Ten Health Care Terms You Need to Know
Posted by rpereira on August 20, 2009 at 04:41pm
 

By: Emily Beaver

Maybe you've heard President Obama talking about reforming health care or seen TV news reports about people protesting recent town hall meetings. But if you think health care reform doesn't impact you, it's time to tune into the debate.

One goal of health care reform is making sure that everyone can get health insurance, including young people. About 30% of Americans ages 19-24 don't have insurance, and one in seven teens doesn't have insurance, says Claire Brindis, Director of the Philip R. Lee Institute for Health Policy Studies at University of California, San Francisco.

Many young people aren't covered by their parents' health plans, don't get insurance at work, can't afford to buy insurance or simply don't think they'll get sick. But if you get sick or injured when you're uninsured, you might not get the medical care you need or you may go into debt because of medical bills.

 

Cutting through the health care jargon isn't easy. Here are ten health reform terms you need to know:

1. Expanding coverage

Expanding health insurance to cover all Americans is a major part of health reform, Brindis says. Other important goals are making sure that people who do have insurance can keep it and lowering the costs of providing health care.

2. The public option

You may have heard debate about whether a "public option" should be included in health reform. The public option is health insurance run by the government, says Melissa Rodgers, Associate Director of the Berkeley Center on Health, Economic and Family Security.

A public health insurance plan would be one option for people who don't have insurance, or don't have insurance that covers their medical needs, Rodgers says. No one would be forced to participate in the public plan.

A public plan can do things the private insurance market can't, like make sure that everyone gets access to affordable healthcare, she says.

3. Medicare/Medicaid

Medicare and Medicaid (which is called Medi-Cal in California) are public health insurance plans the government already runs. Medicare is a national program that provides health insurance for people age 65 and older, and some younger people with disabilities.

Medicaid is a health insurance program for low-income people run by individual states. Each state has different rules about how poor you must be to qualify for Medicaid, Brindis says.

4. Individual Mandate

An individual mandate means that every American would be required to have health insurance. If this mandate was approved, young people could no longer go without health insurance because they can't afford it or don't think they will get sick, says William H. Dow, Associate Professor of healthcare economics at U.C. Berkeley.

If everyone has to be insured, the government will have to help people who can't afford insurance pay for it, Dow says. That could put pressure on the government to find more money to help people pay for health care.

5. Employer-sponsored coverage

Many workplaces, from small businesses like your neighborhood coffee shop to large companies like Starbucks, provide health insurance coverage for employees. People who are self-employed or work part-time usually don't get employer-sponsored coverage.

6. Individual market

The individual health insurance market is currently the main option for people who can't get insurance coverage through a government program like Medicare or Medicaidan or an employer-based plan (or through a parent or spouse's employer-based plan). On the individual market, private insurance companies negotiate prices for health plans with individual people or families rather than large groups of people, such as all the employees at a company.

Employer-sponsored coverage has a different set of rules than the individual market. In the individual market, nothing prevents insurers from denying participants coverage or charging high prices, Rodgers says.

"The individual market is the wild, wild west of insurance," she says.

7. Underinsured

If you have health insurance, but it doesn't cover a service you need, you're underinsured. For example, you're pregnant but your insurance doesn't cover care you need through pregnancy or childbirth.

8. Pre-existing condition

If you have a history of illness or a medical condition that existed before you applied for insurance, private insurance companies may refuse to insure you. Diseases like cancer or diabetes are examples of pre-existing conditions that may make it difficult for a person to be approved for private health care coverage. Insurance companies may also refuse to pay for any care related to a pre-existing condition, Rodgers says.

9. Exchange

An exchange is one way to expand coverage to the uninsured. Anyone who doesn't have access to health care would be placed in a group called an exchange, where they could choose from a variety of private and public health plans, Rodgers says.

10. Electronic medical records

Electronic medical records let doctors and other health care professionals share information about patients across different healthcare settings, like hospitals and doctors' offices. Electronic medical records could prevent doctors from duplicating costly tests that increase the cost of medical care, Brindis says. Lowering what health care costs will be important if the government tries to expand coverage to everyone.
 

 

 




Comments

I agree

I fully agree with the previous commenter, lets get everybody involved it is an issue of great impact for this nation, we are the most powerful country in the world yet out health system is below that of many countries

USA needs health reform

I think, USA needs health reform badly, making health insurance available for everyone is very good idea. Ornela from inzercia zdarma

Health

The health issue is very serious tho many people simply ignore it. These terms should be implemented in the whole USA and worldwide. Thanks

I think that this an

I think that this an important issue. For example, people who smoke make up 2 or 3 times of the costs, than people who do not smoke. The same applies for exercises. People who are sitting on their 'lazy asses' cost even more money than people who sport regularly.

The current healthcare sux

I hear from people all the time if your in public healthcare you might as well be dead, its not far of considering all the care you'd be getting or lack there off. It's no wonder everyones so angry about it!

Health Issue

The health issue is very serious tho many people simply ignore it. These terms should be implemented in the whole USA and worldwide.

you have taken a long time

I find it incredible that a country as developed does not have minimum medical services. I live in Ibiza, Spain. Everyone here is entitled to medical care. This service is part of our salary we pay. Maybe not sick, but I am calm when I think that other patients can be cured thanks to my salary and that of others.

Pay the price - unhealthy behaviour

I think that the regulation has to be transformed in such way, that people who harm their health by doing things that are not healthy, like smoking, should pay more for the costs. I think that this an important issue. For example, people who smoke make up 2 or 3 times of the costs, than people who do not smoke. The same applies for exercises. People who are sitting on their 'lazy asses' cost even more money than people who sport regularly. I think everybody has a responsibilty to be healthy. Regards, Sms dating

I'm completely in favor of

I'm completely in favor of government health care paying for abortions. Despite the views of the right to life crowd, the majority of fetuses that are terminated (or babies that are killed, if you prefer) would otherwise be born into families that neither want them nor can afford them. They are likely to become an immediate drain on the welfare system, will probably end up in schools that are overcrowded, where they will represent just one more bored student taking time from students who might want to learn, may very well end up in jail, where tax dollars will continue to support them. Is this a generalization? Of course. Is this result guaranteed? No, a percentage of them will turn out okay. But I don't mind losing 20% of potentially productive citizens if it means losing 80% of potential drains on the system. I wonder how many millions of dollars abortions save the country over a single lifespan. Johnny, how to get pregnant

what we need to do

Us teenager need to band together to show obama that he is a president who deos not deserve to be in office i am not saying we should over throw him but he does not relize who he is hurting sure bush screwed up but thanks to obamahose of us who live in the 808 state that are public schooled who care about school r losing our school time and are alsolosing the amount our breaks are . what i porpose is that we come together to show obama that we mean buisness

point no. 6 is important for me.

No. 6 point has a lot to do with knowledge of health care. The individual health insurance market is presently the main option for people who can't get insurance coverage through a government program. Individual market is total different from the Employer-sponsored coverage. I found out this point more important than other 9 points. Regards, Magnesium Supplement

I fully agree with the

I fully agree with the previous commenter, lets get everybody involved it si an issue of great impact for this nation, we are the most powerful conutry in the world yet out health system is below that of many conutries, Regards Galilea Montijo

make some sort of health

make some sort of health care reform festival, get cool indie bands to play, get the kids interested. i see it happening.

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