Zamosky - Healthcare, Insurance, and You: the Savvy Consumers Guide
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Healthcare is changing and you need to know how-and what to do about it. Getting good medical care shouldnt be so confusing-or so costly. Healthcare, Insurance, and You simplifies the many confusing details about our healthcare system so you can make informed decisions. Result? Better health at lower cost. With the advent of healthcare reform, things are changing-especially when it comes to insurance. Most people will now have to buy insurance. Do you know where to get a policy or what to look for in one? Did you know more people will now qualify for free or subsidized healthcare? Even if you get insurance through work, youll face new choices that youd better understand to maintain your peace of mind. As this book shows, the failure to understand how insurance and the healthcare system work can have a major impact on your physical and financial health. Healthcare, Insurance, and You is an easy-to-use guide that explains the main challenges you face when trying to get excellent healthcare: choosing the best insurance policy for your situation, finding the right doctor or hospital, buying prescription drugs the least expensive way, picking out the right Medicare plan, or fighting for your rights when dealing with insurers or medical providers. Healthcare, Insurance, and You includes tips, resources, and strategies for navigating the healthcare system and avoiding common mistakes so you can get the best healthcare for you, your family, or your organization without breaking the bank. This book shows you: How to choose a health plan that best meets your medical and financial needs, including new options under the Affordable Care Act Ways to cut through red tape and fight billing errors and claim denials What businesses need to know about offering-or not offering-insurance to employees How to plan ahead for a disability or for end-of-life care Healthcare costs rank high on the list of money concerns Americans have. And when it comes to getting great healthcare for you and your family and avoiding crippling medical bills, knowledge is power. Healthcare, Insurance, and You is a practical guide that explains the complicated healthcare system in plain language-and puts the power of good health back in your hands.
Zamosky: author's other books
Who wrote Healthcare, Insurance, and You: the Savvy Consumers Guide? Find out the surname, the name of the author of the book and a list of all author's works by series.
Mark L. Friedman
Jeanne Moore
Archelle Georgiou MD
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Lisa Zamosky Healthcare, Insurance, and You The Savvy Consumers Guide 10.1007/978-1-4302-4954-2_1
Lisa Zamosky 2013
1. A New Healthcare System
Things Are About to ChangeBig Time!
Lisa Zamosky 1
(1)
California, USA
Abstract
The Patient Protection and Affordable Care Act (President Obamas health reform law) is ushering in major changes to the American healthcare system. Millions of people will gain new access to health insurance coverage and go about shopping for and buying a health plan in new ways.
The Patient Protection and Affordable Care Act (President Obamas health reform law) is ushering in major changes to the American healthcare system. Millions of people will gain new access to health insurance coverage and go about shopping for and buying a health plan in new ways.
Operating Below Capacity
To understand the changes coming, its helpful to know where we are today and how thats led us down the path to health reform.
The United States stands alone when it comes to healthcare. Many of us have come to believe that we have the best system in the world. And, no doubt, the United States is home to some of the most advanced medicine the world has to offer. But we also fall short, horribly so in fact, in some key areas.
If youve been paying for health insurance for a number of years, I dont have to tell you that premiumsthe monthly cost of your health plankeep rising. Trips to the doctors office or the hospital have gotten pricier too. And, for millions of Americans, it seems accessing health insurance benefits has become a complicated maze you have to wend your way through without a road map.
Jargon alert
A Premium is the cost of a health insurance policy. Often paid on a monthly basis, these are the payments you make to keep an insurance policy in place.
What are we getting for the high price we pay?
In America, we spend more on healthcare than any other industrialized country, and we get less for our money. Here are some quick statistics to put things in perspective:
- In the United States, we spend more than $8,300 per person annually. Compare that to the $5,000 the worlds second and third biggest healthcare spenders, Norway and Switzerland, spend per person.
- Despite the higher price we pay, Americans actually see the doctor and are admitted to the hospital less frequently than citizens of other countries.
- Our rates of preventable death due to asthma and diabetes-related amputations, among other conditions, are the worst among 12 other industrialized nations.
Whats more, a study released by the Institute of Medicine (IOM) and the National Research Council found that people in the United States younger than the age of 50 live their lives in worse health and die younger than people in 16 other wealthy countries in Western Europe, Canada, Australia, and Japan.
There are a number of reasons for our poorer health. We eat more and less nutritionally, have higher rates of drug abuse and deaths from guns, wear seatbelts less often than people in other countries, and have more alcohol-related traffic accidents. Another main reason cited for our poor health has to do with our healthcare system. Unlike other countries, we have millions of people without health insurance and much more limited access to primary care. And Americans, according to the IOM report, find it harder than people in other countries to get the care they need and to be able to afford it.
In short, citizens of other countries are healthier, yet in some cases the price of healthcare is about half the cost of what we pay here in America.
We are the only industrialized country that doesnt guarantee healthcare and some kind of insurance coverage to our citizens.
We have been on an unsustainable path. Fewer people are being offered health insurance at work, and employers are struggling to keep up with the cost of making health benefits available to their employees.
Whats more, those among us who dont get health benefits at work and buy insurance on our own are faced with a host of challenges around getting the coverage we need to help pay for medical care, including high insurance costs and fewer benefits in exchange for the high price we pay.
Health Reform Is Changing Your Healthcare
These, and other forces, led to the passage of the Patient Protection and Affordable Care Act, also known as health reform and Obamacare. Signed into law on March 23, 2010, the Affordable Care Act represents the most significant overhaul of our nations healthcare system since the Medicare law was passed 1965.
Many people have called the law a government takeover of healthcare. Its important to understand, however, that the most fundamental aspects of our current systemthat care is delivered by private doctors and hospitals, that health plans are sold by private insurance companies, and that the majority of Americans continue to get their health insurance through their employersremain intact.
But it is true that through the new law, insurers, healthcare providers, and employers will all face new requirements in the interest of expanding health insurance coverage to millions of uninsured Americans.
No matter where you stand on health reformwhether you believe the law is in the best interests of the country or a horrible mistakemost people agree that something fundamental about our healthcare system simply must change if its to serve the needs of all our citizens.
Healthcare costs in this country have continued to rise at rates that far outstrip our earnings, and there is considerable fear that without finding ways to curb how much we spend on healthcare in the United States, were going to face serious trouble. Likewise, efforts to improve the quality of the care were paying for are underway and offer some hope for improving the inadequate level of care that comes in the form of poor coordination, a lack of preventive medicine, and medical errors that result in needless deaths each year.
Insuring the Uninsured
At least one part of the solutionand a central goal of the new health reform lawincludes making sure more Americans have access to health insurance. With most of the country able to gain coverage, the theory goes, those of us with health insurance will no longer pay for those without coverage who tend to get medical care through expensive emergency room visits or who fail to catch treatable illnesses early because they dont have access to preventive care. Part of the price we pay for our health insurance includes paying for the costs resulting from medical care that goes unpaid for because some people dont have coverage.
The health reform law takes aim at our countrys growing number of uninsured and makes an effort to keep future healthcare spending down. It does this largely by making changes to the way insurers and healthcare providers operate and get paid.
Big Changes: More for Some than for Others
The changes on the way as a result of the law will vary, depending on who you are, whether you already have health insurance, and where you get your coverage (at work vs. on your own).
The biggest changes, at least early on, will be in store for people who have middle or low incomes. Starting in 2014, these groups will be eligible for financial help to pay for their insurance coverage.
The law will also have a huge impact on people with pre-existing medical conditions who do not have access to health insurance through work and have been unable, because of their illness, to buy a plan on the private insurance market. Again, this changes starting in 2014, when insurers will be prohibited from turning away anyone interested in buying a health plan.
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