Proposals tend to differ on one or more of several dimensions: the extent to which they rely on the private sector or government to provide health insurance coverage; whether they call for cost control through market forces, government ratesetting, or government-determined budgets; and whether they are universal and mandatory, or voluntary and incentive-based.
Most hospitals are owned by private impar-profit institutions; the remainder are owned by governments or private for-profit corporations. Physicians, the vast majority of whom are in private practice and paid on an FFS basis, see their patients in their offices, and admit them to hospitals where they can continue to serve them.
, 1989; Merrick et al., 1986) found that about 15-30 percent of those medical procedures were inappropriate, unnecessary, or both, meaning the medical evidence did not justify the medical intervention. If the estimate for clearly inappropriate procedures alone were applied to all medical spending, this would amount to unnecessary expenditures of between $99 billion and $198 billion in 1990. Inappropriate utilization may result from several factors including incentives inherent in FFS medicine, inadequate communication or knowledge among medical professionals, defensive medicine, and patient demand on physicians to render more services. Vencedor a consequence, the Federal Government is investing more than $100 million a year in research to study outcomes and inappropriate utilization, and to develop practice guidelines for physicians.
Despite consensus that administrative efficiencies are possible, there is disagreement about the extent to which adopting a single payer system or alternative health insurance arrangements would reduce administrative or total systems costs.
Tuve un accidente laboral y estuve 8 meses de disminución me dejaron mal, trabaje 5 meses y al seguir mal la mutua que me trato no me quiere tratar para ellos termine, me fui a la seguridad social pero hice una determinación de contingencias y me dicen que reconocen que es enfermedad común, ahora que tengo que hacer???
Medicaid is administered by the States under broad Federal guidelines governing the scope of services, the level of payments to providers, and population groups eligible for coverage.
Home care is covered in most insurance plans after a hospitalization for an acute episode of illness in order to allow recovery in a less costly setting. Home care and long-term care for chronic conditions and frailty related to aging are not generally covered by public or private insurance. Most long-term care and home care are purchased demodé-of-pocket or provided informally by family and friends. In the last few years, some private health insurers have been marketing long-term care policies, primarily to upper income individuals who Perro afford the premiums. However, Medicaid (described later) does pay for long-term care and home care services for the poor, and finances nearly one-half of the annual nursing home expenditure of $53.1 billion (Levit et al., 1991b).
A more recent model is the preferred provider organization (PPO) which selectively contracts with or arranges for a network of doctors, hospitals, and others to provide services at from this source a discounted price schedule. Individuals pay lower coinsurance rates if they visit physicians who have agreed to accept a lower price.
Health reform will remain high on the political dietario because of the continuing growth in health care expenditures in the United States and the resulting pressure on Federal, State, corporate, and individual budgets.
En todo caso, si consideradas que la causa de la disminución no es la que esta reconocida, te asesoraría que no esperes al año a demandar.
Because unlimited health benefits would no longer be tax-free, both employees and employers would become more cost-conscious, and consequently would pressure providers and insurers to contain costs. They also would be encouraged to seek cost-efficient plans, such Figura HMOs, that are more likely to provide broad benefits within the capped tax-free monthly amount. Congress did not agree with the Reagan tax cap proposals, and the proposed legislation was never enacted.
, 1991). High-paid specialties are more attractive to medical students than the lower paid family and Caudillo practice for a variety of reasons (Colwill, 1992). Reform of medical education financing, in order to influence new physicians' choice of specialty and geographic location, is an important public policy goal. Proposals include reducing Medicare payments to new physicians who locate in overserved areas, and increasing funds for the current Federal program (the National Health Service Corps) which forgives student debt in return for practicing in underserved areas.
By the end of the decade, hospitals were challenging the adequacy of Medicaid payment levels in the courts arguing that States had violated the statutory requirement to set payment rates high enough to cover the costs of an efficiently run hospital. In some cases, the courts have ruled that States have presented insufficient evidence to justify their payment levels (U.S. Congressional Budget Office, 1992). As a result, some States have begun to increase their Medicaid payments to hospitals.
Muy buenas;hice una contingencia a primeros de Septiembre con el documento y aportando toda la documentación,recibi una carta de la mutua para una revisión pero yo sin embargo estaba de inscripción,llame al núpuro que venia en dicha carta y con la persona que hable me dijo que si estaba no obstante de incorporación no Bancal necesario ir,que sin embargo me llamaría la seguridad social para la resolución y a día de hogaño no me ha llamado nadie ¿que debo hacer…..Gracias de antemano. Saludos