U.S. Healthcare System

The current healthcare system in the United States has changed from managed care to healthcare management. Its center of gravity has gradually shifted from merely caring for the patient to caring for the health of the entire population. In recent years, health insurance has not only served the insured, but has also provided information and technology to health care workers through its comprehensive and integrated services, giving them access to the latest scientific and technological information. Effective health plans encourage patients to get tested; individualized treatment plans are designed for the chronically ill as never before; doctors are provided with the latest treatments; and the health care system is unmatched in its ability to analyze information, manage finances, and meet the rising information needs of hospitals and medical staff, and to assist them in making the best possible treatment plans.

The new system has achieved tangible results in the shift away from lump-sum health insurance and reactive medical compensation programs, which were difficult to monitor in the past. This can be seen in several ways:

First, ****together with participation is an indispensable element for the smooth running of the insurance program. Doctors are thus able to make clinical decisions more effectively; and enrollees are more aware of, for example, how the insurance program works and how they can benefit.

There are three broad types of health insurance in the United States:

1) Government insurance: the government, through the Public Health Service (PUBLIC HEALTH

SERVICE), which includes health care organizations (e.g., hospitals, medical colleges and universities) and research institutes; and

Social Security Services, such as those that administer the MEDICARE and MEDICAID programs. Programs implemented by the Department of

Medicare Programs

2) Commercial Insurance: are a number of general insurance companies

3) Business owners pay the majority of the cost of the business, and the insured individual pays the rest of the cost of the corresponding

There are a variety of health plans in existence, but the selection of the most suitable insurance plan for you is the

most important.

The renowned Blue Cross and Blue Shield insurance company uses a questionnaire to help its customers make their choice:

The questions are as follows (each question is worth 1, 2 or 3 points depending on whether it is a yes, a neutral or a no question):

1) Do you travel a lot? Would you like an insurance plan to ensure your safety and that of your family when you go

away from home, e.g., to college, on long trips, etc.?

2) Have you been sick before?

3) Is it important to you to be able to use a particular prescription drug?

4) Do you think it's important to be able to get access to specialists without a referral from your doctor

5) Would you prefer to choose your own doctor or hospital, but it may cost more

6) Would you like to be able to be provided with a plan for your routine and preventive care

7) Would you like to have the responsibility for covering the most of your medical expenses

Are you willing to change family doctors to save money?

Clients can choose the right insurance plan based on the score of the question

Score: 8-11 can choose HMO health insurance

Score: 12-16 can choose POS health insurance

Score: 17-20 can choose PPO health insurance

Score: 21-24 can choose one-time payment health insurance

What is a PPO

[Preferred Provider Organizations] (PPOs) are health insurance plans that offer discounts on medical expenses exclusively for members. Members must go to a designated provider who may or may not be a member of the PPO network.

What is an HMO

HMO stands for Health Maintenance Organization, and is designed to provide financial risk and delivery risk to volunteers who provide health care services in special areas, usually for a fixed return and in advance.

What is POS

The full name of POS, Point-of-service, allows members the freedom to choose their provider, which can be any provider within or outside the organization's network.

What is a health care provider

A health care provider is an organization or individual such as a hospital, medical facility, doctor or other health care worker who can provide health care services.

What is a PCP (PRIMARY CARE PHYSICAN)

A PCP is the initial and primary provider of services in a health insurance plan, such as a doctor or medical professional, also known as a PERSONAL CARE PHYSICAN or PERSONAL CARE PROVIDER. In general, the implementation of the health care system is a rigorous "referral system" consisting of PCPs to state-of-the-art treatment programs and an oversight process by so-called "gate-keepers," an evaluation body. It is incumbent on health economists to do more to reduce spending, redirect resources, and ensure that Medicare grows.