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Health Insurance and Healthcare Quality
Health insurance plays a significant role in determining the number of healthcare services performed. When a consumer has insurance, they can often access medical procedures and treatments at a lower cost, as the insurance company covers a portion of the expense. However, this can also lead to excessive use of healthcare services, as the consumer may be less concerned with the cost of the procedure. In this essay, we will consider the effects of health insurance on the demand for healthcare services, the relationship between demand and cost, and the potential for excessive use of healthcare services. We will also discuss policies that might be implemented to prevent this excessive use.
The consumer demand for healthcare services would likely be lower if the consumer had to pay the full $200 for the medical procedure. This is because the procedure cost would be significantly higher for the consumer without insurance, making it less affordable and, therefore, less appealing. Consumers generally base their purchasing decisions on cost, so if the cost of a healthcare procedure is too high, they may be less likely to seek out that service. On the other hand, if the consumer has health insurance and only has to pay $25 for the same procedure, they may be more willing to consider it due to the lower cost. In this case, the demand for healthcare services would be higher (National Academies of Sciences, Engineering, and Medicine., 2018).
If there is high demand for a healthcare procedure, the cost of the procedure will likely go up (Thuong, Huy, Tai, and Kien, 2020). This can be due to the basic principle of supply and demand. When there is high demand for a product or service, the price of that product or service tends to increase (National Academies of Sciences, Engineering, and Medicine., 2018). Another reason can be the overall increase in healthcare costs, which have been rising in recent years....…via case management; the consumer must get approval from their insurance company before receiving certain procedures or treatments. Case management has been shown to significantly help ensure that the procedures are medically necessary and not just sought out to take advantage of insurance coverage. By requiring prior authorization, insurance companies can ensure that they only cover truly necessary procedures and not pay for unnecessary or unnecessary treatments (Kim and Lee, 2020).
In conclusion, health insurance plays a significant role in determining the demand for healthcare services. When the cost of a procedure is lower for the consumer, the demand for healthcare services is likely to increase. However, this can also lead to excessive use of healthcare services, as the consumer may be less concerned with the cost. Policies such as cost sharing or prior authorization can be implemented to prevent this excessive use. These policies can help ensure that healthcare services are being used appropriately and not just sought out to take advantage…
References
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee on Health Care Utilization and Adults with Disabilities. Healthcare Utilization as a Proxy in Disability Determination. Washington (DC): National Academies Press (US); 2018 Mar 1. 2, Factors That Affect Healthcare Utilization. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500097/
Kim, M. J., & Lee, E. (2020). How to Reduce Excessive Use of the Health Care Service in Medical Aid Beneficiaries: Effectiveness of Community-Based Case Management. International journal of environmental research and public health, 17(7), 2503. https://doi.org/10.3390/ijerph17072503
Thuong, N. T. T., Huy, T. Q., Tai, D. A., & Kien, T. N. (2020). Impact of Health Insurance on Health Care Utilisation and Out-of-Pocket Health Expenditure in Vietnam. BioMed research international, 2020, 9065287. https://doi.org/10.1155/2020/9065287
Kaplan, J. (2022). Why your healthcare is about to get a lot more expensive. Business Insider. Retrieved January 9, 2023, from https://www.businessinsider.com/healthcare-cost-increase-forecast-making-it-more-expensive-for-you-2022-10
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