Question

Chapter 10, Health Care Financing What does finance of the health care system include? What makes the U.S. health care system unique? Describe the insurance system? What is insurance? What are premiums? What are cost-sharing mechanisms? Explain them Copayments Deductibles Co-Insurance Define public health insurance. Give examples of public insurances in the U.S. What is private health insurance? Privately financed health care Give examples of the private insurances. Health insurance - is it a commodity or a right in the U.S.? How does it work? How do individuals pay for health care in the U.S.? U.S. National Health Expenditures and its share of GDP U.S. health care per capita cost Insurance rates - public versus private What is managed care? Describe its key characteristics Differentiate between HMOs and PPOs plans Explain moral hazard (economic theory) What mechanisms do insurers use to influence the behavior of beneficiaries? Cost-sharing mechanisms Copayments Deductibles Co-insurance What mechanisms do insurers use to influence the behavior of providers? Capitation Gatekeeping Pre-authorizations Referrals What do employers do when premiums go up? Cost-shift to whom; how? Describe consumer-driven health care and high deductible plans What is Medicare? - who does it cover, who pays for it, what does it cover - Parts A, B, C, D What is Medicaid? - who does it cover, who pays for it What year was the Medicare/Medicaid law enacted? Examples of fixed payment approaches Differentiate between prospective and retrospective payments models

Answer 1

Answer: The finance of healthcare system includes the revenue collection which is the basic function of the finance system. It also includes collection of resources as well as purchasing of interventions.

The US healthcare system is unique because it doesn't not have uniform healthcare system. It does not provide universal health coverage. The healthcare coverage is for the people insured with Medicare or Medicaid.

The insurance system involves as the people get themselves insured under Medicaid or Medicare. People need to pay monthly or yearly premiums. The insurance companies reimbursed the expenses of the treatment according to the type of health insurance.

Insurance means protection from the loss of finance. In the healthcare insurance means providing coverage for the treatment. This mainly aims to provide financial support in case of treatment.