The United States spends more on health care than any other country in the world. U’S’ health care expenditures have gone from 5.3 percent of the gross national product in 1960 to 14 percent recently. Yet the percentage of full-time workers receiving job-related health benefits has declined, with over 45 million Americans uninsured as of 2005. The United States also trails Japan and western Europe on measure of life expectancy and infant mortality.
Unlike workers in most western European countries, who have nationalized health systems, the majority of Americans received health insurance get it through their( (or a family member’s) employers. Consequently, health insurance. like pensions, discourages employee turnover because not all employers provide health insurance benefits. Not surprisingly, the fact that many Americans receive coverage through their employers has meant that many efforts at controlling costs and increasing quality and coverage have been undertaken by employers. These efforts, broadly referred to as managed care, fall into six major categories: (1) Plan Design (2) use if alternative providers (3) use of alternative funding methods, (4) claims review, (5) Education and prevention, (6) external cost control systems.
One brand in plan design has been to shift costs to employees through the use of deductibles, coinsurance, exclusions and limitations, and maximum benefits. These costs can be structured such that employees act on incentives to shift to less expensive plans. Another trend has been to focus on reducing, rather than shifting, costs through such activities as permission testing and second surgical opinions.
The United States spends more on health care than any other country in the world. U’S’ health care expenditures have gone from 5.3 percent of the gross national product in 1960 to 14 percent recently. Yet the percentage of full-time workers receiving job-related health benefits has declined, with over 45 million Americans uninsured as of 2005. The United States also trails Japan and western Europe on measure of life expectancy and infant mortality. Unlike workers in most western European countries, who have nationalized health systems, the majority of Americans received health insurance get it through their( (or a family member’s) employers. Consequently, health insurance. like pensions, discourages employee turnover because not all employers provide health insurance benefits. Not surprisingly, the fact that many Americans receive coverage through their employers has meant that many efforts at controlling costs and increasing quality and coverage have been undertaken by employers. These efforts, broadly referred to as managed care, fall into six major categories: (1) Plan Design (2) use if alternative providers (3) use of alternative funding methods, (4) claims review, (5) Education and prevention, (6) external cost control systems. One brand in plan design has been to shift costs to employees through the use of deductibles, coinsurance, exclusions and limitations, and maximum benefits. These costs can be structured such that employees act on incentives to shift to less expensive plans. Another trend has been to focus on reducing, rather than shifting, costs through such activities as permission testing and second surgical opinions.
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