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You will prepare and submit a term paper on Health Insurance and Managed Care. Your paper should be a minimum of 1000 words in length.
You will prepare and submit a term paper on Health Insurance and Managed Care. Your paper should be a minimum of 1000 words in length. The goal of the medical plan is to reorganize medical care to provide millions of people with prepaid and comprehensive services at prices they can afford. The rates are low making it affordable, and at the same time, they do not compromise on the quality. It is this same managed healthcare plan that receives discounts for its members (Kongstvedt 97). Despite having higher premium rates as compared to health insurance, the managed care subscribers tend to have superior coverage and benefits as well as having the utmost emphasis on preventive care, outpatient care, and other services not included in insurance covers like immunizations, as opposed to those who have health insurance. At the same time, managed healthcare pays the health care providers directly, so that the enrollees do not have to pay out-of-pocket for covered services or submit claim forms for care received from the plan's network of doctors. This is as opposed to health insurance where one has to pay premiums that are usually expensive (Brisenbaum p2) and the medical care provided is not proportional. The people enrolled in the health insurance program are over-insured meaning that the premiums they pay for include uncertain expenses. Furthermore, under the expense is the part where the medical care providers raise their fees especially when the cover is more extensive and may not necessarily improve on the care, this, in turn, means that the higher the physician’s fees more extensive use of insurance accompanies (Feldstein 251). Owing to these facts managed medical care is a better option for health insurance. Access Moreover, managed healthcare plan was formulated to give healthcare access to employers whose labor force was too isolated or detached to acquire medical care on its own. In these cases, employers hired doctors and nurses. The whole idea of doing this was to increase access healthcare to those who could not through normal means. However, it was coupled with problems that were because of the above practices leading to the ratification of state-sponsored anti-corporate medicine legislation. The same plan was successful in the provision of healthcare to most workers as it followed medical practices familiar to them. On the other hand, insurance is a better option when it comes to selecting and sticking to one’s physician (Birenbaum 106). This is due to the attempt made to use certainly predetermined healthcare providers by managed care providers to force enrollees. However, health insurance providers allow one to go with or use any healthcare provider of their choice. This is evident in cases where enrollees perceive a healthcare provider as inferior or inconvenient thus, will not be cooperative, or the plan will not be received well. In addition, if one changes employers or the employer changes plans, the participants may not have their doctor on the new network joined which presents a challenge in terms of quality and knowledge of participant’s medical history.