Question #1
I really enjoyed the posts from last week and listening to
everyone’s thoughts on the Health Reform and where you believe the health care
system in our country will be in 2020. This week’s reading focuses on how
the state of Maryland is implementing health reform and the health benefit
exchanges, which by definition “Establishes a one-stop, transparent
marketplace where individuals and small businesses can compare rates, benefits
and quality among private insurance plans to ensure all Marylanders have access
to affordable healthcare. Based on recommendations established through an open
and collaborative stakeholder process, puts in place policies to guide the
Exchange’s operations to ensure quality coverage, reduce costs, and assist consumers
in choosing the best plan for their family.” (.governor.maryland.gov/blog/?p=7332″>http://www.governor.maryland.gov/blog/?p=7332)
The Maryland Exchange will need to be self-sustaining in the
future. Citing text from this week’s reading, select which financing
model(s) do you believe will best lead to the Maryland Health Benefit
Exchange in being self-sustaining and why?
The first answer is fromReginahEjiogu
ReginahEjiogu
Maryland
and Health benefit exchanges
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I believe that we may need to
implement components or ideas from different models, if not use multiple models
at the same time inorder to yield the best results. However, I think that the
best financing model to lead to the making the Maryland Health Benefit Exchange
self-sustaining would be the Broad based/Fixed cost public funding model.
Using this model, tobacco tax
increase if made steep enough might serve as a deterrent to smokers. If there
is significant enough increase in the tax on tobacco products, it may cause
marylanders to reconsider smoking if not for the health benefits but for the
cost. When this is done, individuals would have less to pay for premiums
because smoking and tobacco use is a factor in high insurance premiums for
individuals.
This will also have the added
benefit of improving the health of the population by eliminationg/ reducing the
contributing factors to all the diseases and consequences of smoking and
general tobacco use and therefore improving productivity in the general population.
This is a significant health
benefit exchange for Maryland because by quitting smoking/tobacco use, it
reduces the the financial burden of the individual – when they spend less by
eliminating tobacco use from their expenses as a result of tax increase; the
individual has the benefit of improving their health status and paying less
insurance premiums.
Reference
Joint Committee on Maryland
Health Benefit Exchange Financing (2012). Options for Financing the Maryland
Health Benefit Exchange
The
second answer is fromSaskiaRupnarain
SaskiaRupnarain
Week 3 DQ 1- MD Health Benefit Exchange Plan
It took me a while and some background research before I got the
gist of what the MD Health Benefit Exchange plan was. First, I must say that
this is a great way to ensure that all residents are able to enroll in the new
health care plan. I believe the general public still does not fully understand
what the Affordable Care Act is. Thus, I feel that the Exchange plan will help
better educate the public as well as help answer any confusions from our
residents. Second, I believe that in order for this Exchange to work multiple
financing models will have to be used in oder for the program to be
self-sustaining.
In my opinion, at least 2 or more models should be used, I
would recommend the following financing models: transactional/variable cost
model and the broad-based/fixed cost- public funding model. As stated in this
week’s literature, the transactional model is based on two assesments,
“Percentage-based fee: If the assessment is based on a percentage of
premium, a cap should be considered to place an outside limit on its penalizing
impact on higher-cost policies; and b. Flat fee: If the assessment is a flat,
per member fee, different fees should attach to each insurance line, i.e.
medical, dental and vision( Unknown, 2012).” In other words, residents would
be paying flat rates for procedures and therefore reducing the costs of out of
pocket procedures. So, I suppose that is more cost-effective and friendly
towards the consumer rather than the insurance companies. However, if consumers
are satisfied with this model then I assume they would recommend it to their
friends and neighbors, which in turn would bring in a large group of new
consumers in the market and create more revenue.
The broad-based/fixed cost-public funding model, which places a
tax on cigarette users would be a great choice for a while until cigarette use
declines. After cigarette use declines we would have to find something else to
tax that is unhealthy and pleasurable to the consumers. I believe we have quite
a few pleasurable items we can tax. For instance, we can tax candy, soda,
chips, etc. In essence, with this model we hope that we create revenue to keep
the exhange going as well as making our consumers healthier. Whether this is
realistic or not, only time will tell. Regardless of what we tax, if it’s
addicting our consumers will go out and splurge.
Reference
Unknown. (2012).Options
for Financing the Maryland Health Benefit Exchange: Report and Recommendations
to the Governor and General Assembly .
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In
some of the posts from Week 2, there was some discussion among the class on how
the general public will increasingly utilize the health care system with the
requirement and expansion of private health care coverage. Based on
the second reading/link for this week, please indicate an Outreach Plan on how
you would reach a specific demographic (i.e. young adult males) to
make them aware that these health insurance options are available to
them? How would you educate them on their eligible benefits and what
types of communication would you use? Also, how would you overcome any
objections? I would like to see various groups targeted by the class for
this exercise.
The first Answer is fromMohamed Geire
Mohamed Geire
Week 3, Q2
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Outreach Plan
My outreach program would focus
on immigrant families from East Africa, mainly from Ethiopia and Somalia who
live in Maryland. I would educate them their rights to health care and ensuring
they know how to enroll and obtain coverage. The information they will receive
includes; enrollment in qualified health plans, Medicaid, the Maryland
Children’s Health Program, subsidized and non-subsidized qualified health plans
and available tax credits.
In response to Maryland health
exchange, I would set up digital and traditional educational materials and
content. The website would be an easy-to-use where you can search and compare
plans. I would set up a call center where the people who do not have access to
Internet could call and ask questions. Furthermore, I would set up places where
you can sign up in your community. Also, I would establish community health
educators to counsel and enroll residents into qualified health plans and
Medicaid through Maryland. In addition to these outreach, I would post
adverting on community TV/Radio in Maryland.
Finally, These communities face
many challenges, which includes, language barrier and the culture. In order to
make it very clear, the first step I would take is to translate the Maryland
health exchange program into Amharic and Somali languages.
The
second answer is from Cynthia Van Fleet
Cynthia
Van Fleet
Reaching
Out to Parents of Young Children (0-5)
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It is important for parents
with young children (ages 0-5) to know what their options for health insurance
coverage are, through both state-funded programs and consumer-purchased plans.
It is important for families to be aware not only of the penalty for not
purchasing insurance, but of the benefits that having insurance can provide and
the ease of access that the Maryland Health Benefit Exchange (MHBE) can
provide. The first reading discussed not only benefits for consumers in
Maryland, but also for providers and insurance companies. However, this
outreach should focus on “what’s in it for me?” from a consumer’s point of
view. Individuals who are not already prepared to utilize the MHBE need to know
how it will be convenient for them to access information on available plans,
compare the costs/benefits of different plans, and allow them to find the right
plan for them. How it works, how it benefits consumers, and why coverage are
important will need to be featured.
There
are a variety of ways to reach this population including pamphlets,
newspaper/web articles, social media, and information at local community
centers/schools/libraries/etc. For those who already have a healthcare provider
or seek emergency care, information can be sent home from the care provider.
Many parents are on social media and ads or articles can be posted; word of
mouth by sharing an informative article or link to information on Maryland.gov
will be relatively inexpensive. Schools and local government agencies can
certainly have brochures/information available on the MHBE as well as
libraries, day cares, and other places that parents frequent. Making these
materials available in both English and Spanish or even other languages based
upon need/request can be an aid in reaching more households.
Few parents will object to the need for coverage for their children. Check-ups
are frequent during infancy. Immunizations and a physical are necessary for
children to enter day-care/school and often to participate in sports. Some parents
may object however to needing health insurance coverage for themselves, citing
lack of recent healthcare need, being healthy, not wanting to go to the doctor,
etc. Even if one does not often get sick often, an injury can occur at any
time… and be costly. It may be necessary to provide statistics with
“sticker-shock”. For example, in 2006, the average cost of a hospital stay in
Maryland was $9,440. (Bishop, 2007). It is important to educate parents that by
ensuring health coverage for themselves, they are: creating peace of mind for
themselves/family, protecting against a potential financial disaster, and
protecting themselves against preventable health conditions (if they choose to
utilize preventive/wellness care).
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