At present, there is a crisis of sorts that the healthcare industry is going through with regard to health insurance coverage. The number of uninsured people has continuously been rising since 2000 and it is estimated that today about one in four Americans below the age of 65 would not have access to health insurance. Affordable health care insurance needs to become a top priority and this article talks about the attempts of various states to increase health care coverage by providing greater access to healthcare and public coverage to those unable to afford private insurance and also emphasizes the growing reliance on individual coverage. This has implications for the general public, insurers as well as healthcare providers.
Insurers would benefit from the broader eligibility scope of the Medicaid and SCHIP because it would mean greater revenue for them as well as encouraging more carriers to join the business of catering to people enrolled in Medicaid and SCHIP programs. The private insurance market would witness a restructuring and there would be a lesser demarcation between the rules which apply to group and individual coverage. All of this gives states a lot more power to determine the terms at which coverage will be offered and they will also be managing the quality of healthcare delivered.
For hospitals, this means a radical reform that will help them solve the chronic problems of high healthcare costs, lesser than optimal quality at times, and lack of insurance which have afflicted the industry for many years. While public coverage will still expand incrementally over the years, it is the higher accessibility of private insurance which is serving as an opportunity for change. At this point, this change will be led by individual states which are looking for solutions to the healthcare problems plaguing them, and they are planning on increasing individual coverage either through public programs or private. When state governments start playing an active role in coordinating how state programs and private insurers finance healthcare delivery, the contribution of Medicaid and SCHIP is likely to increase.
As hospitals witness higher levels of financing which is more stable in nature, this will be a welcome change for them as it will reduce their reliance on charity care as well as incidences of bad debts with patients who have inadequate health insurance coverage and low-income levels. State governments would have developed incentive programs to increase quality and control costs. But, this means a change in the way hospitals have functioned for years: an overhaul in patient care, billing practices, and reporting would have to take place in order to meet the requirements of the reformed system.
There are also important implications for the consumers as changes would also occur in the kind of insurance and healthcare demanded by them. Consumers who perceived there to be a lesser need for health insurance would opt for high-deductible plans while lesser healthy or those consumers who most likely to need insurance would be left with low-deductible plans. Since the low-risk segment of the population would select high-deductible plans, this would render the low-deductible plans financially unviable. Also, as consumers bear a larger portion of healthcare costs, the demand for preventive care to prevent illness or injury will decrease. Hence, healthcare providers would have to promote the health benefits as well as cost-effectiveness of preventive care to consumers.