Many HMO’s constantly evaluate their services to "ensure" the best care and coverage. But in many cases, what is happening is the exact opposite. HMO's can and do conduct their business quite ruthlessly. Patients are continuously unable to receive the necessary treatment due to the insufficient HMO coverage. Many HMO's actually make more money if their doctors see or treat fewer patients.
The reform of health care is a tremendous feat. The changes made to the program affect our country. This also means that any negative aspects of the program also affect us. President Obama’s Patient Protection and Affordable Care Act (PPACA), also known as “Obamacare”, intends to improve health care and ensure that more Americans possess health insurance. While this seems like a good premise, the new system is flawed and is far from being the perfect healthcare system.
The hospital and physician practices in prior decades are not the same today and it’s vital to uphold standards for patient safety, care, and medical costs. As (Medicaid.gov, 2015) states, by contracting with various MCO’s to deliver Medicaid program health care services to their beneficiaries, states can reduce Medicaid program costs and better manage utilization of health services. Most states are implementing and coordinating more traditional services for managed care. Medicaid will to rise and aiding people who live in poverty, but the amount of challenges that lie ahead are problematic. For instance, the types of services including long-term care, mental illness, and eligibility standards are not permissible for everyone.
The lack of medical care is causing many deaths that could have been evaded with the proper medical attention. It is time to start spending money where it is needed. Our citizens are crying out for help when it comes to their medical needs, but is anyone listening? The Need for Health Care Reform Our economy is in recession. Many people are looking for jobs that are just not available.
However, the reason a lot of these insurance companies are not popular among the general public is because they are new to the insurance game and are often unable to handle processing claims that have become second nature to the giants of the insurance industry. Opponents could also claim the ACA’s out of pocket maximum helps people not get drowned in debt. Sure, maybe the individuals themselves aren’t directly in debt and being spammed with outrageous hospital bills. However, the part of their bills that count toward their out of pocket maximum are sometimes unclear. “Even though things are a lot simpler now, depending on your plan not all services are going to be covered 100% and not all services are always going to count toward your out-of-pocket maximum.
The affordable health-care act, much more commonly known as Obamacare was designed to provide insurance to a large amount of Americans, who would otherwise be uninsured. However it has been a major issue since being created. Americans should have their own choice on health insurance because Obamacare is failing tremendously. The cost, low quality, and the rights are just a few of the main issues with the act. For people who were happy about the law, there was a realization that they would soon be able to have health insurance and could not be rejected due to having pre-existing conditions, leaving them no longer struggling with medical bills if something unexpected were to happen.
Cultural Sensitivity and Cultural Competence In Prevention and Intervention Programming Culturally competent care is care that respects diversity in the patient population, and cultural factors that affect health and health care, such as language, communication styles, attitudes, behaviors, and beliefs. The national CLAS Standards provide the blueprint to implement such appropriate services to improve health care in the United States. The standards cover many areas, such as leadership, workforce, governance; communication and language assistance; organizational engagement, continuous improvement, and accountability. (Agency for Healthcare Research and Quality, 2014). There is a lack of conceptual clarity with cultural
Healthcareproblems.org elaborates on the issues and statistics data with healthcare, Many Americans are battling with health care costs, fail to get check- ups and visit the doctor because they can’t afford to cover their entire medical expenses. Healthcare is one of the top social and economic problems facing Americans today. The rising cost of medical care and health insurance is impacting the likelihood of many Americans in one way or another. The inability to pay for necessary medical care is no longer a problem ...
This approach has made it difficult for patients to be able to “shop around” for the best prices when in most cases they are not sure what the cost treatment will be. They were, by no fault of their own, uninformed consumers due to plan designs. The plan design of the health maintenance organization (HMO) for example, “masks the true cost of care” because the consumer only pays the copay (Kongstvedt, 2007, p.474). The copay is only a part of the total cost resulting in the consumer not seeing the value of the health insurance benefit. Consumer driven health plans (CDHP) were created, partly, so the consumer becomes aware of the true cost of health care, an example is the high-deductible health plan (HDHP).
Recently President Obama has enacted new Health Care Reforms requiring everyone to have some form of insurance. Many citizens have a problem with being forced to buy insurance that is to expensive; or finding insurance policies that are affordable monthly, but the copays are too expensive to ever be able to use their policies. There is also the issue of some people do not believe in western medicine and have other practices of healing. I feel that it is unfair to make people finically or morally burdened by forcing them to buy health insurance. I know many people who would rather pay a fine than be forced into something they do not want or cannot afford.