Note: Sample below may appear distorted but all corresponding word document files contain proper formattingExcerpt from Term Paper:
What this in essence means is that the patient would not be able to choose his own brands of medication; he must only buy what the committee has recommended, otherwise, he would lose out on his health insurance payments.
A woman who faced a problem similar to that mentioned above talks about her experience as a diabetic. She said that when the health insurance company stated that they would be able to pay for a higher priced drug to control diabetes, than the one that the committee recommended, she argued and fought it out with the company, until, eventually, they agreed, albeit reluctantly, to pay for the higher priced drug 'Glucophage.' Her experience was that as soon as she started on hits drug, she found to her amazement that her sugar levels had started to drop considerably, and that her vision, which had been deteriorating for quite some time, gradually started to return to normal. Her problems were not over, however. (Damocles; Bykin, 2004)
According to this woman, when her employers became aware of the fact that she had experienced a loss of vision because of her diabetes, they started to consider her more of a liability than an asset, especially in relation to the steep costs that the company would have to incur in term of health insurance payments and other benefits for her. She was fired, and she found herself with no job, and also no health insurance, and with a chronic disease to manage. Since she had already exhausted all her savings in trying to pay for her medications, and really could not afford to pay for her insurance premiums any more, she found that she was in a tight quandary indeed. There were no jobs available for an over-qualified fifty-five-year-old, and by the time she found a small job, she was off her all important medication for almost a year, because of which she lost her vision, and developed serious cataracts. (Damocles; Bykin, 2004)
In America today, there are almost eight percent children and adults, who live without life and health insurance, and it is a fact that the uninsured population will continue to grow steadily over the next few years, unless some sort of action is taken by the government and by health insurance companies. (Iom, 2004) It must be remembered that health care in the United States is considered to be one of the most expensive in the entire world today, and in general, access to health care is dictated and controlled by private and government based insurance companies. As far as the diabetic population is concerned, about 10% to12% is left uncovered by health insurance. (Ekoe; Zimmet; Williams, 2001)
For a diabetic, as mentioned earlier, the costs of managing the disease, seeking health care, and insurance can be prohibitive indeed, and a diabetic, on an average, spends about $13,243, when compared to a healthy person, who spends about $2,560. This is the reason why accessing health insurance is extremely important for an individual with diabetes; costs must not deter the person from seeking out the best medical care available to him. (Yu; Stjernholm; Munier, 2004) This is especially true where minorities, such as Hispanics and ethnic races are concerned. (United States Congress; Select Committee on Aging, 1992) The U.S. Health Care system is in general oriented towards the reactive treatment of disease, and as a direct result, the costs of providing health care is largely motivated by illness related care. (Clark; Cefalu, 2000)
Health insurance companies must gear up to deal better with diabetics, and in certain states, like for example in Montana state law allows health insurance companies to turn people who approach them for insurance, at will, based on the status of their health, and in most cases, diabetics are considered to be 'uninsurable'. (Montana: American Diabetes Association) Obtaining insurance cover can therefore be an uphill task for a diabetic, and some agencies, like for example, the Diabetes Federation of Ireland in conjunction with ERM Financial Services have managed to negotiate, with insurance underwriters, a number of schemes that a diabetic would find useful in managing his disease efficiently, as also in availing of health insurance benefits. Some of these are: Motor Insurance, Travel Insurance, Group specified Illness and life cover, Group Personal Accident Cover Mortgage & Mortgage Protection Facility and Household Insurance Cover. (Diabetes & Insurance: Diabetes Federation of Ireland)
Research has revealed the fact that among adults who have diabetes, almost 92.0% have some form of health insurance or the other, but at the same time, almost 640,000 people with diabetes do not have any health or life insurance. Of those diabetics wit insurance, 10.3% are covered under Medicare, 69.3% by private health insurance companies, 5.5% by military benefits, and about 14.1% through Medicaid. Among these people, there is absolutely no difference in the types of diabetes; the health insurance is accessed by insulin-dependent diabetes mellitus sufferers, and also by non-insulin dependent diabetes mellitus sufferers. However, there are subtle differences between coverage for males and females; everywhere, it was found that males availed of more health insurance than females. (Harris, 1995)
When the sufferer is a child, then the problems become compounded, because of the fact that diabetes places severe restrictions upon one's lifestyle and habits. One case is that of a woman, whose son, aged 19, is a diabetic. He is covered by health insurance, under the mother's, and also under the father's plans, which are sponsored by their employers in the state of Oregon. The son would start to receive insurance from SSI and from Medicaid, both through the state of Washington. Suffering from severe depression and anxiety and other related symptoms, he has reached a point where he does not care any more about managing his disease. His parents and his doctors are at the present engaged in trying to get him admitted to the Cumberland Hospital for Children, where people up to the age of 22 are admitted, but the fact is that the insurance company will not accept this, and is fighting the parents all the way, and the parents have had to employ an attorney at great cost to manage these issues. (Children with diabetes, insurance costs, ask the diabetes team)
Another similar case is that of a young girl, who has to purchase test strips that would test her urine ketones. Expensive to buy on a regular basis, her parents sought help from the insurance company that handles her case, but the company refused outright to cover the test strips, even though it is a very important part of her management strategy for diabetes. (Ask the diabetes Team)
To conclude, it must be stated that the quality of health insurance that is available to diabetics in the country today is more often than not inadequate, and a diabetic must be ready and willing to manage his disease with the little or no resources available to him. The government and private insurance companies must sit down and formulate policies that would handle the issue in a better manner, so that these chronic sufferers would get some respite from the great burden that the disease places on their resources.
ADA and Georgetown University Health Insurance Research" Retrieved at http://www.diabetes.org/advocacy-and-legalresources/healthcare/insurance-research.jspAccessed 24 July, 2006
Ask the diabetes Team" Retrieved at http://www.childrenwithdiabetes.com/dteam/2005-12/d_0d_di8.htm. Accessed 24 July, 2006
Children with diabetes, insurance costs, ask the diabetes team" (January, 2006)
Retrieved at http://www.childrenwithdiabetes.com/dteam/2006-01/d_0d_dlz.htm. Accessed 24 July, 2006
Clark, Nathaniel G; Cefalu, William T. (2000) "Medical management of Diabetes Mellitus."
Damocles, Bonny; Bykin, Jayne. (2004) "Live like you have no Diabetes"
PageFree Publishing, Inc.
Diabetes and Insurance" Diabetes Federation of Ireland. Retrieved at http://www.diabetes.ie/view.asp?ID=1052Accessed 24 July, 2006
Diabetes Patients have difficulty maintaining health insurance coverage, often go uninsured" from http://www.newstarget.com/004773.html. Accessed 24 July, 2006
Ekoe, Jean Marie; Zimmet, Paul; Williams, Rhys. (2001) "The Epidemiology of Diabetes
Mellitus, an International Perspective" John Wiley and Sons.
Harris, Maureen I. eds. (1995) "Diabetes in America" 2nd ed. Washington, DC: National
Institutes of Health, NIDDK. pp: 591-600.
Health Insurance Information for People with Diabetes" American Diabetes Association.
Retrieved at http://www.diabetes.org/advocacy-and-legalresources/healthcare/insurance.jspAccessed 24 July, 2006
Iom, J. (2004) "Insuring America's Health, Principles and Recommendations" National
Lundstrom, Ruth E; Rossini, Aldo A. (2004) "The Diabetes Handbook" Jones and Bartlett
Montana" American Diabetes Association. Retrieved at http://www.diabetes.org/advocacy-and-legalresources/insurance/montana.jsp. Accessed 24 July, 2006
Rowell, Joann C; Green, Michelle A. (2003) "Understanding Health Insurance, a Guide to Professional Billing" Thomson Delmar Learning
United States Congress; Select Committee on Aging (1992) "Diabetes Mellitus, an unrelenting threat." U.S.G.P.O., Supt. Of Docs., Congressional Sales Office.
Valentine, Virginia. (1998) "Diabetes Type 2 and what to do"
Yu, Winnie; Stjernholm, Melvin; Munier, Alexis. (2004) "What to do when…[continue]
"Health Insurance And Diabetes Is" (2006, July 26) Retrieved December 5, 2016, from http://www.paperdue.com/essay/health-insurance-and-diabetes-is-71184
"Health Insurance And Diabetes Is" 26 July 2006. Web.5 December. 2016. <http://www.paperdue.com/essay/health-insurance-and-diabetes-is-71184>
"Health Insurance And Diabetes Is", 26 July 2006, Accessed.5 December. 2016, http://www.paperdue.com/essay/health-insurance-and-diabetes-is-71184
Pre-Existing Condition and Denial of Health Insurance The focus of this work in writing is to examine whether the individual with a pre-existing health condition should be denied health insurance coverage. Toward this end, this work will examine the literature in this area of study. A pre-existing condition is "a medical condition that existed before someone applies for or enrolls in a new health insurance policy. It can be something as
" (National Conference of State Legislatures Forum for State Health Policy Leadership, 2007). However, regardless of state, the applicants have to meet certain qualifications. First, applicants have to be both uninsured and not eligible for Medicaid for other forms of state sponsored insurance. In addition, not all S-CHIP recipients have to be children; states can get waivers to use S-CHIP funds to cover adults. These other recipients are generally adults
5 billion in unpaid medical claims from 2005-2007 and there was a total of $80.6 million in unpaid interest owed to providers treating Medicaid patients between July 1999 and November 2007, despite the existence of an Illinois prompt-payment law. This interest is money that should not 'need' to have been spent, since money paid for interest does nothing to improve the quality of care for recipients. Another problem is a
Health Care in the U.S. And Spain What Can the U.S. Learn About Health Care from Spain? In 2009, Spain's single-payer health care system was ranked the seventh best in the world by the World Health Organization (Socolovsky, 2009). By comparison, the U.S. health care system ranted at 37 (Satiroglou, 2009). The Spanish system offers coverage as a right of citizenship that is constitutionally guaranteed. Spanish residents pay no expenses out-of-pocket, with
Health Care Disparities Race Related Healthcare disparities Serial number Socioeconomic status and health Correlation between socioeconomic status and race Health insurance and health Who are the uninsured people? Causes of health care disparities Suggestions for better health care system The latest studies have shown that in spite of the steady developments in the overall health of the United States, racial and ethnic minorities still experience an inferior quality of health services and are less likely to receive routine medical
Healthcare Reform Revised We know that the burden of diseases is increasing all over the world. The percentage of people suffering from diabetes, cardiovascular and pulmonary diseases has considerably increased in the last decade. It is noteworthy here that the importance of preventive care now comes at par with the importance of curative care. Considering the prevalence of diseases and the health status of the American population, President Obama introduced a
Healthcare Spending The United States Health Care System is probably the worst organized system. It expends double than other developed countries on health care system but face worse outcomes. The Government is running healthcare programs but still lagging behind the rest of industrial world. The healthcare expenditures are rising year by year with no significant outcomes. Current National Health Expenditures The national health care expenditures of United States have increased at an alarming