issues and advocacy
Most long term care insurance pays for some or all of the long term care you may need, but does not guarantee that you will be able to find a long term care facility with an opening near where you live. An alternative approach is a retirement community that not only provides payment for long term care, but also provides guaranteed access to a long term care facility nearby. These communities often require a significant payment to join. They are often called Continuing Care Retirement Communities (CCRCs) or Lifecare Retirement Communities.
"Group Health Insurance" is health insurance that covers all eligible people in a group regardless of their age or physical condition. In the U.S., group health insurance has generally been provided by employers. Thus, the concepts of employer-based insurance and group health insurance have become linked. However, group health insurance can be provided by other types of organizations such as professional and trade associations, unions, social or civic groups, and governments.
Medicare Prescription Drug Plans were originally created during a time when drugs were less used and less expensive. As drug prices have gone through the roof, and drugs are prescribed in greater numbers, older individuals for whom Medicare was designed have found it increasingly difficult to pay for their prescriptions. The Medicare Prescription Drug Improvement and Modernization Act of 2003 was intended to address this issue.
Politics and health care have a very close yet adversarial relationship. Health care practitioners accuse politicians of making decisions that compromise their ability to provide appropriate care without giving them protection the protection they feel they need to be safe from frivolous malpractice lawsuits. Politicians in turn criticize the health care system for skyrocketing medical costs. They claim this is making health care in the U.S. an elitist system, one which provides less affordability and accessibility to the people who need it most.
"Adverse Selection" happens when unusually high-cost people select an insurance plan. Informally, people often use the term adverse selection when people with expected costs that are higher than a population average sign up for a policy. For example, suppose the average expected cost for employees at a company is $2,000 and that one of the health plans offered by the company attracts people with an average expected health care cost of $3,000. The insurer might complain about "adverse selection" -- saying that people who selected that plan are sicker than average.
When someone asks an insurance company to pay a bill, this is called a "Claim." The "Medical Loss Ratio" is the amount that an insurance company pays for claims divided by the premiums that people paid for insurance. For example, if an insurance company pays an average of 80 cents in claims for every dollar it collects in premiums, then its medical loss ratio is .80.
Without health insurance, a single hospital stay could leave you deep in debt and your savings account empty. By having health insurance you gain some peace of mind. Insurance companies pay for most of the bill, but exactly how much they pay depends on the contract, or policy, you sign with them. Insurance company practices vary from plan to plan, so be sure to compare premium, deductible, and co-payment amounts, and the level of service they provide, before choosing an insurance product.
More than 45 million Americans go without health care. At 14% of the gross domestic product, national health care spending is at an all time high. Health care issues and prescription drug costs continue to gain increasing attention during election campaigns, and many Americans are calling for the need to provide national health coverage as a universal service to all residents.
Many people are concerned about the number of people who lack health insurance in the U.S. There have been proposals for "Universal Health Insurance" to ensure that everyone has health insurance -- either public or private insurance, through a group or as an individual. "National Health Insurance" is one form of universal health insurance in which the private market for insurance is eliminated and the government directly insures everyone.
