Abdel, Susan
Erin, Irma
September19, 2011
I. Introduction
Providing health care service for uninsured and underinsured individuals in the United States is an ongoing concern. A report released by the U.S. Census Bureau reveals the number of uninsured Americans under age 65 rose from 45.7 million in 2008 to 50.0 million in 2009 and an estimated 25 million American’s were reported to be underinsured in 2007 (Gould, 2010). Uninsured are individuals not covered by any type of health insurance. Underinsured are individuals who have health coverage that does not adequately protect them from additional costs of care. From an economic perspective, the weight of this concern falls heavily on the leaders and citizens of the nation. II. How has the evolution of health care affected the financial decision-making process among the uninsured and the underinsured? a) Tradition-understanding tradition through historical research allows a basis for comparison, critique, and ultimately for decision making, which allows change and ensures vulnerable patient populations are served (Pape, 2010) b) Evidence-based decision making c) Policy and Regulation d) Market demand: Demand curve, Supply Curve
III. Evolution of health care and the financial decision-making process. a) Evolution of health care. b) Expansion of the health care system. c) Use of evidence in decision making.
IV. Uninsured/Underinsured and the financial decision-making process. a) Utilization and the decision making process. b) Shifting the cost / billing adjustments. c) Resources. d) Quality of care implications / liabilities. e) Patient input.
V. Policy and regulatory impacts on decision making 1) EMTALA: not federally funded thus causing financial burden to health care providers 2) ERISA preemption provisions-difficult to predict making it hard for states
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