1 / 23

Health Care Reform: Insurance Companies

Health Care Reform: Insurance Companies. Michelle Berry Megan Dirks Jennifer Ellifritt Louisa Golay Roxy Johanning Krystal Morris. Health Care Reform. Insurance. History of Health Insurance. 1930s- Blue Cross/Blue Shield created Blue Cross-insurance plan to cover hospital care

mervin
Download Presentation

Health Care Reform: Insurance Companies

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Health Care Reform: Insurance Companies Michelle Berry Megan Dirks Jennifer Ellifritt Louisa Golay Roxy Johanning Krystal Morris

  2. Health Care Reform Insurance

  3. History of Health Insurance • 1930s- Blue Cross/Blue Shield created • Blue Cross-insurance plan to cover hospital care • Blue Shield-insurance plan to cover physician care • 1935- Social Security Act-did not include health care • 1950s- Commercial insurance companies began • 1965- Social Security Act amendment to include Medicaid and Medicare • 1970s-1980s-Health care benefits from employers began • 1990s-Managed care plans by employers began to “dominate the health care market” Pulcini & Hart, 2007

  4. Stake Holders • PHARMA • Hospitals • ANA • AMA • State Governments

  5. Social/Legal Issues • All Americans have health coverage regardless of pre-existing conditions • Reform will establish a high-risk pool to enable people who cannot get insurance today to find an affordable health plan • Individuals are healthier, with a greater focus on wellness and better management of chronic conditions • Easier for individuals and small businesses to shop, compare and enroll in coverage Blue Cross and Blue Shield Association, 2009

  6. Social/Legal Issues • We will be able to provide coverage to additional consumers at a more affordable cost • Big cost savings are likely to be found at the level of doctors and hospitals, not in health insurers • Physicians spend on average about 140 hours and $68,000 a year working with insurance companies • Approximately 343,000 people, or 12% of Kansas’s population, cannot access a primary care provider due to shortages in their communities Aetna, 2009

  7. Economic Issues • Reform Malpractice insurance • Over ordering • Over charging-15 % of the population does not have health insurance • Sustainable Growth Plan (SRG) - 17 % Growth Domestic Product in unsustainable growth in health care spending • Community Rating

  8. Ethical Principles • Bill Young, Sr. Vice President and Chief compliance officer for Blue Cross stated: • “Customers should be able to trust the companies with whom they do business with.” • “We pride ourselves on our companies’ commitment to integrity, honesty, ethics and to the peace of mind those traits in return bring to our customers.” (Blue Cross Blue Shield Association, 2009)

  9. America’s Health Insurance Plans • Reform Add about Illness • http://www.youtube.com/watch?v=R36YJl8SagU&feature=player_embedded

  10. The Best Interest For The Patient • Angela Braly, WellPoint CEO stated: • “The current system, including Medicare, which is administered by the federal government, was inefficient and promotes quantity over quality.” • She supports guaranteed coverage for all Americans, but wants to ensure that everyone will stay covered too. (Huffington Post, 2009)

  11. The Golden Rule • Equal treatment for all American people • No discrimination for people with pre existing health conditions • Insurance companies question their autonomy

  12. Stake Holder Associations • Relationship with Pharma: Both support he plan • The proposed reform reduces the gap in Medicare coverage for seniors. • Relationship with Hospitals: Both support the plan • The proposed reform will create an independent commission of doctors and medical experts that are geared toward eliminating waste

  13. Stake Holder Associations • Relationship with ANA: Both support the plan • The proposed reform will allow for more primary care to be given in a family practice setting and reduce the number of unnecessary emergency visits. Also, the proposed reform will promote the use of advanced practice nurses when possible for lower reimbursement costs. • Relationship with AMA: Insurance supports, AMA does not support the plan • The proposed reform will place a cap on the out of pocket expense that may be charged to a patient and will eliminate extra charges for preventive care.

  14. Stake Holder Associations • Relationships with State Governments: Varies from state to state • Republicans support, Democrats do not support

  15. Closing Statements • President Obama’s Health Care Reform Plan has three main goals. (whitehouse.gov) • Provide more security and stability to those who have health insurance.  • It will provide insurance for those who don't.  • Slow the growth of health care costs for our families, our businesses, and our government

  16. Closing Statements • Currently approximately 15% or 45 million Americans are without health insurance. (New England Journal of Medicine) • Under President Obama’s Health Care Reform Plan this means there are a potential 45 million new health insurance customers for insurance companies to pick up. • More customers = more $$

  17. Closing Statements • Linda Blumberg, a health policy analyst at the nonpartisan Urban Institute, a Washington think tank states “The insurers are going to do quite well, They are going to have this very stable pool, they're going to have people getting subsidies to help them buy coverage and . . . they will be paid the full costs of the benefits that they provide -- plus their administrative costs.” (LA Times)

  18. References • America’s Health Insurance Plans (2010). Retrieved January 29, 2010, from http://www.ahip.org/ • Blue Cross Blue Shield Association (2009). Retrieved January 29, 2010 from http://www.bcbs.com/ • Fuchs, V. (2009) The proposed government health insurance company- no substitute for real reform. The New England Journal of Medicine. Retrieved from http://healthcarereform.nejm.org/?p=492.

  19. References • Los Angeles Times. (2009). Health Insurers Set to Benefit from overhaul. Retrieved from http://articles.latimes.com/2009/aug/24/nation/na- healthcare-insurers24 • Medscape Today (2009) AMA endorses senate healthcare reform bill, but warns it will withdraw support unless sustainable growth rate formula is amended. Retrieved January 29, 2010, from Medscape Medical News http://www.medscape.com/viewarticle/714177 • National Public Radio (2010) Opposing views on health care bill. Retrieved on January 26, 2010,from http://www.npr.org/templates/story/story.php?storyId=122993764

  20. References • The Huffington Post (2009) Insurance companies support health care reform. Retrieved January 29, 2010, from http://www.huffingtonpost.com/david-dayen/the- insurance-companies-s_b_276838.html. • The New York Times (2010) No such thing as ‘simple’ health reform. Retrieved January 29, 2010, from http://economix.blogs.nytimes.com/2010/01/29/no-such-thing-as-simple-health-reform/

  21. References • The New York Times (2010) Giving their senators what their constituents have. Retrieved January 29, 2010, from http://economix.blogs.nytimes.com/2010/01/15/giving-senators-the-health-plans-their-constituents-have/ • The New York Times (2010) Is ‘community rating’ in health insurance fair. Retrieved January 29, 2010, from http://economix.blogs.nytimes.com/2010/01/01/is-community-rating-in-health-insurance-fair/ • The New York Times (2010) Defining ‘health care reform’. Retrieved January 29, 2010, from http://economix.blogs.nytimes.com/2009/03/27/defining-health-care-reform/

  22. References • The New York Times (2009) America’s health care priorities II: doctors, hospitals and the quality of care. Retrieved January 29, 2010, from http://economix.blogs.nytimes.com/2009/06/23/americas-health-care-priorities-ii-doctors-hospitalsand-the-quality-of-care/ • The Wall Street Journal (2010) A good start. Retrieved January 29, 2010, from http://online.wsj.com/article/SB10001424052748704675104575001101419588486.html

  23. References • The White House (2009). Office of the Press Secretary. Remarks by the President to a joint session of Congress on health care. http://www.whitehouse.gov • Wilensky, G. (2009) Financing health care reform. Retrieved January 29, 2010, from http://finance.senate.gov/Gail%20Wilensky.pdf

More Related