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Financing and Structuring Health Care

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Running head: FINANCING AND STRUCTURING HEALTH CARE

Financing and Structuring Health Care
Health Services Organization- HSA 500
December 15, 2011

Identify and describe the three main types of health insurance in the U.S.
The three main types of health insurance are: * Voluntary Health Insurance * Social Health Insurance * Welfare Health Care
According to the authors of our textbook (Williams & Torrens, 2010) “Voluntary or private health insurance in the United States can be subdivided into three distinct categories: (1) Blue Cross and Blue Shield, (2) private or commercial insurance companies, and (3) health maintenance organizations” (p. 82). Initially, Blue Cross and Blue Shield were two separate entities. Before merging in the early eighties, Blue Cross provided coverage for hospital services and Blue Shield covered physician services only. The companies under the Blue Cross and Blue Shield umbrella are licensees and operate independently of each other but all offer plans within specific areas of the country. Private or commercial insurance companies are those that provide health benefits to groups or individuals which are paid for by other parties (ex: employers, employees, unions, etc.) besides the United States government. This particular type of insurance can vary in cost and the benefits received; it all depends upon who is paying and what they are willing to cover. Health Maintenance Organizations (HMOs) are companies that manage the care between the insured and health care providers. “The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options” (Williams & Torrens, 2010, p. 84). HMOs differ from traditional insurance in that they only cover the care rendered by specific doctors who have agreed to

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