HA415 Unit 3 Discussion 2&3

In two separate paragraph give your personal opinion to Tia Heikkinen  and Dalron Mcallister 

Tia Heikkinen 
Community rating of health insurance is when insurance companies rate premiums based on a group of people like families and geography (Teitelbaum, n.d.). Most consumers would prefer to purchase insurance that is part of a large group as it is cheaper than purchasing insurance individually or in a smaller group (Teitelbaum, n.d.). The advantages of community rating in health insurance are that if there is a larger group then the health risk rate is usually at an average which makes the premiums lower than the would be as a smaller group or individually (Teitelbaum, n.d.). The disadvantages of community rating health insurance are that insurance companies also use age and gender when calculating premium costs when using a “modified” community rating (Teitelbaum, n.d.). Which could cause higher premiums for those who are healthier than others (Teitelbaum, n.d.).
In general, the best possible rating method would be community rating rather than experience rating because premiums would be less expensive with a few unhealthy people with more healthy people (Teitelbaum, n.d.). Community rating would also benefit those in a much larger group. If insurers preferred experience rating, then a consumer might have to pay more for the same type of insurance plan another consumer has based on their health risk (Teitelbaum, n.d.).
However, it may be different for that of a young, healthy individual because then their premium may be lower based on his experience rating (Teitelbaum, n.d.). If this individual does not have a higher health risk, then he/she may opt to use the experience rating (Teitelbaum, n.d.). Depending on the health of the older individual then they may prefer experience rating as well if he/she has a lower health risk (Teitelbaum, n.d.). If the older individual has a higher health risk, they may opt to choose community rating (Teitelbaum, n.d.).
References:
Teitelbaum, J.B. Essentials of Health Policy and Law. [Purdue University Global Bookshelf] Retrieved from https://purdueuniversityglobal.vitalsource.com/#/books/9781284158793/ 

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 Dalron Mcallister 
Ultimately the government is responsible for those that are uninsured and finding a solution to counter this problem. I believe demographic characteristics such as High blood pressure in African Americans or Hep B outbreaks in some of the Asian countries. These are healthcare demographics that will affect your health coverage. If you present with criteria that shows you will inherit issues that could potentially cause the insurance company money your policy could be higher. The reason your policy may be higher than others of the same age is due to the potential of the insurance company having to pay out money for your care. I believe that insurance should be based on race but off the actual insurer’s health separately. Yes, these pre-diagnosed issues could be potential big payouts for insurance companies, but I don’t think a person should be charged for something that could never occur.
Overall insurance companies should change their methods because they’re outdated and considered racial profiling by some now and days. The government as I stated previously has the final say in all matters about this problem. A meeting between insurance companies reps and the local governments from each state should meet to find solutions that are both legal and ethical based on today’s parameters. 

 

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