Government regulation of healthcare markets: the case of Sunnydale Care

Role of Government in Healthcare/How Government Influence Sunnydale

Similarities between Monopoly, Perfect Competition and Oligopoly

Importance of Government Involvement with Health Care Entities at the Local, State, and Federal Levels

Structure, Conduct, and Performance Paradigm As It Relates To Health Care

Implications of the Sherman Antitrust Act on Sunnydale Care

Overview of the Structure and Operation of Medicare and Medicaid

Services That Each Cover

Coverage Establishment

Funding Differences

Benefits and challenges of government involvement at Sunnydale Care

Similarities between Monopoly, Perfect Competition and Oligopoly

Monopoly and perfect competition

Both perfect competition firms and monopolies face similar production and cost factors. Both also are in the business of maximizing profit. Both have the potential of earning super-profits but in the long-term they would only achieve normal profits (Boundless, 2015).

Perfect Competition and Oligopoly

In both these is more than one firm in the market competing with the others and no single firm has monopoly status. In both cases companies need to market their goods and services so as to increase their sales, although marketing plays a more significant role in oligopolistic markets (Blurtit, 2015).

Monopoly and Oligopoly

Both oligopolies and monopolies are made up of large companies. These companies hold significant market control over specific goods and services over which they have copyright (Ladyheart123, 2008).

Importance of Government Involvement with Health Care Entities at the Local, State, and Federal Levels

Local level

The moment that local officials are not involved from the initial stages of planning for the implementation of healthcare reforms, unnecessary problems and delays may occur, with detrimental effects on individuals who depend on the local healthcare services (U.S. Advisory Commission on Intergovernmental Relations, 1994).

State level

Participation of state governments in the provision of healthcare services ensures delivery of quality services (Tang et al., 2015).

Implications of the Sherman Antitrust Act on Sunnydale Care

The act would have a huge impact on Sunnydale care, since it is based on the notion that free trade benefits the national economy, consumers and businesses alike and thus it disallows monopolization and quite a number of restrictions on trade such as contractual agreements between seller and buyers, competitor agreements, and the pursuit of monopoly power (West Group, 2015).

Overview of the Structure and Operation of Medicare and Medicaid

Medicare

As part of the amendments to the Social Security Act in 1965, a health insurance program was established the elderly to complement disability, survivors, and retirement benefits under title XVIII of the Act which then became commonly known as Medicare (Klees et al., 2010)

Medicaid

The social security act in title XIX establishes an entitlement program that covers medical assistance for people with low income. Also known as Medicaid, this entitlement program is the single largest source of finance for healthcare services for the poorest people in the United States. Within the guidelines established by the federal government, states come up with their own standards for eligibility; determine the amount, type, duration and level of services; and administer their own services (Klees et al., 2010).

Services That Each Cover

Medicare

Part A: Hospital admission coverage, Part B: Healthcare insurance, Part C: privately bought complementary insurance that offers additional services besides offering access to services in Part A and Part B, Part D: Prescription medication coverage (Smith, 2015).

Medicaid

Medicaid policies, for services, payment and eligibility are complex and vary significantly between states (Klees, 2010).

Coverage Establishment

Medicare

Part A, provided free of premium payments to most eligible people, is important in the payment of inpatient hospital care, home health services and hospice care. Part B provides payment for the physician and also outpatient services, for one to be covered by Part B, he or she must pay premiums (Klees et al., 2010).

Medicaid

Eligibility varies between states and services may also vary significantly in terms of scope, amount and duration (Klees et al., 2010).

Funding Differences

Medicaid, as stated already, is the single largest source of funding for long-term healthcare. It is often utilized to cover long-term care services that are not catered for or covered by Medicare and/or private insurance companies.

Benefits and challenges of government involvement at Sunnydale Care

Benefits (Kling, 2007)

Taxpayers will help ensure that individuals are not denied the care they need.

Helps individuals with lower income by providing them with vouchers to pay for healthcare.

The high risk pools here will help people with expensive medical conditions.

Statistics on the effectiveness and risk of medical procedures would be quite helpful

Challenges (Kling, 2007)

Medicaid does not solve the issue of access to healthcare for the poor.

A bad approach for improving the quality of healthcare would be malpractice lawsuits that only work to the degree that the person being sued is actually a bad doctor.

Mandates do not work because legislators are under a lot of pressure to glamorize the insurance policy.