Medicine and Social Justice: Essays on the Distribution of Health Care, Essay Example

Section I: Employer-Sponsored Health Insurance Plan Proposal

Employer-sponsored health insurance plans are a considerably reliable way of ensuring employee health coverage as required by the affordable care act. Assuming an organization with 50 employees, between 25 and 55 years old, wished to purchase a health insurance plan of its employees, it would use the official consumer healthcare website to view the available healthcare plans. All alternatives that are highlighted offer the same fundamental health benefits. The plans are also ranked according to the manner in which the employer and the plan share costs for the healthcare of the employees. The lower premiums usually result in higher costs when medical care is required.

For an organization based in Fairfax County, Virginia, it would select a recommended Silver Level health insurance plan. This insurance plan. The most ideal would be the Kaiser Permanente · KP VA Silver 1250/35/Dental/Ped Dental. This health plan is defined by the following characteristics

Table 1: Kaiser Permanente • KP VA Silver 1250/35/Dental/Ped Dental

(Helathcare.gov, 2015)

While the table above depicts the general costs associated with the healthcare plan, the plan has a detailed coverage that is essential for both single employees, as well as those with families. The plan has a primary care visit package that includes specialists’ visits, eye glasses for children, routine eye exams for children and a health savings accounts. The plans also has a prescription drug coverage which encompasses generic drugs, preferred brand drugs, non-preferred brand drugs and specialty drugs. The pan covers three type of hospital services; (1) emergency room services, (2) inpatient hospital services, (3) inpatient physician services (Helathcare.gov, 2015). This also extends to offer both adult and children dental cover, medical management programs for asthma, diabetes and pain management, as well as other specialized services.

While the healthcare plan is extensive, the lifestyle chose by each individual employee will affect the organization’s position relative to the insurance plan provider. Regular claims made on a health insurance plan can be traced to the lifestyle one chooses to live. As such, employees engaging in riskier lifestyles would eventually attract higher premiums r incur higher costs on medical care when required. This is also compounded by the amount of disposable income after taxation.

Section II: Implication of the Affordable Care Act

The affordable care act plays an important role in an employer purchasing health insurance cover for their employees. This is because the act places the mandate on employers to provide a guarantee for their employees’ health and general wellbeing, furthermore, the act places the mandate on organizations or firms with fifty or more employees (Rhodes, Battin, & Silvers, 2012).

Employer-Sponsored health insurance has been found to be generally preferred to government-sponsored health insurance. This is due to some evident advantages;

• Employer-sponsored healthcare is more cost effective when compared to government-sponsored insurance. The government spends more per person to provide the same services.
• Employer-sponsored health insurance creates a fair marketplace where employers are responsible for their workers as assists(Buss & Van de Water, 2014).

However, there are some inherent disadvantages associated with employer-sponsored health insurance.

• This type of cover neglects the unemployed in society. This would create a society where the poor cannot access affordable medical care.
• It does not take into consideration cyclical unemployment. When individuals are temporarily unemployed, they lose medical cover under employer-sponsored plans.

In conclusion, the affordable care act is an essential tool to ensuring a healthy economy and labor force. It has significantly influenced the nature in which businesses, employers and employees relate with regards to compensation. However, it is important to consider the role that employer-sponsored health insurance and government-sponsored health insurance have to play within the economy. They both complement each other and should ideally be employed at varying intensity, relative to the socio-economic environment.

References

Buss, T. F., & Van de Water, P. N. (2014). Expanding Access to Health Care : a Management Approach. Hoboken: Taylor and Francis.

Helathcare.gov. (2015, May 10). Kaiser Permanente · KP VA Silver. Retrieved May 30, 2015, from Heathcare.gov: https://www.healthcare.gov/see-plans/20171/details/95185VA0500008/?county=51059&data=4d8be58274a9a13f6436493df5959967f48bb0792ce3bfb90278c27aaa56be92317148e9d09f01054b8d28561d808a9e77bc6803060de5876d0881a7d0c04b75313aefb7078fed614c7c61cf2a5337bdeba4185ed1

Rhodes, R., Battin, P., & Silvers, A. (2012). Medicine and social justice : essays on the distribution of health care. New York: Oxford University Press.