Changes in the Healthcare Plan - Article Example

Point of Service Plans Affiliation: The article points put the fact that health care plan has shifted since 1998 for employees and especially the full time government employees. Before 1998, the government at both the local and state level used to be in charge of providing the health insurance of their employees and paying for it fully while at the same time the employees enjoyed other benefits of health care insurance like reduced costs, family members being covered in their insurance scheme among other benefits (U.S. Bureau of Labor Statistics, 2012). Health care costs have been on the decline but so have the health care services at the prompting of the government. The health care sector has changed its insurance plans which used to be high but were being paid in large amounts by the employers to a “more cheaper, manageable and consolidated” plan where the patient (employee of the family member of the employee) receives medical care from one point and the physician acts as the point of service of the patient (Point of Service health plan). The new plan as explained in detail by the article reduces the health care costs but at the same time increases other costs like family deductibles, premiums and even the out-of-pocket expenses. All these expenses are almost fully paid by the employee and not the employer and hence increasing event he burden of health care further than it previously was before this new merger of Preferred Provider Organization plan (PPO) and Health Maintenance Organization plan (HMO) that brought about the birth of Point of Service plan (POS) was formulated and implemented. The latest statistics collected by the Bureau of Labor Statistics (BLS) in the United States of America show that the employer no longer fully caters for the health care plans of their full time employees. The statistics indicate that in 1998, over 86% of the employees participated in a medical insurance plan which catered for all their health problems. However, data collected in 2011 shows that only an average of 82% of the employees are involved in a medical plan. The plan the government employees were being offered and are still being offered is the Point of Service Plan. The decline in the health care plan has been pin-pointed to certain services like dental care, prescription drug coverage for outpatients and even in visual care. This is attributed to the fact that these services are costly and hence the employees cannot afford to pay for them. These services are also usually not provided in local health care centers and hence requires the patient to seek them in other health care facilities which mean under the current medical plan, they have to pay the charges from their own pockets and most just fore go them altogether. Part-time employees have not been left behind in this decline. According to the same statistics presented in the article, the decline of obtaining the medical cover in the same services mentioned above has been from 37% in 1998 to 18% in 2011. As a result of the extra charges that accompany the Point of Service plan; its enrolment amongst most employees was recorded to be only 5%. The article further explains how the cost of health insurance underwent an all-time increase between 1998 and 2011 and this prompted the employers to withdraw from paying full insurance premium like before and hence left the burden to employees. The average percentage decline of such employers’ commitment was from 49% to 34%. This therefore necessitated the health insurance premium payment for employees to increase by nearly three times what they previously were paying. The family deductibles which were health insurance cover for the family of the employees also rose from around $400 in 1998 to $1000 in 2011. The government had shifted the health care from Health Maintenance Organizations plans (HMO) to Point of Service plans (POS) as a way to reduce the health care costs for its citizens. This new plan though was formulated with good intentions has brought about its share of disadvantages which have prompted employees to reject it quietly and opt for lack of proper health care. One of the major disadvantages that have contributed to its decline is the fact that the low medical costs associated with it cover only minor health care problems and the major ones have to come from the pockets of the patients. The POS plan also limits the number of health care options in terms of consultation an employee has despite it being said to be open. It is only open to those who can afford to pay for the consultation services of another physician who is not the designated “point of service physician” and they are not many. This therefore has necessitated many employees to opt not to continue with this plan and hence its decline with time. With more employees realizing that the current health care plan being provided is costing more than they can afford, they have opted to restrict their health care plans or just utilize the limited services being provided and ignore the others at the expense of their health to avoid all those extra charges that are mostly “hidden” and not discussed or explained to them. These options have therefore greatly and still greatly continue to cause more decline in this health care plan just like the other plans declined in the past. Even with the decline and the options being taken by employees, some of the employees still continue with this plan hoping that the government will come to their rescue someday. Others continue with it as they have no other health care plan and hence no other options or limited options and especially where their families are concerned. The general conclusion of the article however is that the level of participation from 1998 up to 2011 of the health care plan and coverage has continued to decline while at the same time the costs of the plan to the employees continue to increase (U.S. Bureau of Labor Statistics, 2012). References U.S. Bureau of Labor Statistics. (June 2012). “How have health benefits changed in state and local governments from 1998 to 2011?” Beyond the Numbers, vol. 1, no. 5. Retrieved from: http://www.bls.gov/opub/btn/volume-1/how-have-health-benefits-changed-in-state- and-local-governments-from-1998-to-2011.htm Read More