1412197745-Current Legal, Ethical, and Regulatory Issues in Health Care -

1412197745-Current Legal, Ethical, and Regulatory Issues in Health Care -

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Issues in Health Care 1 Running head: CURRENT LEGAL, ETHICAL, AND REGULATORY ISSUES IN Current Legal, Ethical, and Regulatory Issues in Health Care - Phase 1 Project [Author’s Name] [Institution’s Name]
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Issues in Health Care 2 Current Legal, Ethical, and Regulatory Issues in Health Care - Phase 1 Project Despite its small size, the individual health insurance market plays an important role in a voluntary, private-public "system" of health insurance. At least in principle, it accommodates the population without access to either an employer plan or a public program. These include primarily workers and their families, but also a significant proportion of self- employed individuals, retirees, and dependents. Prices in the individual health insurance market are notoriously high. The administrative cost of individual coverage as a percentage of premium is much higher than in the group market, sometimes accounting for nearly half of the premium. Unless restricted by state law, insurers may deny or aggressively limit coverage, and they may vary premiums (by many orders of magnitude) for differences in age, gender, occupation, location, and past or present health status at the time of issue. In at least six states 1 and the District of Columbia, insurers may further adjust premiums as health status changes. The federal HIPAA that reformed group coverage did very little to assist people who buy coverage in the individual market, and it did even less for those who "live" in the individual market - those without recent access to employer coverage. The small size of the individual market makes it relatively volatile. Changes in insured lives
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Issues in Health Care 3 and premium volume that would be minor in the group market can represent a major change against the much smaller base of business in the individual market and (because most individual insurers write very little premium volume) can profoundly affect any given insurer's business. But ironically, because the individual health insurance market is a residual market, it is peculiarly subject to change: growth in employer coverage especially can take significant business from the individual market (and it may take disproportionately its preferred risks - younger workers who most benefit from expanding group coverage), while economic recession may fail to restore lives to the more costly individual market. These problems of the current market notwithstanding, the
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1412197745-Current Legal, Ethical, and Regulatory Issues in Health Care -

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