Managed Care
There are so many problems with our society’s health care. Everyone wants to find a
solution, but no one has been able to come up with one yet. Many different things have been
tried, but none have put a cease to the exorbitant costs, which most believe to be the main
problem. Out of everything tried, the most recent and popular system is known as managed care.
Managed care is the most common form of health insurance in the United States, and provides
more a cost efficient coverage than paying a fee-for-service charge. However, it is also a very
complicated system. Over the next few pages I am going to try and go over the main parts of the
managed care structure. In the end, I am going to decide the strengths and weaknesses of this
system, and decide whether or not I think it will be the answer to our system.
First I am going to go over exactly what managed care means, as simply as possible.
Managed care is an organized approach to delivering a comprehensive array of health care
services to a group of enrolled members through efficient management of services needed by the
members, and negotiation of prices or payment arrangements with providers. It has two main
functions; first it integrates the functions of financing, insurance, delivery, and payment with one
organizational setting, and it also exercises formal control over utilization.
Now I am briefly going to go over the history of managed care. Managed care dates back
to as early as 1882. Northern Pacific Railroad Beneficial Association was one of the first
employers to offer health care coverage. In 1910, the Western Clinic in Tacoma, Washington
offered medical services through its providers for a premium of only $.50 per month, which
served lumber mill owners and employees. In 1929, Blue Cross was originated when Baylor
Hospital in Texas agreed to provide coverage by the case on a prepaid basis for some 1,500
teachers. The Kaiser Foundation Health Plan was started in 1937 as well. In 1971, the Nixon
Administration announced a new national health strategy, which was the development of health
maintenance organizations. The federal government established grant and loan guarantees for
HMO’s to reach a goal from 30 in 1970 to 1,700 by 1976, enrolling 40 million people, and 90...
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... insurance. Also, MCO’s favor preventative care and
health promotion. Many people feel that if you get to the root of the problem, it will help our
financial health costs, and managed care provides help for this.
Some of the negative things I feel about managed care is there is somewhat of a public
dissatisfaction. As I said before, everyone wants the system to change and be better, but no one
knows how to do it. Another negative thing about it is there are many limitations on what
doctors you can see, and the ease of seeing a secondary doctor. There is also the issue of rising
prescription drug costs that managed care does not address.
All in all I think that even though managed care is not perfect, it is the best that we have
right now. It has done a good job of controlling costs, and keeping individuals out-of-pockets
costs down. Until something better comes along, I think people need to realize that we are doing
the best with what we have, and try to be more accepting and understanding. Americans have
made health care the way it is today, so they need to understand big problems like this can’t be
changed overnight.
Cinderella is a childhood fairytale created through Disney that highlights fairy godmother magic, animated nature with talking animals, and happily ever after ending. While the latent meaning we grow
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He says, “I do not tell lies. Mother used to say that this was because I was a good person. But it is not because I am a good person because I can’t tell lies.” This means that because of his learning disabilities, his mind physically can’t let him tell something that is not true because he just is not wired that way. People without autism have a better grasp on lies and being told them. He thinks that telling the truth is just something that should be done no matter what and just because he tells the truth does not make him a good person. His mom, however, understands that everyone else lies and she is trying to tell Christopher that he is a good person by not
When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large variation may also be detrimental to the insurance company. This would fall into the category of management of utilization, if hospitals and managed care organizations can control treatment utilization, they can control premium costs for both themselves and their customers (Rodwin 1996). If health care organizations can implement prevention as a way to warrant good health with their consumers, insurance companies can also illuminate unnecessary health care. These are just a few examples of how the health care industry can help benefit their patients, but that does not mean every issue involving physician over utilization or quality of care is erased because there is a management mechanism set in place.
Prostitution has been as issue in many societies around the world for almost all of recorded history. There has been evidence of brothels and prostitution dating far back into human history. Many different societies have different views, ideals, and reservation about the matter. Some cultures around the world view it as a necessary evil for people who need to support themselves and their families. Others view it as morally evil and socially destructive; helping to rot our society from the inside out. Even still there are cultures who don’t view it as evil at all and even a normal part of life. A person’s view on the act is formed largely based on the culture they are living in. Even sub cultures inside of larger one can have different view on the matter, such as religious groups that denounce it, to some groups in the same culture that say it is okay. Even the gauge of how industrialized a country can determine how that culture views prostitution, with many third world countries being more lenient on the matter, and many first world countries being much more strict on the matter, such as the some of the countries in Europe and also the United States.
Health Maintenance Organizations, or HMO’s, are a very important part of the American health care system. Also referred to as managed care programs, HMO's are combinations of doctors and insurance companies that are formed into one organization. This organization provides treatment to its members at fixed costs and decides on what treatment, if any, will be given based on the patient's or doctor's current health plan. Sometimes, no treatment is given at all. HMO's main concerns are to control costs and supposedly provide the best possible treatment to their patients. But it seems to the naked eye that instead their main goal is to get more people enrolled so that they can maintain or raise current premiums paid by consumers using their service. For HMO's, profit comes first- not patients' lives.
What is managed care? According to the Oxford English Dictionary, managed care is “a system of health care in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company.” Managed care is a variety of techniques designed to reduce the cost of providing health benefits and advance the quality of care. In the United States alone, there are various managed care programs, that are ranged from more restrictive to less restrictive. As stated in the National Institutes of Health, the future of managed care is uncertain. It is enthralling to note that in spite of the advances in healthcare systems, such as our hospital’s ability to provide patients with lower cost, managed
The version in the United States is known as Cinderella. Cinderella's mother dies when she is young and her father remarries. The woman he gets married to has two daughters. They become Cinderella´s new evil stepsisters. Her sisters are jealous because she is very pretty and petite. They treat her very poorly. She is to do chores around the house and attend to every need of her stepmother and stepsisters. The Prince is having a ball and requests that every available lady in the kingdom attends. Cinderella is told by her stepmother that she can not attend the ball unless she finishes her chores. She finishes her chores and
Esperanza was a cowardly child who transformed into a brave woman. Alicia and Esperanza had a conversation about Mango Street and Alicia says, “Like it or not you are Mango Street, and one day you’ll come back too,” (Cisneros 107). Esperanza replies with, “Not me. Not until somebody makes it better,” (Cisneros 107). Alicia tells Esperanza that even though she does not like Mango Street, she will still come back, but Esperanza says she will not until someone makes it better. Esperanza does not want to go back to Mango Street even though she is a part of it. Esperanza wants to leave Mango Street for good. Although Esperanza knows she is a part of Mango Street, she does not want to be. The ignorant child believed she could leave Mango behind and forget about where she came from, but little does she know that someone will. When Esperanza decides to leave Mango Street, she says, “They will not know I have gone away to come back. For the ones I left behind. For the ones who cannot out,” (Cisneros 110). Esperanza will leave Mango Street to come back and help those who cannot escape. Esperanza is leaving not for herself, but for others. She grasped the understanding that nobody would do anything to help Mango Street, or care about what happens to it, and decides to take matters into her own hands. Esperanza realizes that she has to be the one to change Mango Street. Throughout the story
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Nearly every American can agree that our current health care system needs reforms. Primarily do to the fact that 45.7 million Americans are without health insurance. That's approximately 16 percent of Americans who sometimes have to do without healthcare, or face crucial financial responsibility. The main issues are admission to healthcare, and the affordability of health care. Before 1920, doctors didn't know enough about diseases to really provide useful care to sick people. Therefore the...
Each person in the world has heard of Cinderella, no matter what kind of version it may be. Cinderella is the one fairy tale story that has been popular and will always be the one tale that has to be told to children. Words and story lines might be twist and turn, but in the end the knowledge of the story will be learned in similar ways. As we all know when one story is told another is created, when one is at its best then another is at its worse. One version will always be better than another, but no matter what version it might be the story will be told.
According to the DSM-5, gender dysphoria is “the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender” (American Psychological Association, 2013). Even though studies have shown that not every individual suffers from distress, it is still possible that an individual might suffers from distress due to the hormonal treatment or surgical procedure(s). In the past, gender dysphoria has been referred to as “gender identity”. However, gender identity, by the DSM-IV definition is “a category of social identity and refers to an individual’s identification as male, female, or occasionally, some category other than male or female” (American Psychological Association, 2000). Individuals that identify themselves with another gender tend to change their sex, which has been proven to be a hard and long process.
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