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Argumentative on Health Insurance and Managed Care - Essay Example

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Name Instructor Course April 25, 2012 Outline Introduction Cost Costly but Superior No out-of-pocket Payments Access Increase Healthcare Access Choice of Physicians Bureaucracies hindering Access in Health Insurance Quality Preventative Confidentiality Construed Objectives Conclusion Health Insurance vs…
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Argumentative on Health Insurance and Managed Care

Download file to see previous pages... Insurance, on the other hand, is a plan aimed at paying premiums to a company that in turn remits the funds to the health care provider of one’s choice. However, health insurance, as opposed to the option of managed care, is business focused rather than a healthcare service provider. Rates / Cost The goal of this 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 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 to 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 this 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 certain 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. In spite of all the glamour in choosing ones healthcare provider in health insurance, there is a significant disparity between ...Download file to see next pagesRead More
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