capitation to a more expansive geographic area. This analogy is valid in part, which implies that global budgets share the same drawbacks as capitation payments to private plans in Medicare. Among them is the administrative formula used to determine the payment level. (...)

The real Medicare reform lies in the use of indemnities (03/09/2010)
(...) Through these choices, the policyholder reveals how much the repair is worth to him. Health insurance and indemnity payments In the case of medical insurance, indemnity payments would be made after a particular illness was diagnosed. Patients would then be free to use the money to select the optimal course of treatment. (...)

Indemnities are not used in Medical Insurance for a number of reasons (03/09/2010)
(...) While it is too early to discuss the issue of claims verification in detail, the evidence from other insurance markets - especially automobile insurance - suggests that verification can be difficult. A cursory examination of the literature indicates that automobile insurance is rife with moral hazard. For example, holders of car insurance policies with a "total replacement" provision (the opportunity to get a new vehicle in the event of theft or total destruction of the car within a specified period) have a higher probability of theft near the end of this protection period. (...)

Health care indemnities that had success and care benefits (03/09/2010)
(...) According to Stone, the most ambitious of these was the Cash and Counseling Demonstration and Evaluation, initiated to test the efficiency of "cashing out" Medicaid-funded home and community-based care services. Participating states obtained waivers to allow the payment of cash allowances in lieu of a service package. The largest program, in Germany, lets beneficiaries living in the community select a cash indemnity, agency services set at twice the value of the indemnity, or a combination of the two. (...)

Medicare indemnities and a reform proposal for the health care system (03/09/2010)
(...) Thus, the last dollar of medical care spent under the indemnity policy is worth one dollar to consumers, whereas the last dollar of medical spending under the coinsurance policy is worth only a fraction of a dollar. Having received an indemnity payment, an individual would consume the same amount of medical care as he would when paying with his own money. As a consequence, he would have an incentive to use the right amount of medical care and to shop for the best prices and types of care offered by alternative providers. (...)

Indemnity coverage problems and ways to overcome them (03/09/2010)
(...) Must the Indemnity Be Spent on Medical Care? Recall that "pure" indemnities are fixed amounts of money paid to an individual after the occurrence of a well-defined event. After the individual receives the payment, he or she is free to spend it on a repair or not. Should the same principle be followed for Medicare indemnities? Public health consequences The list of such instances includes treatment for infectious diseases that have serious public health consequences, and settlements made on behalf of minors and mentally incompetent patients. (...)

Patient costsharing is what Medicare must do (03/09/2010)
(...) Two studies have attempted to control for unmeasured selection into Medigap. First, Susan Ettner examined spending differences between elderly individuals without Medigap and those who got Medigap insurance through an employer. She argued that getting Medigap through an employer reduces the importance of individual selection. (...)

Why a successful implementation of indemnities cannot be done (03/09/2010)
(...) Individual physicians in a perfectly competitive market would face infinitely elastic demand curves, while pure monopolists would face demand curves that have the same price elasticity as the total market demand for physicians' services. Health plans Physicians and hospital systems have consolidated to achieve negotiating leverage with health plans. In sum, the current market for physicians' services is not competitive, and subjective evidence indicates that physicians' market power vis-à-vis private health plans is increasing. (...)

Medicare must become a more competitive market (03/09/2010)
(...) More important is that controlled prices can hide differences in quality among physicians. We analyzed how price controls work in a market where physicians are monopolists and their services vary in two dimensions - quantity and quality. As a reference point, we began by fixing quality. (...)

How Medicare could make use of indemnities in the future (03/09/2010)
(...) This might be decided by setting a minimum percentage of total Part B spending for inclusion of a condition in the demonstration. I pointed out that conditions allowing for a large amount of personal discretion over how to spend the indemnity are likely to be difficult to verify. Healthy people might claim to have these conditions because they value for other reasons the items, such as chiropractic care, that comprise the nontraditional treatment. (...)

Partial indemnities for Medicare patients with various medical conditions (03/09/2010)
(...) If each eligible person were given an indemnity of this size, we could use the formulas above to calculate how many people would experience costs greater than the indemnity and how much they would have to pay out of pocket. For example, if the indemnity were set at the mean expense, then 37 percent of the eligible population would have costs that exceed the mean, and, on average, they would have to pay USD 10,000 out of pocket. In other words, they would be exposed to a significant amount of risk. (...)