Introduction
An efficient health insurance system is one of the main tools that ensures people’s access to high-quality health care in the United States. Many different health insurance schemes exist, but the “fee-for-service” or FFS system is the most common. It is important to note that the conventional FFS health insurance scheme guarantees people in the United States the provision of the best possible health care because of its low costs and access to various specialists and services, Opportunities to improve the related policies, and the role of advocacy will also be considered in this paper.
Discussion
Conventional FFS medical insurance, or private or indemnity insurance, provides several benefits for insured individuals. Thus, insured people receive access to a wide range of quality healthcare services at any time, and this approach promotes their longevity. Furthermore, the insured can choose their treating doctor and visit any medical center or clinic offering the necessary medical assistance. According to Beik and Pepper (2020), “this type of health insurance offers the most choices of physicians and hospitals” (p. 134). This approach encourages doctors and healthcare providers to provide high-quality services, as their income is directly related to the quantity and quality of services.
Additionally, this system provides access to different medical services at a low cost. The cost of medical care in the US is very high, which can be a problem for many people. Still, the FFS insurance contract usually determines the insured persons’ right to receive needed care and pay less. Clients are also entitled to additional discounts and benefits the insurance company provides (Garcia, 2020). One should state that paying for a service contributes to developing medical technologies and improving treatment methods, as healthcare providers and clinics benefit from introducing new and effective methods to increase their income. To improve the health insurance system, it is necessary to reduce the cost of medical care by reducing medical service costs and improving the organization of medical care.
Indemnity insurance is attractive for most people because it gives access to various medical tests and procedures that can help maintain health and provide long-term health that is not covered according to other insurance plans. This system is handy for the poor and unfortunate cases when people need exceptional medical help and cannot pay for it directly (Di Guida et al., 2019). In these cases, regular FFS medical insurance allows people to get medical help without paying large sums out of pocket.
However, the FFS approach has some weaknesses that can be addressed with the help of improving related policies. One of the main drawbacks of the system is the difficulty of obtaining compensation when visiting a medical facility. In addition, restrictions on treatment and medical services may be applied in some cases, as well as increased fees for visiting a partner network (Garcia, 2020). To improve the functioning of medical insurance, transparency, and detailing should be introduced into policy so that people can better understand the processes for obtaining compensation (Gomberg et al., 2022). Furthermore, it is also important to note that many people in the United States do not have access to medical care due to lack of insurance or high cost of medical services, and it is necessary to improve policies ensuring the accessibility of medical care for all US citizens, including underserved and low-income groups.
It is also important to note that information and advocacy activities can significantly help improve the principle of conventional medical insurance. Thus, it is necessary to carry out information work with the population to raise awareness about various types of health insurance, access to medical care, and patient rights (Gomberg et al., 2022). In particular, medical institutes can inform patients about available medical services and provide correct information about potential expenses. This will allow people to better understand the medical insurance system and make more informed decisions about medical services and the type of insurance system to choose (Frean et al., 2021). In addition, advocacy work in the health insurance field is necessary, for example, to protect patients’ rights and fight for more accessible and quality services. This can contribute to improving the quality of medical care and reducing the cost of medical care.
Conclusion
To conclude, although the FFS-based medical insurance system provides people with easier access to quality health care, it can be improved through detailed and transparent policies, information, and advocacy activities. In most cases, conventional medical insurance provides the best medical care for people in the United States, and the proper allocation of resources will help improve medical care and provide people with better health and longevity. The choice of FFS insurance guarantees most individuals that they can choose any specialist they want, and they can receive any care they need.
References
Beik, J. I., & Pepper, J. (2020). Health insurance today (7th ed.). Elsevier Health Sciences.
Di Guida, S., Gyrd‐Hansen, D., & Oxholm, A. S. (2019). Testing the myth of fee‐for‐service and overprovision in health care. Health Economics, 28(5), 717-722. Web.
Frean, M., Covington, C., Tietschert, M., Bahadurzada, H., So, J., & Singer, S. J. (2021). Patient experiences of integrated care in Medicare accountable care organizations and Medicare advantage versus traditional fee-for-service. Medical Care, 59(3), 195-201. Web.
Garcia, L. S. (Ed.). (2020). Clinical laboratory management (2nd ed.). Wiley.
Gomberg, J. D., Knadig, T. M., & Hammaker, D. K. (2022). Health care ethics and the law. Jones & Bartlett Learning.
