Log in
Economics
1
answer
0
watching
86
views

Bookmark The Affordable Care Act, the 2010 health care reform law, made it a priority to reduce the number of uninsured. At what point, if any, should the government step in to provide individuals with assistance to purchase insurance coverage? Do you think such assistance should be a federal or state responsibility? Show Critical Thinking and Examples to Support your answers.

Watch
1
answer
0
watching
86
views

For unlimited access to Homework Help, a Homework+ subscription is required.

Darryn D'Souza
Darryn D'SouzaLv10
28 Sep 2019

Unlock all answers

Get 1 free homework help answer.
Already have an account? Log in
Share

Related textbook solutions

Principles of Economics
2nd Edition, 2017
Openstax
ISBN: 9781947172364
Principles of Macroeconomics
2 Edition,
Openstax
ISBN: 9781947172388
Principles of Microeconomics
2 Edition,
Openstax
ISBN: 9781947172340

Related questions

(Please Summerize the work down below, thank you)

Political

Economic

Growing political influences on healthcare advances

Cost of living increases

Global government influence on healthcare cost

Cost of insurance prices

Government control of Medicaid, Medicare funding

Rise of forecasted interest rates

Social/Cultural

Technical or Technology

Increase average age of population

Demand on new medical treatments

Patient expectations increase

Customize treatments

Demographics are in constant change

More advance service facilities

Environmental

Legal

Growing need for green business

Constant change of government drug

Regulations

Environmental agenda and community awareness

Consumer laws

Health and safety regulations

Porters 5 forces of business model

Competitive Rivalry

Growth opportunity for healthcare companies are expected to growing the next few years

Increase in new revolutionary drugs both in and outside of the US

Threat if New Entrants

Strict government regulations

Difficult to keep up due to constant change

Huge startup cost

Substitute Products

Threat of other substituting product and service at lower cost

Bargaining Power of Customers

Generic drugs offered at large discount to consumer

Larger less customized healthcare facility with lower housing costs

Several facilities offering similar services.

Bargaining power of supplier

Medical suppliers have a large pricing power

Bargaining power of physicians and nurses is huge because of large hospital benefits

Swot Analysis

Strengths

Highly trained and capable employees

Market experience

Strong leadership

High level of organizational efficiency

Excellent facilities

Strong commitment to bettering the community

Weaknesses

Increased cost of healthcare could lower our clientele

Limited staff resources

Limited cash flow to hire and train new employees

Lack of resources

Opportunities

Fast growing technology opens new doors for using state of the art equipment to better serve the patients.

Nursing and residential care is one of the fastest growing industries

Aging population

Threats

Uncertainty in political and economic climate causes hesitation for receiving new patients.

Funding constraints

Highly competitive market

Product or Service Analysis

Our services will be used by patients who cannot afford experimental treatments and patients who have been abandoned by the system because hospitals can no longer provide medical assistance. At our facility, we will be able to work with the families and provide them with different payments options, such as low monthly payment plans. Our main goal is to be able to treat the patient at a very affordable cost; however, if any patient does not possess the means to pay for treatment, he or she would not be turned away; our facility will tap into government and private funding to cover treatment cost.

The beauty of this service is that there isn’t a charge of any kind to take part in our program because it is completely funded by government grants. Individuals that would take part would more than likely not have the means to pay a monthly deductible. Due to the nature of the business listed as a non-profit agency, there is no way to make a profit of any kind, as it would jeopardize the business in its entirety.

Some of the market factors that create a demand for our services include the need of medical care after having maximized all resources, the number of low income families, and the number of patients facing health issues needed extended medical care.

Opportunities that may derive from this business is the opportunity to expand and open multiple facilities, while extending a helping hand to many more in need. The risk, however, is the unstable funds deriving from grants. This can pose a huge treat to the business, as grants often times come and go and cannot be counted on as a constant income.

After studying the healthcare system and current policies in place, data shows many individuals facing severe health issues usually go untreated and uncared for due to the outrageous cost of medical care. It is devastating to see how often people, especially the elderly, are sent home and forgotten for the mere reason that hospitals and doctors are not willing to care for patients without financial means. In fact, in 2009 Harvard news reported 45,000 annual deaths due to lack of health coverage in the U.S. alone, which is significantly higher than the 18,000 reported by USA Today in 2002.

Financial Analysis

Clermont will be a nonprofit organization, dedicated to help the most needed. To open the facility fully operational we must take in consideration some fixed expenses like the land acquisition, permits, interest, brokers, administration fees, professionals (facility setup), staff, reports (environmental, occupational, fire, FDA), electricity, water, phone, water & sewer , connections, taxes, insurance, management, security, advertising, accountants, food, lawn mowers, bank fees, etc.

The facility will need have a total value of approximately three million dollars, but if we break the price of the land acquisition in to a thirty (30) year mortgage we can star up the business with an investment of approximately $ 233,944.61 USD to cover the first month of operation including all the startup permits and connections. After the first month the fixed expenses will be $184,444.00 USD with the exception of the months were taxes are due; taxes are around $ 43,000.00 USD paid quarterly will increase the tax month (depending on the facility fiscal year) for $ 10,750.00 USD approximately. We will fund all the costs with private and public funding, fundraiser, events, raffles, and most important with the help of the community.

As we mentioned before, Clermont is a nonprofit organization and we will do everything in our power to give the relief to the families in need. No one will be rejected because they do not have the money or the insurance cannot help. No money will be required from patient and every single dollar received will be spent in the patients, and in improving our facility and our service every day.

We believe our financial even breaking point will be a year after we begin operations, and be profitable soon after. There are many patients in need, and with the government and public grants each person will receive the treatment they need, and we will become the hope of many.

29.Which of the following payment initiatives are included in healthcare reform legislation (the Affordable Care Act)?

a. Value-based purchasing

b. New models of bundled payment

c. Patient age-based reimbursement

d. Initiatives a. and b. are both correct.

e. Initiatives a., b., and c. are all correct.

28.Which of the following statements about Medicares payment system for physicians services is most correct?

a. Each patient is assigned a Medicare Patient Identification Code (PIC) that reflects the severity of the patients diagnosis.

b. Patients are divided into five groups (A-E) based on diagnosis, with the E group reimbursement being the greatest.

c. Each service performed has a relative value unit (RVU) assigned that reflects the amount of physician work, practice expenses, and liability insurance costs.

d. Physicians are paid using Medicares Outpatient Observation Payment System (OOPS).

e. Physicians are paid using Medicares Ambulatory Patient Payment System (APPS).

27.Which of the following statements about Medicares inpatient prospective payment system (IPPS) is most correct?

a. Each discharge is assigned to a Medicare severity diagnosis-related group (MS-DRG) with a specified relative rate.

b. The relative weight is multiplied by a base dollar payment amount adjusted for local input prices to obtain the reimbursement amount. c. The relative weight is multiplied by a base dollar payment amount adjusted for the size of the hospital to obtain the reimbursement amount.

d. Statements a. and b. are both correct.

e. Statements a., b., and c. are all correct.

21.Which of the following statements about medical coding is incorrect?

a. ICD, CPT, and HCPCS provide a standard set of codes used to transform medical diagnoses and procedures into code numbers that can be universally recognized and interpreted.

b. ICD codes are published by the World Health Organization.

c. CPT codes were developed and are copyrighted by the American Medical Association.

d. HCPCS expands the CPT codes to include nonphysician services and durable medical equipment.

e. Because the coding process is technical and complex, there is little concordance between the information in the medical record and the classifications produced by medical coding.

19.Which of the following reimbursement methods creates the greatest incentive for providers to control the cost of delivering health services?

a. Cost-based reimbursement

b. Charge-based reimbursement

c. Discounted charge based reimbursement

d. Per diagnosis prospective payment

e. Capitation

23.Which of the following statements about capitation is most correct?

a. Capitation creates a delay between providing services and receiving payment.

b. The capitation payment amount to providers varies significantly from month to month and hence is difficult to predict.

c. Capitation encourages providers to focus on prevention and wellness.

d. Capitation places a greater administrative burden on providers than does fee-for-service payment.

e. Capitation uses a per diagnosis methodology to set hospital payment rates.

8.Which of the following tax-related benefits are generally granted to not-for- profit corporations?

a. Exemption from federal and state income taxes

b. Exemption from property taxes c. Ability to issue tax-exempt (municipal) debt

d. Ability to accept contributions that are tax deductible to the donor

e. Answers a., b., c., and d. are correct.

16. True or False: Under current law, the profits of not-for-profit corporations can be distributed to individuals.

14.Which of the following is NOT expected to result from healthcare reform initiatives?

a. Increased formation of accountable care organizations (ACOs)

b. Increased emphasis on population health

c. Decreased need for data analytics

d. Increased provider consolidation

e. Staffing shortages in selected areas

13. True or False: Because the organizational and financial goals of for-profit and not-for-profit provider organizations differ, their financial decision-making processes usually lead to very different decisions.

Case Study #3

TO WAL-MART OR NOT TO WAL-MART?

Wal-Mart is a $250-billion-a-year retailer. Eighty two percent of U.S. households made a

Wal-Mart purchase in 2002. It is the largest company in the world with a global

workforce of 1.4 million. Where Wal-Mart competes the average grocery prices are 14%

lower. In the past it was General Motors, IBM and other companies that were considered

to be the leaders in industry and the ones to watch. Now it is Wal-Mart that is being

studied in universities around the world.

At Wal-Mart, cost is king. Costs are kept low and this translates into goods being sold

for less. The entire organization is focused on reducing costs and passing those savings

on to the consumer. This allows poor people to buy food and other necessities that they

otherwise might not be able to afford. In the U.S. it dominates sales in a number of

categories : 32% of disposable diapers, 30% of hair products, 26% of toothpaste, 20% of

pet food and 13% of textiles.

Wal-Mart simply has developed the most efficient methods for operating their business.

Their inventory management, through a network of scanners, computers, and at-the-ready

suppliers, makes it the leader in successful turnover of inventory. How can we blame

Wal-Mart for being the efficient cost conscious giant that it is?

The Wal-Mart phenomenon has occurred at the same time that high-paying skilled jobs

are being lost in the manufacturing sector. When these jobs are lost, the alternative often

means being employed at Wal-Mart at a much lower pay scale with reduced benefits

such as medical insurance. Its labor costs are twenty percent less than those at

unionized supermarkets, and sales clerks make less, on average, than the federal poverty

level ($8.50 an hour).

Barbara Ehrenreich* has described the problems faced by the under class, such

as waitresses and Wal-Mart employees. They barely survive on a day-to-day basis, living

from hand to mouth, with no reserves, no safety net, no medical insurance and almost no

prospect of improving their positions in life.

The loss of manufacturing jobs has affected the lifestyles of many people. What they see

is the reality of reduced opportunity with a permanent reduction in wages and standards

of living. They are trapped in a new marketplace, with diminishing expectations and few

alternatives to shopping at Wal-Mart. This is a change in our American culture--the

dreams have now been down-sized.

Is Wal-Mart the hero or the culprit? After all, low prices, competition, and growth have

all been mantras that Americans have been chanting all of our lives. We were

told that if you built a better mouse trap, everyone would come to you. Well, Wal-Mart

has built a better mouse trap. Is there any logic in our looking at Wal-Mart as a

contributor to the loss of some our middle class or is it just jealousy and sour grapes?

For one thing, its hard line on costs has forced many factories to move overseas.

Wal-Mart imported most of the items it sells. Environmental standards

are lower in these countries where these goods are manufactured than they are in the

U.S. This probably results in increased health issues and costs. In addition, shipment of

goods many thousands of miles to their ultimate destinations, involve utilizing the

world’s limited oil resources. When you add up all this, the cost of the goods may be

greater than if they were produced in this country.

Another issue is that Wal-Mart is a non-union employer paying wages that are below the

poverty level, with minimal health insurance coverage. As many employees cannot

afford the co-payment required for doctors office visits, when a medical crisis occurs they

are forced to use the emergency room facilities of local hospitals. The result is that the

community bears the direct cost of their medical treatment and the indirect, as well as

ancillary costs such as diminished work capacity, child care, etc.

There are other economic ramifications to the Wal-Mart explosion. When Wal-Mart

arrives in a town, “main street” erodes. Neighborhood stores that used to provide goods,

services and paid their workers well, are eliminated, uprooting families and ways of life

in the process. The Wal-Mart decision to saturate Oklahoma City, resulted in the closure

of 30 supermarkets.

If Americans shop with price being the only factor that determines where they

purchase their goods, doesn’t this mean the permanent down-sizing of our standard of

living? How can the local retail establishment survive when they can’t compete with a

Wal-Mart? Look at what has happened to the local supermarket, bookstore, hardware

and clothing store. The demise of these small business constitutes the loss of a middle

class of society in a community. We need to think: As consumers are we better off

paying a little more to enable the local merchants and their families to survive in order to

preserve the character of our communities and society or should we concern ourselves

with price only?

HERE IS YOUR DILEMMA:

You are the mayor of a small city in the West. You can’t worry about the 4,700 workers

at IBM and the other workers at technology companies who lost their jobs. Your problem

is a more local one.

A Wal-Mart representative has approached you about the possibility of building a super-

store within your city limits. The store would serve communities within a twenty-five mile

radius. The land that they intend to build upon would require new zoning. Wal-Mart

would expect a certain amount of property tax and other relief. If your city does not

want a super-store, you are certain that one of the other towns close-by would be happy

to accommodate their needs.

What studies would you require before deciding which way to vote? What ramifications

do you foresee with this new super-store? What would you ask of Wal-Mart before

agreeing to their request? How much input would you seek from the residents of your

city

Weekly leaderboard

Home
Homework Help 3,900,000
Economics 400,000
Start filling in the gaps now
Log in