Insurance and Payment

Insurance and Payment

Question 1

The third-party refers to any person who pays for medical treatment and is not a patient. The US healthcare system has several third party payments, and they influence the finances of the healthcare facilities. I do agree that quality of care is compromised in the third-party payments because most third-party payers do not pay a full cover to the patients but a portion of the amount of income that the patient owes the hospital (Ali, 2019). Each third party also has its own set of conditions that must be met before the clinician authorize payments on behalf of the patient. Such decisions affect the kind of care that patients receive. In some instances, the patients lack the authority to choose from the variety the best option that fits them because the third party payments are up to a certain limit.

Question 2

Although many people have gained healthcare coverage through the expansion of Medicaid, which is under the Affordable Care Act (ACA), there are still many people left out of the cover, especially elderly childless adults. The elderly childless are disadvantaged due to the lack of someone to take care of them and require more specialized care than their counterparts that have children (Strauss, Pierro, & Forspan, 2019). These people also lack financial assistance and rely mainly on government programs for medical treatment and other specialized services such as caregiver to take good care of them (Ali, 2019). Most elderly childless are poverty-stricken and, to some extent, may have used all their saving on their medicals. Since most of them depend mainly on the savings that they made while working, such savings cannot cater to their medical services until the end of their lives or meet all their requirements.

The elderly childless require love, care, and affection, and this may not be possible if there are no individuals to take good care of them. They need caregivers, and the government needs to increase the current health care to ensure all these services are included in the government health care program.

Question 3

The government needs to mandate the kind of benefits that health insurance covers. Most insurance has hidden policy not known to all citizens, and when an individual falls sick, they are the first to come out to deny paying the insurance because of what they term not specified under the health policy that the patient pays (Strauss, Pierro, & Forspan, 2019). Therefore, specifying the health benefits enable the insurance subscribers to understand the kind of benefits that they are to get from the insurance cover they have taken.

References

Ali, A. (2019). Affordable Healthcare: Challenges to Solutions. FriesenPress.

Strauss, P. J., Pierro, L. W., & Forspan, E. (2019). Financial Planning Challenges Facing Older Americans: How CPAs Can Help. The CPA Journal, 89(5), 22-27.