Tag Archives: healthcare

Single Payer Healthcare Systems, Options And Benefits

Single payer healthcare is not a new concept – it may look differently to different people when discussed. When single payer healthcare system is optionally proposed to private healthcare insurance it’s said to be “socialized medicine” or it hasn’t worked in some areas, But a more bare look  is required today to seriously solve healthcare costs.
   In other words, the main goal intent should not be a support of the  status to say or should health insurers be dismissed for their
relative increase in prices above healthcare provider costs, but
rather a general effort to study those options which may better serve healthcare needs to be undertaken.

Analyzing The Fundamental Purpose Of Private Healthcare Insurance And Its Cost

The fundamental purpose of private healthcare insurance is to provide insurance services whereby the transfer of risk is universally accepted. Briefly, the probable healthcare cost of an individual or a group under several condition is actuarilly determined, this is merged with the right rate of return for accepting risk, the cost of operations and a return on that amount must be added to end-up at “premium” for the individual/group for a particular point in time. The
problem here is that the costs for risk, operations and returns are
add-ons to provider cost. Indeed if Americans were able to pay their healthcare cost directly to their healthcare providers 2004, then about $70billion will be saved. But additional costs must be incurred by the third party payer system, though payer net expenditures can be reduced to claims processing operational costs.

  Hence, lot of organization moving to self-insured healthcare benefit structure with many discovery that their claim processing function can be sold to self insured organization which becomes revenue and thereby reducing healthcare cost.

Single – Payer Healthcare Options

Proposals (state & national legislature) had been put forward with the aim of reducing health care cost and dealing with vast of Americans who are uninsured or under-insured. These measures need to be discussed and analyzed; however, it is instructive to briefly review the success and failure of other

implementation healthcare system specifically those of Canada and the U.K.

Is Single – Payer Healthcare System Available And Beneficial Option?

One of the firm relative to California measures, is the lewing group, they have undertaken healthcare consultancy and analysis for 10years, if their conclusion on healthcare is correct then the answer is likely to be “yes”. Hence, the state would be more attractive for individual seeking cheap healthcare. This will motivate other states to adopt these healthcare measures in order to maintain good tax-base. However, in this discussion single healthcare cannot be conclusive over private
healthcare insurance, demand for healthcare is increasing and if
single payer healthcare is implemented that would benefit lot of
America without healthcare and individuals with high cost private
healthcare insurance. If the demand for healthcare increases by 20%,
the providers would be beneficiary and increased provider supply, utilization would lead to demand for healthcare equipment and robust services from vendors. Other benefits of single payer healthcare is it would help in establishing nice healthcare information network, and other expensive healthcare providers that are exerting high prices in the market will lose ground.

Conclusion
This subject on single payer healthcare needs to be carefully and
openly be discussed and analyzed. Those strategies that might
significantly reduce costs while improving general healthcare need to be aggressively studied.

 
 
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United Healthcare Organizational Structure & Insurance Plans

United healthcare is a situation whereby health services are combined with health insurance or it’s a combination of healthcare services and health insurance. United healthcare is one of the largest company in
the world.

United healthcare includes four divisions:

(1) United healthcare employer and individual- provides health
benefits plans and services of large national employers.

(2) United healthcare medicare and Retirement- provides health and wellness services to individuals at the age of 65 years and older.

(3) United healthcare community and state – provides services and programs that care for economically disadvantaged individual, the medically undeserved and people without the benefit of employer financed healthcare, in exchange for a monthly premium per member from the state program.

(4) United healthcare Global services – serves around 6.2 million
people with medical benefits, residing mainly in Brazil, Chile,
Columbia and Peru but also in more than 130 countries.

Health Insurance Plans
United healthcare offers commercial group insurance plans across the united states under several brand names with different offer.

(a) United healthcare select is exclusive provider (EPO) with no
coverage for out-of-network providers.

(b) United healthcare select plus is a preferred provider organization.

(c) United healthcare choice work as a WHO plan which allows for
out-of-network coverage.

(d) United Healthcare Navigate Charter and Compass require and primary care physician referral to see a specialist meaning that they are more restrictive managed care plans, similar to point of service plans.

United healthcare negotiate with providers in periodic contract
negotiations; contract may be stopped from time to time. High profile contract disputes can span provider network across the nation.

The provider directory should be up-to-date ever since the centers for medicare and medicaid services can fine insurers with outdated directory. As a condition of participation, united healthcare requires that providers notify them of recent changes, but also has a professional verification program that requests information from providers from time to time.

However, providers have the responsibility of having to maintain their information with different networks, so they incur cost of
maintenance.
A blockchain initiative began in 2018 to share information’s across directories.

 
 
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Primary Healthcare Providers,Settings

Primary healthcare is the earliest service an individual had with the health service system when he/she had a health issue, primary healthcare is a broad area of health services provided by medical professionals in the community like the general practitioner(GP), nurse, pharmacists and other health providers like the dentists. Primary healthcare services include diagnosis, treatments, support, management of health problem and chronic conditions either in the short-term or in the long-term. Primary healthcare also involve visiting health professional that will help us maintain good health, getting regular health checks, health advise and support for steady healthcare.
Primary healthcare providers are health providers who work in the community, they are the first contact an individual has when he/she have a health issue in the community. A lot of individual visit the ” General Practitioner” (local doctor), nurse or pharmacist in the community as a first step when they have a health problem that is not emergency. The primary healthcare system also involve other allied healthcare professionals like the dentists and physiotherapists.
Primary healthcare is available in community setting in areas such as general practice or dental clinics. Primary healthcare providers may work in medical clinics, community health centers and allied health practices such as physiotherapy and podiatry practice. Primary healthcare can be available through health service providers such as NURSE-ON-CALL.
Hence, healthcare services delivered by primary healthcare providers include diagnosis, treatment, healthcare, promoting good health, preventing health problem, early intervention, managing ongoing and long-term conditions.
Healthcare services is very important in advising and helping you to prevent and maintain good health. Areas that healthcare service advise are crucial are; managing stress and depression, low quality diet, low exercise, dangerous drinking and reducing or stopping smoking.
Furthermore, your relationship with your primary health care provider should be cordial since you may be having other primary healthcare providers like the dentist, dietician, physiotherapist, counselor. Having a nice relationship with your primary healthcare provider is very essential, because it will help you and your provider to feel confident whenever you have a medical problem.
To maintain a good and quality relationship with your primary health care provider; keep your medical history, feel confident sharing sensitive information, and write down all your health issues or symptoms and any other factor before visiting your primary healthcare provider.
Finally, primary healthcare services are available through telephone line 24hours a day, these services can be helpful if you want to see a healthcare expert personally as well as providing health services when other services are closed.
Primary healthcare services can help in diagnosis and treatment of common health issues. They can also help in directing urgent medical issues to places to get medical attention. Go to your local community health center and find out the phone numbers used to contact your GP (general practitioner or local doctor) , nurse or pharmacist in case of emergency.

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