Price Discrimination in Health Care Essays

Price Discrimination in Health Care Essays Price Discrimination in Health Care Paper Price Discrimination in Health Care Paper Abstract The price of health care can vary dramatically depending on insurance coverage, and whether the care received was in network, out of network, government funded, or self-pay (Miller, 2012). Price discrimination is used by many industries such as airlines, hotels, and grocery stores with rewards for frequent users, or higher price for convenience or last minute reservations (Tiemstra, 2006). However, efficiency and fairness demand that new ways should be found to avoid price discrimination in health care in order to ensure patients equal access to care and economic justice. Uninsured or self-pay patients should not be charged rates significantly higher than those with Medicare, Medicaid, or insurance. Prices for health care should also be more transparent to allow patients to accurately shop for best prices and values in health care. Imagine a system in which you go to the grocery store and are told that the price you must pay for your groceries is dependent on whether you have a job, and if you have a job the price is dependent on where you work. If you are work for a certain employer the price you will pay is near wholesale, for another retail, another twenty to thirty percent more, and if self-employed or unemployed you must pay a price three to four times higher for these groceries. Unfortunately this is the way our current health system works. Most hospitals charge those without insurance three to four times the price of that paid by those with insurance or government coverage such as Medicare or Medicaid. New ways should be found to avoid price discrimination in health care in order to ensure patients equal access to care and economic justice. Uninsured or self-pay patients should not be charged rates significantly higher than those with Medicare, Medicaid, or insurance. Prices for health care should also be more transparent to allow patients to accurately shop for best prices and values in health care. Price discrimination Price discrimination is the practice of charging different customers different prices for the same product or service. While price discrimination is not necessarily unethical, the price should have commensurate value for the price charged. If this condition is met price discrimination is not necessarily wrong. It can be considered ethical for one to be given a better deal than another. However, if it is used to take advantage of those with a special need or the ignorance of customers it may be unethical. Under the Robinson-Patman Act 1936 it is unlawful when it substantially lessons competition or tends to create a monopoly. This has been cited in numerous lawsuits against hospitals and HMO’s. Because an uninsured person has limited resources to contest hospital rates class action attorneys have tried to obtain class action status for clients with limited success (Anderson, 2007). Many industries and firms utilize price discrimination because it can have a huge impact on company profits. It is much easier today because of improvements in technology to separate patients by demographic information to maximize the amount they are willing or able to pay (Elegido, 2009). Price discrimination is an attempt to get each consumer to pay for the product the highest price he is willing to pay. Price discrimination is common in industries that have high fixed costs and low marginal costs. Setting prices at the level of marginal costs would make it difficult to recover original investment costs. In order for price discrimination to occur there are several conditions that must exist. The producer must have information about what the maximum price of each group of consumers are or have reliable indicators of such. This information is obtained through prices for services set by government diagnosis related groupings for payment that set a near minimum price. The hospital then establishes a charge-master file that is several times more for each item. This may be updated several times a year and is not published for the public. There must not be significant competition from rival firms. For many consumers there are not multiple options for hospital care resulting in limited competition that might lesson cost. Arbitrage must not be possible. The buyer cannot resell the product for a higher price to others (Elegido, 2009). The uninsured or self-pay patient In a study published as a Web Exclusive by the journal Health Affairs, it was determined that approximately half of U. S. bankruptcies, were reportedly attributable to illness or medical bills (Anderson, 2007). It is estimated that three-fourths of these individuals were covered by insurance when they got sick. However, skimpier policies, rising health care costs, and the cancellation of coverage when illness results in job loss have increased the financial risk for those with insurance as well as the uninsured. When patients lose their insurance due to inability to work they become vulnerable to higher self-pay prices. While there are many uninsured that are unable or won’t pay their bills, hospitals pursue those that don’t pay with aggressive collections activities. Price discrimination in health care Hospitals do not charge every patient the same price. Uninsured and self-pay patients are often charged two and one half to four times as much for the same care as those covered by insurance or government plans such as Medicare or Medicaid. This gap has grown substantially since the mid 1980’s (Anderson, 2007). Patients that are uninsured or self-pay are often presented with bills that reflect full charges derived from the hospital’s charge-master file. There are five categories of patients that routinely receive undiscounted bills based on charge-master files created by each hospital. These include those that are international visitors, those that are uninsured, people covered by automobile insurers, people covered by workman’s compensation plans, and those covered by health plans that are lacking contracts with the hospital such as individuals that utilize health care savings accounts or are out of network. Equals should be treated equally in order to satisfy justice and should appropriately balance the gains of trade between buyer and seller with neither side having disproportionate power over the other (Tiemstra, 2006). If prices are directly related to costs and equal for all, the allocation of resources will be more efficient. The ratio of charges to costs measures the relationship between actual charges for services and Medicare allowable charges. In 2004 this ratio for U. S. hospitals was 3. 7 meaning that for every $100 in Medicare charges the average charge was $307. There is considerable variation in hospital charges depending on the type of hospital and the setting, rural or urban. The gross to net revenues overall averaged 2. 57 meaning that collected from all payers, for each $100 collected the initial charge was $257. Since 1984 the charge to cost ratio has increased from 1. 35 to 3. 07 and the gross to net revenues from 1. 25 to 2. 57 in 2004 (Anderson, 2007). Hospital charges have increased faster than costs. Increased charges have not been shown to significantly increase revenues however because as charges rise insurers negotiate for larger discounts and only self-pay patients are expected to pay these higher charges (Anderson, 2007). In Pennsylvania, hospitals collect only about one fourth of what they charge. These discounts are reflected on explanation of benefits forms from insurers. The only ones expected to pay the full charges are often those least able to pay them (Miller, 2012). There is evidence that discounts and price discrimination are making health care less affordable because fixed prices, discounts, and variable reimbursement systems distort normal marketplace competition. Patients and business are the losers as hospitals and health plans try to get bigger to â€Å"win† price negotiation. Insurance is discounted from the standard billed charge, Medicare and Medicaid pay flat rates and those without medical insurance pay the highest charges. When money spent is from somewhere else such as insurance or government coverage there is no incentive for hospitals or patients to control costs and may result in unnecessary medical costs for unneeded tests and procedures when insurance deductibles are met (Lilly, 2011). Cost shifting Cost shift policies in hospitals have resulted in shifting of costs to private patients due to inadequate payments from state and federal government plans such as Medicare and Medicaid. Cost shifting is also use to cover bad debts of unpaid hospital bills. Cost shifting acts like a tax on the costs of private pay patients. The burden of cost shifting falls on non-Medicare and non-Medicaid households in proportion to the sum of their out of pocket expenses and hospital premiums. The government does not assume costs of serving people that are ineligible for government programs but that are unable to pay their bills. They also do not cover common costs for research and teaching. Private pay patients subsidize public program beneficiaries through cost shifting. Because Medicare and Medicaid patients utilize socially valuable resources these costs must be borne by society. These costs may be covered implicitly through cost shifting by price discrimination or explicitly when government taxes are used to finance the full cost (Meyer Johnson, 1983). Hospitals obtain what revenues they can from insurers and those over whom they have little control such as Medicare and Medicaid. They then demand as much as possible from those over whom they have the most leverage. Over fifty percent of health care costs are paid by state and federal governments. This system results in lower incentives to be more efficient and contain costs. Charges for self-pay and uninsured patients are inflated to compensate for discounts given to insurers and low reimbursement rates of Medicare and Medicaid. Public program beneficiaries are subsidized by private pay patients (Lilly, 2011). Recommendations The commercial health industry has called for equitable payment rules for all patients including mandatory rate setting or doing away with rates by diagnosis and cost shifting in favor of transparency and the same rate no matter the payer source. One regulatory approach might be to have the government regulate prices so hospitals cannot charge more based on their type of insurance coverage. Maryland has done this and their hospital costs are lower than other states. However the regulation of prices removes incentives for hospitals to look for innovations to deliver care in a more cost effective way. Another option would be to establish maximum rates that can be charged to all payers for medical care. This may be set by the hospital voluntarily, be set by legislation, or have the rate determined by courts. A single rate would also decrease administrative and collection costs associated with multiple charge rates by payer type. Price transparency has been suggested as a tool to allow patients to comparison shop. Hospitals may increase transparency by limiting the price that can be charged above the Medicare rate. Hospitals could advertise their charge as being a certain percentage above the Medicare rate for comparison. Another approach would be systemic changes that let hospitals charge patients any price but all must be charged the same and prices must be made public. Instead of being restricted to in-network providers, patients could go anywhere but be able to make choices based on quality of care and pricing. Greater transparency in pricing and an ability to make informed decisions based on quality of care and price may allow patients to choose those hospitals that give quality care at lower costs. Transparency in pricing would encourage people to economize on the use of routine health services. These changes would make consumers more aware of and accountable for health decisions based on choice, limits, and patient responsibility (Miller, 2012). Health care reform is necessary and decreasing the use of price discrimination in health care pricing is just one component of those needed. Though the Affordable Care Act 2010 may increase the number of patients with insurance there still will be those that are uninsured. Price discrimination in health care should not be allowed. No patient should be charged more than another for the same service based solely on their payer source. References Anderson, G. F. (n. d. ). From soak the rich to soak the poor: Recent trends in hospital pricing. Health Affairs, 26(3), 780-789. Elegido, J. (2009). The ethics of price discrimination. In 2009 BEN-Africa Annual Conference (pp. 1-19). Accra, Ghana: GIMPA. Retrieved April 21, 2012, from benafrica. org/downloads/Elegido,%20Juan. pdf Geyman, M. D. , J. , Fegan M. D. , C. , Skala, N. (2005, February 2). Bankruptcy Study Highlights Need For National Health Insurance. Http://www. pnhp. org/facts/bankruptcy_study. php. Retrieved April 21, 2012, from pnhp. org/news/2005/february/bankruptcy_study_hig. php Lilly, J. (2011, June 16). Medicare reform; Its the price-fixing, stupid. Www. Americanthinker. com. Retrieved April 7, 2012, from www. americanthinker. com/articles Meyer, J. A. , Bruce, W. R. (1983). Cost shifting in health care: An economic analysis. Health Affairs, 2(2), 20-35. Miller, H. D. (2012, March 04). Price discrimination in health care. : Price Discrimination in Health Care. Retrieved May 04, 2012, from pittsburghfuture. blogspot. com/2012/03/price-discrimination-in-health-care. html

Dispute Resolution Process Paper Essay Example | Topics and Well Written Essays - 750 words

Dispute Resolution Process Paper - Essay Example Presently, the dispute resolution process in my organization is largely guided by the conditions as mentioned in the appointment letters or contracts as devised and executed by the company’s top brass managers. The process is modeled in a top down fashion, where in the case of a dispute issues are resolved professionally on the basis of the hierarchic positions of the disputing individuals. Such a dispute resolution paradigm can, thus, be identified as a human resource management based organized process guided in the conventional lines of conflict management. In a more complicated conflict situation, the company prefers to act along the â€Å"Dunlopian integrated system† (Colvin 2012, p. 459) of dispute resolution. Suggestible Alternative Dispute Resolution Approaches Alternative dispute resolution processes that can be suggested in this context involve essentially individualized considerations and concepts. As a whole, the current dispute resolution system of my organi zation is based on older concepts of industrial relations. But in the 21st century, individualized labor management appears to be more practical and potentially productive. At the first place, information and communication technology (ICT) has revolutionized present day workplace. Now there is a lot more scope of one to one interactions between peers. Also, superiors can interact with their subordinates on an individual basis with the help of techniques like social networking, online chatting, etc. Brett et al (2007) have explained the importance and inevitability of the utilization of ICT methods for resolving disputes and facilitating the dialogue in case there is a conflict. Further in my personal opinion, I believe that a policy of talking to the other party first can settle disputes before they surface. According to Colvin (2012), the new labor management conception in the USA is a lot more individualized. As such, emotional quotient and soft skills too can be highly fruitful a nd can help us before disputes reach serious dimensions. In the case of a conflict, if everyone is groomed to be good listeners beforehand, then we, the employees, can start a dialogue process on our own without an actual intervention of the higher management. Recommended Areas of Improvement There are two main recommended areas of improvement. Firstly, I think that my organization should now implement available ICT techniques more seriously with the specific consideration to the issues as related to the greater dispute resolution paradigm. For example, if the higher managers give at least a weekly feedback to their subordinates in a regular and periodic manner, then the subordinate staff can have a better understanding of both the good and bad things they do. And to facilitate such a kind of ICT powered individualized process of a periodic communication; we can induct ideas from the work of the scholars like Brett et al (2007). Secondly, the higher management should now consider ar ranging training sessions for the staff. All the staff must be given classroom lessons in soft skills at least once in a fortnight. In the view of the new labor management paradigm that gives an excessive importance to one to contact and dialogue, an increasing emotional quotient is critical and special soft skills training for all the staff of different departments can be rewarding. Another important aspect of necessary dispute resolution techniques might involve contract management set along strictly legal lines. My organization has set up contractual agreements with several workers. So, particularly in case of employment conflicts and confusions, the actual contract documents can be referred to. Scholars like Faems et al (2008) have given contextual suggestions

Simplifying Expressions Speech or Presentation Example | Topics and Well Written Essays - 500 words

Simplifying Expressions - Speech or Presentation Example Expressions are solved by moving terms around, combining like terms, applying the real numbers’ properties. There are several ways in which the properties of real numbers help in the simplification of the algebraic expressions. For instance, the distributive property of real numbers is applied to multiply the terms inside the parenthesis with the real numbers outside them which results into the parenthesis removal. Likewise, terms are moved to different places in the expressions with the help of the commulative property of real numbers. Concluding, we have to deal with real numbers in everyday life as the principles discussed in this assignment have application in matters as simple as totaling the price of items bought at a grocery store for the bill to as complex matters as engineering designs and calculations. In all the cases, expressions are solved using the same distributive and commulative properties of real numbers that have been discussed. Hence, knowledge of the principles of real numbers is essential to achieve accurate results in mathematics including

Encountering Conflict Essay Example for Free

Encountering Conflict Essay When confronted with conflict, peoples moral centre can cause them to act in heroic ways. When we are exposed to war and devastation our reactions to this Thousands of Chinese students gathered in a peaceful protest for basic Democratic reform at Tiannaman Square 1984. Due to these actions they were senselessly and inhumanely killed in cold blood by the Chinese Military. The students were unarmed and in no way of a danger to anyone. This devastation shocked the world and erupted massive conflict. One thing that this devastation proved to the world that during times of conflict where ones moral compass is tested there true heroism is revealed. A small, unexceptional figure in pants and white shirt, looking tiny next to the hulking tanks, carrying what looks to be his shopping, positions himself before an approaching tank, with a line of 17 more tanks behind it. The tank swerves right, he moves in front again. The tank swerves left, he moved in front again. Then this anonymous bystander climbs up onto the vehicle of war and says something to its driver, Why are you here? My city is in chaos because of you. With a single act of defiance, a lone Chinese hero revived the worlds image of courage. He was the â€Å"unknown rebel† also know as the Tanks Man a man who was immensely courageous and a beacon of hope. The courage that it took to walk out against such massive machinery, knowing good and well that it could very well be your last day on this earth is inspiring. He took courage to a whole new level, becoming a world hero of sorts. This ordinary everyday man had stood up to one of largest of armies which was an undeniably, extraordinary act. Another man who stood up for what he believed in response to such brutal and callous acts was a man named Bradley Manning. A man who new his moral obligation was to show the world what the Government was hiding from them. Manning was an American soldier and as apart of his job he has witnessed such cruel and inhuman acts performed by the military that the world were unaware of. Manning new what was right, his response to this conflict was to present this information to the world. Manning fulfilled his legal duty which was to report war crimes. He complied with his legal duty to obey lawful orders but also his duty to disobey unlawful orders. An order not to reveal classified information that  contains evidence of war crimes would be an unlawful act. Manning had the legal duty to reveal the commission of war crime. Manning revealed to the world, the unjust detachment of Guantanamo Bay, he revealed the human cost of wars in Iraq through the â€Å"Collateral Murder† video which depicts U.S forces in a helicopter killing unarmed civilians. The video even showed men trying to rescue the wounded who then were shot down as well. Manning had sent this information to a website called Wiki Leaks; a website created by Julian Assange in order to reveal to the world the truth about our leaders and what they are not telling us. Manning has been held 19 months in military custody. Manning has been held in solitary confinement 23 hours a day. He is only allowed to walk one hour a day in shackles. When he sleeps he is not allowed to between 5AM and 8PM weekdays and 7AM and 8PM on weekends. If he tries to he was made to sit up or stand by guards. The goal was simple the Government want to make Manning an example to other potential whistleblowers and wanted to seek to, pressure Manning into an admission that wikileaks solicited material from him, making that organization and Julian Assange part of a criminal conspiracy. Manning was a hero. This ordinary man, a solider witnessed cruel and brutal acts that the Government were hiding and presented it rightfully to the world â€Å"I want people to see the truth†. For these extraordinary actions he has been humiliated and inhumanely tortured. When our moral center is tested, ordinary inadvertent individuals who act in miraculous and extraordinary ways are revealed. Manning was tested. His moral obligation and his legal duty was to present these war crimes to the world. Conflict can stir emotions, including emotions of hatred, fear and protection of ones self and loved ones at the expense of anyone or anything else. As a result, people may act in irrational ways causing them to abandon their moral values for something that is inhumane and amoral. In times of conflict often people are fighting for there ideologies. In these times people who can lose there touch with reality and who’s blind devotion to the belief causes them to act in ways they normally wouldn’t. However, people who don’t think of the morality of there actions and are blind to the suffering there actions cause, they perform the most extraordinary acts that are the most  dangerous. The ‘Quiet American‘ written by Graham Green explores how in times of conflict peoples moral obligation for what is wrong and right is truly tested. The character in the novel Alden Pyle is a man used to provide readers with an American who is strong commitment to democracy in Vietnam has caused him to have a false conception of the world. Pyle with the intentions of saving Vietnam from the grasp of Communism in the process killed many innocent civilians in the name of what he believed was right, democracy. Through the character Fowler, we can see through his reactions to the devastation to the human impact of the bombings that emphasizes the cruelness and naivety of Pyle. Fowler witnesses the Bombings at Place Garnier, in fowlers words â€Å"what I remembered was the torso in the square, the baby on its mothers lap. They had not been warned: they had not been sufficiently important†. The horrific scenes Fowler describes presents Pyle as inhuman. Fowlers reaction to the devastation emphasizes on Pyle’s reactions as callous and brutal. We see this when Pyle uses a dismissive tone, â€Å"they were just war casualties †, as he shows no remorse for those who he has killed. Pyle again dismisses the deaths in saying â€Å"we are looking after the relatives†. To Pyle the actions that have occurred are for the good of the majority, these deaths lost are necessary for everyone. Pyle is blinded by his ideology of democracy and he remains untouched by the human suffering around him. Its not necessarily the good extraordinary acts that people can respond to conflict with but we can make the wrong choices and we question our morals and beliefs. Times of turmoil can bring out the worst in people and they can make the wrong decisions. In Harper Lees novel, To Kill a Mocking Bird, Bob Ewell is fueled by his hatred for the African Americans and is only concerned about power. He uses his position as being above African Americans so that people believe him and his family are more than white trash. He does this by accusing Tom Robinson of raping his daughter. We see here how someone can respond negatively to conflict, this conflict being racism and lack of civil rights during the 1930‘s. Ewell during this conflict, doesnt look to his heart or conscience. He doesn’t care if an innocent man is executed, he is run by purely selfish motives. We see a different response in times of intense circumstances, how someone so evil and cruel can fakley accuse a man for his own benefits. A man who just as Pyle was, is oblivious to the suffering but in order to follow his beliefs  he must be immune to the suffering.

Why I admire Benjamin Franklin Essay -- Leaders American History

Benjamin Franklin completed many accomplishments from childhood to adulthood. When he was just 22 he established his first printing business with a partner, Hugh Meredith. Benjamin soon bought out Hugh Meredith's share. In 1732, when Franklin was only 26 he published the first edition of 'Poor Richards Almanack,' the book shows evidence that it was successful for 25 years. 'Poor Richards Almanack' allowed Franklin to retire from business a rich man in 1748. In 1741 Benjamin Franklin invented the Franklin Stove. The stove was handy for both, heating a room or cooking. In 1752 Benjamin Franklin conducted his famous electricity experiment with a kite. In 1757 Franklin returned to England as a Colonial agent for Pennsylvania. Next, in the year of 171 Benjamin began to write his own autobiography. In 1775 as a member of the Continental Congress, Franklin advocated separation from England. In 1776 Franklin helped draft the Declaration of Independence, in the fall he goes to France to plead the American cause. In 1778, Benjamin arranged the American Alliance with France, which soon led... Why I admire Benjamin Franklin Essay -- Leaders American History Benjamin Franklin completed many accomplishments from childhood to adulthood. When he was just 22 he established his first printing business with a partner, Hugh Meredith. Benjamin soon bought out Hugh Meredith's share. In 1732, when Franklin was only 26 he published the first edition of 'Poor Richards Almanack,' the book shows evidence that it was successful for 25 years. 'Poor Richards Almanack' allowed Franklin to retire from business a rich man in 1748. In 1741 Benjamin Franklin invented the Franklin Stove. The stove was handy for both, heating a room or cooking. In 1752 Benjamin Franklin conducted his famous electricity experiment with a kite. In 1757 Franklin returned to England as a Colonial agent for Pennsylvania. Next, in the year of 171 Benjamin began to write his own autobiography. In 1775 as a member of the Continental Congress, Franklin advocated separation from England. In 1776 Franklin helped draft the Declaration of Independence, in the fall he goes to France to plead the American cause. In 1778, Benjamin arranged the American Alliance with France, which soon led...

Masque of the Red Death By Edgar Allen Poe

Edgar Allen Poe â€Å"The Masque of the Red Death† 1) What does each color in each room mean? These colors represent the seven deadly sins which are laziness, lust, gluttony, greed, pride, anger, and covetousness. The colors can also represent the seven stages of man starting from birth, toddler age, childhood, teen age, middle age, old age, and lastly death. Blue is birth, Purple is royalty and power, Green is growth and life, Orange is destruction, White is purity, Violet is knowledge and memory, and Black is death. ) Why do you think Poe arranged the apartments in this manner? The way Prince Prospero arranged the rooms is very peculiar. He did it from east to west according from when the sun would rise to when it would set. When the sun would rise it would mean birth and when it would set death. Just like the rooms blue was on the east so it would mean birth and black being on the west meaning death. 3) What do the colors add to the suspense in the story?The colors add cert ain suspense to the story because we do not have a meaning to them. They give you a mysterious out look towards what can happen next. We obviously have the idea that the black room means death and that someone will eventually die. 4) What does the ebony clock represent and what in the story leads you to this conclusion? It represents every hour that they live past the Red Death or until it comes since they cannot escape it. The fact that the clock is ebony meaning black it symbolizes the color of death.So we can come to the conclusion that sooner or later someone is going to die. 5) Why does the ebony clock reflect Poe’s personal life? It reflects his personal life because Poe had a lot of deaths happen in his life, starting with his parents when he was young. These deaths were all related because at that time tuberculosis was the main cause of death. Reading his biography we soon see that all his loved ones died from tuberculosis. Although it is not clear of what he died fro m.

Karl Marx And Manifesto Comparison Essay - 1402 Words

Philosophy has shaped the world in almost everything we have done. Philosophy causes everyone to at least question the norms of society and situations. This makes a healthy pattern for society. If we never were to question anything we would just be blind sheep who follow whatever they are told. Many philosophers challenge the norms in a hope to make things better. Karl Marx and Buddha were very influential people in the world of Philosophy and are some of the pioneers of challenging the routine and normal perception of things and ideas. They had their own ideas that helped shaped the practices and things that people do today. They both can be very different in how they would answer basic questions regarding philosophy. Even though, they†¦show more content†¦Marx would think that human ignorance would come from greed and lack of knowledge. With his views on Capitalistic systems you could understand that he thinks money and ignorance play into the unfair Capitalist system. He believed people are ignorant of the people around them and it is in our nature to do so. In most situations we are ignorant due to greed and knowledge. According to Karl Marx’s Social and Political Thoughts, â€Å"Only ignorance, religious superstition, and selfishness stood in the way of the needed resolution and reconstruction.† Marx says that ignorance is one of the factors in stopping a full change in any system. Marx especially believed this for the capitalistic system. What would Karl marx think of how to achieve enlightenment? Enlightenment in a philosophical standpoint would to be aware and self acting of your actions and not controlled by outside beings or thinkers. Karl Marx would think that enlightenment would be when one is not ignorant of the situation around them and to lose the power of greed and money in ones life. 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