Analyzing the Current State and Challenges in the Economic and Practical Aspects of Private Health Insurance in the United States

Meng Sun

doi:10.54097/6bg5cv18

Authors

Meng Sun

DOI:

https://doi.org/10.54097/6bg5cv18

Keywords:

Private health insurance, the United States, insurance coverage, limitations, costs.

Abstract

The expansion of healthcare insurance coverage in the United States is a multifaceted outcome, achieved through a range of concerted initiatives and strategies. These efforts encompass not only government policies and reforms but also the contributions of various healthcare providers and insurers. However, private insurance, mainly provided by employers, remains the most prevalent form of coverage. Therefore, it is imperative to study the status of private healthcare insurance. This examination aids policymakers in understanding insurance plan specifics and limitations. Additionally, analyzing current trends and challenges, such as escalating costs and competition, offers valuable insights for future policy. The study found that healthcare insurance coverage has seen a general increase in the United States. Short-term trends show growth in both public and private insurance, while long-term preferences lean towards public insurance due to recent pandemics. Private insurance, however, maintains stability. Private insurance still has notable coverage limitations, emphasizing the need for services to be necessary and appropriate, resulting in exclusions, administrative complexities, and high costs. The multi-insurer system in the U.S. leads to duplication and increased operational expenses compared to single-payer systems. Policymakers must adopt effective measures to address these issues and enhance healthcare insurance's affordability and accessibility for the future.

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References

Barnes, A. J., & Hanoch, Y. Knowledge and understanding of health insurance: Challenges and remedies- israel journal of health policy research. BioMed Central. 2017. https: //ijhpr.biomedcentral.com/articles/ 10.1186/s13584 - 017 - 0163 - 2.

Holst, L., Victoor, A., Brabers, A., Rademakers, J., & de Jong, J. Health insurance literacy in the Netherlands: The translation and validation of the United States’ Health Insurance Literacy Measure (HILM). PLOS ONE, 17 (9), e0273996. 2022. https://doi.org/10.1371/journal.pone.0273996.

Paez, K. A., Mallery, C. J., Noel, H., Pugliese, C., McSorley, V. E., Lucado, J. L., & Ganachari, D. Development of the Health Insurance Literacy Measure (HILM): conceptualizing and measuring consumer ability to choose and use private health insurance. Journal of health communication, 19 Suppl 2 (sup2), 225 – 239. 2014. https://doi.org/10.1080/10810730.2014.936568.

Bhargava, S., Loewenstein, G., & Sydnor, J. Do Individuals Make Sensible Health Insurance Decisions? Evidence from a Menu with Dominated Options. 2015. https: //doi.org/10.3386/w21160.

Liz Hamel. Kaiser Family Foundation/LA Times Survey of adults with employer-sponsored insurance. KFF. 2019. https://www.kff.org/private-insurance/report/kaiser-family-foundation-la-times-survey-of-adults-with-employer-sponsored-insurance.

Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey. 2022. https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202305_1.pdf.

Cawley, J., Moriya, A. S., & Simon, K. The impact of the macroeconomy on health insurance coverage: Evidence from the great recession. Health Economics, 24 (2), 206 – 223. 2013. https: //doi.org/10.1002/hec.3011.

Jacobs, P. D., & Moriya, A. S. Changes in health coverage during the COVID - 19 pandemic. Health Affairs, 42 (5), 721 – 726. 2023. https: //doi.org/10.1377/hlthaff.2022.01469.

Institute of Medicine (US). Preparing for a Changing Healthcare Marketplace: Lessons from the Field. Washington (DC): National Academies Press (US). The Evolution of Private Health Insurance: Past Issues, Future Challenges. 1993. Available from: https://www.ncbi.nlm.nih.gov/books/NBK231254/.

Institute of Medicine (US) Committee on the Consequences of Uninsurance. Care Without Coverage: Too Little, Too Late. National Academies Press (US). 2002.

Christensen S. Effects of selected fee schedule options on physicians' Medicare receipts. Health care financing review, 9 (2), 25 – 37. 1987.

Costs of Health Care Administration in the United States and Canada. New England Journal of Medicine, 349 (25), 2461 – 2464. 2003. https://doi.org/10.1056/nejm200312183492517.

Pauly, M., Percy, A., & Herring, B. Individual versus job-based health insurance: weighing the pros and cons. Health affairs (Project Hope), 18 (6), 28 – 44. 1999. https: //doi.org/10.1377/hlthaff.18.6.28.

Forrest, C. B., Nutting, P., Werner, J. J., Starfield, B., von Schrader, S., & Rohde, C. Managed Health Plan Effects on the Specialty Referral Process: Results from the Ambulatory Sentinel Practice Network Referral Study. Medical Care, 41 (2), 242 – 253. 2003. http: //www.jstor.org/stable/3767537.

Dor, A., Sudano, J., & Baker, D. W. The Effect of Private Insurance on the Health of Older, Working Age Adults: Evidence from the Health and Retirement Study. Health Services Research, 41 (3p1), 759 – 787. 2006. https: //doi.org/10.1111/j.1475 - 6773. 2006. 00513. x.

Gruber, J., & Washington, E. Subsidies to employee health insurance premiums and the health insurance market. Journal of Health Economics, 24 (2), 253 – 276. 2005. https: //doi.org/10.1016/j. jhealeco. 2004. 08. 004.

Dafny, L. S. Are Health Insurance Markets Competitive? American Economic Review, 100 (4), 1399 – 1431. 2010. https: //doi.org/10.1257/aer. 100. 4. 1399.

Private Health Insurance Markets. (n.d.). NBER. https: //www.nber.org/reporter/2012number1/private-health-insurance-markets.