Health Care Utilization
Donna K. Strickland
November 11, 2013
Health Care Utilization
Health care reform is not a recently devised concept. The government and health professionals have studied and tried to establish legislation that would assist the general population with a means of accessing adequate health care for decades. The task has proven itself as a daunting one although studied the world over. Individuals struggle with disease and illness that they cannot afford medical attention and treatment. Insurance companies price gouge or drop individuals from their insurance coverage. Reform has to be implemented to protect the public and provide across the board health care for every situation.
Ronald Andersen wrote in the Journal of Health and Social Behavior there is a model of behavior that determines the seeking out of health services (Anderson, 1995). Anderson collaborated with Odin Anderson and wrote The Initial Behavioral Model in 1968 to assist in the analysis of national survey data collected by the Center for Health Administration Studies and the National Opinion Research Center at the University of Chicago (Andersen & Anderson, 1967). The model explains that there are elements that may determine if an individual will access health services. Anderson explained, “I want to stress that the model was initially designed to explain the use of formal personal health services rather than to focus on the important interactions that take place as people receive care, or on health outcomes”(Andersen, 1968, p. 1).
The Initial Behavioral Model (1960s) PREDISPOSING ENABLING USE OF CHARACTERISTICS RESOURCES NEED HEALTH SERVICES Demographic Personal/Family
Perceived Social Structure Community (Evaluated) Health Beliefs (Revisiting The Behavioral Model and Access to Medical Care: Does it Matter?, 1995)
The president had legislation passed in 2010 to implement the Affordable Care Act. Today, more than 45 million Americans lack access to affordable health insurance. Additionally, many individuals who do have health insurance have incomplete coverage that may include exclusions for pre-existing conditions, or they may be one-step away from losing coverage because of a change in employment. Individuals with health insurance face increasingly high premiums and medical costs that drive some to bankruptcy or force choices between maintaining health insurance coverage and paying for other household essentials (HHS, 2013). These new regulations will provide consumer protections and the developing of a competitive market. Insurance companies will be required to spend a specific percentage on health care and not excessive administrative costs. There have been major changes to the accessibility of insurance coverage for individuals which have been diagnosed with a pre-existing medical condition. Insurance companies will no longer be allowed to deny insurance coverage for individuals, such as children born with life-threatening illnesses. This will also address lifetime limits on medical care. There has been a health insurance exchange in an effort to pool millions of people and allow them to examine various insurance coverage policies to determine the best policy for them and their families. Health and Human Services has implemented a website for the comparison of the insurance coverage options (HHS, 2013).
There have been conversations for decades about the implementation of universal health coverage. The World Health Organization defines it as a goal to ensure that people obtain the health services they need without suffering financial hardship when paying for them. It goes on explaining,...
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