The Cost Of Medical Care Without Health Insurance
Many people today are finding that the cost of health insurance, whether for an individual or a family, has risen to such an extent that they simply cannot afford the cover they need and are either doing without cover altogether or taking the minimum cover available and hoping and praying that they do not have an accident or get sick.
Calculating the direct cost of health care without insurance is rather like trying to say how long a piece of string is because no two people with have the same health needs. However, we do know that the costs are far reaching. For example:
1. People now say the main reason for not having health insurance is the high cost and surveys show a direct relationship between rising health care costs and the fall in health insurance coverage.
2. In the past year a quarter of those individuals without medical insurance have had a problem meeting medical bills and have had to make major changes to their lifestyle in order to meet medical bills.
3. During the past twelve months about one-third of those people without health insurance have had to put off medical treatment, frequently for quite serious conditions, simply because they could not afford the cost of treatment.
Health insurance has now risen very much to the top of the political agenda and nearly half of all Americans now say that it is their main economic concern. Indeed, more that eighty percent of Americans say that they are dissatisfied with the way in which health care is being financed and delivered today.
Perhaps most shocking of all is the fact that someone in the United States files for bankruptcy every 30 seconds as a result of a serious health problem. This of course does not just affect those without health insurance, but also includes those who are under-insured or whose plans have high deductibles and high out-of-pocket expenses which they simply cannot afford to meet.
50 percent of all bankruptcies are caused in part by medical bills and the average out-of-pocket medical bill debt for people filing for bankruptcy is now $12,000.
Claim: An itemized statement of health care services and their costs provided by a hospital, physician's office, or other provider facility. Claims are submitted to the insurer or managed care plan by either the plan member or the provider for payment of the costs incurred.
Indemnity wraparound policy: An out-of-plan product that an HMO offers through an agreement with an insurance company.
Pharmacy and therapeutics committee: Committee charged with developing a formulary, reviewing changes to that formulary, and reviewing abnormal prescription utilization patterns by providers.
Rate spread: The difference between the highest and lowest rates that a health plan charges small groups. The NAIC Small Group Model Act limits a plan's allowable rate spread to 2 to 1.
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