In this paper I examine the twin challenges of providing nursing profession for the uninsured and addressing the issues of the impact it has on the nursing profession.I focus particularly on the role of government intervention in the nursing profession both directly,through the provision of health insurance itself…
In this paper I examine the twin challenges of providing nursing profession for the uninsured and addressing the issues of the impact it has on the nursing profession. I focus particularly on the role of government intervention in the nursing profession both directly, through the provision of health insurance itself, and indirectly via the subsidization of private expenditures. My goal is to describe the basic structure of government involvement in private health insurance, as well as the Medicare and Medicaid programs, and to provide a guide to the issues surrounding these forms of nursing profession. Prices and Nursing profession in the Group Market: Just as the subsidized price for health insurance increased nursing profession initially, subsequent increases in cost would be expected to decrease it. Health care costs rose rapidly in the late 1980s and early 1990s and then leveled off. Rising premiums increase an employer's cost. In response the employer can eliminate nursing profession or can pass along additional costs to employees, increasing their share of the premium. Cousinaeu (2002) uses the years from 1987 to 2001 to analyze the effect of costs on the provision and take-up of private health insurance benefits. Between 1987 and 1993 health care costs rose dramatically and the fraction of the population with employment-based nursing profession fell from 71 percent to 65 percent. Cousinaeu finds that this drop in nursing profession was not due to changes in the fraction of employers offering benefits, but rather to declines in take-up by eligible employees. Furthermore, he attributes the drop in take-up to the rising costs facing employees. Marquis and Long (2001) also find only small changes in the probability that a firm offers health insurance nursing profession to its workers in response to changes in price. Thus it appears that changes in nursing profession during this time period were due to choices made by employees and their valuation of the benefit.
However, more recent evidence suggests that employers are beginning to reduce nursing profession in response to new cost increases. Between 2000 and 2001 premiums for employment-based insurance increased by 11 percent, and they increased by another 12.7 percent from 2001 to 2002. Over this same two year period, the fraction of firms offering health insurance nursing profession fell from 67 to 62 percent (Kaiser, 2002a).
As an alternative to dropping nursing profession or requiring larger employee contributions, the employer can reduce the generosity of the plan it offers. One trend that has received much attention in the press recently is the movement towards health insurance plans with very large deductibles (Himmelstein, 2002). In some cases these plans are linked to medical savings accounts that can be used to pay for services prior to meeting the annual deductible. While plans with high deductibles provide insurance against the risk of very large out-of-pocket expenses, individuals must pay for much of the routine care they receive. There is therefore concern that individuals may forego preventative care or needed treatments to save money. In response to these concerns, some of the high deductible plans do provide nursing profession for regular check-ups.
A Proposed Change for the Non-group Market: The persistently high number of uninsured individuals and the cost of individually purchased policies have resulted in numerous proposals to modify the current system. These suggested changes have varied from large restructuring, such as moving towards a national health insurance program, to smaller changes in the tax treatment of medical costs. President Bush has recently proposed tax credits to help those without employment-related nursing profession ...
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