As the US looks at mandated Health Care these are the terms that are being bandied about that one may hear in the coming months.
Employer mandate a requirement that employers provide or arrange health insurance coverage for employees. Typically, such proposals require coverage of worker’s families, too.
Fee for service an arrangement under which doctors or other health care providers are paid separately for each service they perform. Some economists say this method of payment may give doctors an incentive to provide more services then needed.
Global budget a limit on all health care spending. The limit could be enforced through regulation of doctors’ fees and hospital charges. But such price controls are not always included in the idea of a global budget.
Health insurance purchasing cooperative (HIPC, pronounced HI Pick). An entity that buys insurance coverage and medical care for a large number of people, including employees of small businesses.
Health maintenance organization (H.M.O.). A prepaid group health plan, which provides a range of services in return for fixed monthly premiums,
Managed care a method of delivering, supervising and coordinating health care, often through H.M.O.’s and other networks of doctors and hospitals. The purpose is to eliminate inappropriate services, control costs and assure access to effective treatments.
Managed competition A health policy that combines free market forces with Government regulation. Large groups of consumers and businesses buy heath care from organized networks of doctors and hospitals, which are supposed to compete by offering low prices and high quality. President Clinton has embraced this idea.
Medical Program that provides health care for low income people, including children and pregnant women, as well as some elderly residents of nursing homes. It is financed jointly by the Federal Government and the states.
Medicare Federal health insurance program for the elderly and the disabled. Eligibility is not based on a person’s income.
Tax cap a limit on Federal Tax breaks for health insurance that could apply to employers or employees or both.
Article extracted from this publication >> April 2, 1993
