07-U3-T1-T2: Third-Party Payment, Medicaid and Medicare

Third-Party Payment, Medicaid and Medicare
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Third-Party Payment, Medicaid, and Medicare
Third-Party Payment
Third-party payment approach usually incorporates the coverage of the basic medical services to patients instead of concentrating on covering critical health problems (Buff, 2014, p. 75). Provision of routine medical services inhibits patients from being price conscious or sensitive since their healthcare-related costs are paid by the insurer. As a consequence, the government is forced to spend heavily on these individuals, even though the services they receive are not equivalent to the cost charged (Polite, Ward, Cox, Morton and Hennessy et al., 2014, p. 358). Moreover, the insurance providers tend to inflate their premiums due to lack of price sensitivity on the part of the insured and hence against the normal operation of the market forces. Increased insurance premiums make insurance coverage largely unaffordable, especially to the low-income earners. Furthermore, the existence of information asymmetry among patients and healthcare seekers contributes towards distorting the market.
On the contrary, most governments recommend continued utilization of the third-party system due to the failure of recognizing the real problem in the healthcare services. Additionally, governments also limit the supply of professional doctors and thus hampering with the demand and supply forces. They also believe that the approach is efficient in providing health care services (Polite, Ward, Cox, Morton, Hennessy, Page, & Conti, 2014). Nevertheless, the elderly often enjoy a specific payment program that is different the rest of the population. Such program helps them because of their limited financial capacity to pay for healthcare costs using out-of-pocket money (Yamada, 2017, p. 1747). This payment program also intends to prevent the uninsured elderly from losing property in case of failing they pay for their medical care.
Medicaid and Medicare
Health insurance coverage exhibits several failures, especially as people approach their old age. For instance, poor physician-patient communication makes it difficult for the physicians to sufficiently understand the problems relating to patients. Moreover, there is mismanagement of pain among the patients as the physician usually prescribes many...