NHM 417 Lecture Notes - Lecture 9: Healthcare.Gov, Health Insurance Marketplace, Durable Medical Equipment
6 Dec 2016
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Document Summary
Prevention of disease is good for the individual and for the nation. Prevention over treatment for taxpayer and individual success. So, current public policy is attempting to direct our system toward health promotion, disease prevention, and the efficient use of scare resources but structured around health insurance. Health insurance: public (government funded) or private (employer, union, individual) Private health insurance: fee-for-service plans: a charge for each service. (less common now) Pro: unrestricted access to physicians, tests, hospitals and treatment. Con: may encourage physicians to provide unnecessary services to increase revenue: managed care: prepaid group plans with services through groups of medical practitioners (most common) Goal: improved quality with decreased cost but sometimes limits the use of health services. Hmo: charge a fixed fee per year to provide all medical services deemed necessary. Enrollees must use the plans providers or face financial penalties. Hmos make money by keeping people healthy, preventative activities.
