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At least 181 records · Page 10Linked to original sources
PubMed1975

The Health Maintenance Organization Act of 1973 (P.L. 93-222) and prepaid group practice plans.

Passage of the 1973 Health Maintenance Organization Act (P.L. 93-222) represents a significant effort by the Federal government to experiment with organizational change in the structure of the health care delivery system. The history of the bill is briefly reviewed. The most important sections of the bill are analyzed from the perspective of an existing prepaid group practice plan. The author concludes that the bill contains sufficiently stringent requirements that it will not result in a major increase in the number of Health Maintenance Organizations unless similar requirements are imposed on other private insurance carriers. Furthermore, significant allowance for "phasing in" will be required for the existing prepaid group practice prototype plans to qualify for Federal certification.

Costs and Cost Analysis↗
PubMedDate not supplied

Catastrophic medical protection: a plan for sharing excessive costs.

Cost sharing provisions in both private and public health insurance plans have greatly increased consumer out-of-pocket expenses for medical services in recent years. The effects of these provisions, coupled with the effects of massive unemployment, have been that many individuals are unable to afford adequate health insurance protection. To protect the nation's health, new proposals to expand health coverage have given rise to catastrophic health insurance. This new health policy priority may assist many low-wage and unemployed workers to meet their cost-sharing obligations in the face of rising medical costs.

Deductibles and Coinsurance↗
PubMed1999

The economics of catastrophic health insurance.

Currently over 41 million Americans lack health insurance and would experience severe financial stress if faced with a major illness. Catastrophic health insurance has been proposed as a means of addressing this problem. This study utilizes the National Medical Expenditures Survey of 34,400 households to calculate the cost of catastrophic medical coverage under a number of different assumptions. Estimates of the annual cost range from $109.2 billion to $149 billion, depending upon the size of the deductible, and whether a means test is used to determine degree of coverage. Given the current antideficit climate in Washington, an expense of this magnitude cannot simply be added to the Federal budget. Instead, a simple funding proposal is suggested that provides more than adequate resources to finance the program. Specifically, universal catastrophic coverage would provide insurance companies with relief from approximately $175 billion in medical bills, more than enough to fund even the most ambitious of the proposals.

Catastrophic Illness↗