Alyssa is an active RN and teaches Nursing and Leadership university courses. She also has a Doctorate in Nursing Practice and a Master's in Business Administration.
Health Care Financing in the United States
The United States operates in a largely free-enterprise system, meaning that the healthcare economy is competitive and capitalistic in nature. Numerous options exist for individuals and companies to finance healthcare, which in turn provides excellent variety in services and products. Other than public healthcare programs (state or federally-governed), many private healthcare organizations (private insurance companies) and the recent development of healthcare exchange programs exist to address the need for health coverage.
The United States healthcare system relies on many means to financially support its mission of providing quality care to all Americans. Regardless of program, location, and population, the American healthcare systems largely relies on:
- Individual tax deductions
- Government subsidy (federal funding)
- Private insurance companies
- Personal payments for services
Bill is an entrepreneur attempting to leave his current construction job to start his own business. He is working on developing a business plan and is researching all the details on how to make his dreams actually happen. Because Bill has always cared a lot about his own health and the wellbeing of his family, he is reading about his options as a business owner and considering offering insurance to his future employees.
The Basics of Coverage
Through the use of existing healthcare coverage systems, companies and individuals alike have the opportunity to select plans that best meet their needs. This practice of choosing a plan as an individual or through the organization in which you work is not mandatory to be a part of, but may be offered as an additional incentive of employment. People often choose to adopt their workplace's healthcare options because it allows them to pool their contributions with a larger sum of coverage funds. This pooling of funds benefits the individual by allowing access to a larger amount of funds if the unfortunate need for catastrophic care (high acuity/high cost) ever arises.
Where Bill currently works, he chooses one of several coverage options provided by his company each year. Not only is obtaining insurance through his company tax free, the cost of participating in this healthcare program is much less expensive than if he were to go out and seek coverage as an individual, because the healthcare insurance company takes on less risk with larger groups. Through the pooling of financial resources, like regular pay check deductions that contribute to the plan, Bill's insurance plan is able to offer more services and reduce the high costs related to care because there are more funds available to cover the healthcare costs of a particularly large group.
Considering His Options
Bill is passionate about providing healthcare options for his future employees, but is unsure that his future start-up company will have enough employees to qualify for group rates with private insurance companies. He decides to at least compile a list of options for healthcare coverage to present to future job candidates when begins interviewing for his new company.
- Government Programs: Programs like Medicare and Medicaid exist and are available for certain populations. These programs can be restrictive, and individuals wishing to participate must meet specific criteria to be included.
- Private Insurance Options: Bill gathered program information from several private insurance companies. He made sure to include the most affordable and practical in his list of options.
- National Healthcare Program: Due to changes in health-related legislature over the past few years, the option for coverage through the national health program now exists. Individuals and families can sign up for coverage online or via the telephone to enroll.
Many options exist when seeking healthcare insurance in America. Due to its capitalistic principles, both private and public organizations provide many options for coverage, including large companies in the business of insurance and public programming options that exist to support the health of large populations. Insurance programs require significant funding, and obtain financial support through taxation, membership fees, and government subsidy.
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