Introduction
Hospitals, doctors, and nurses are more expensive in the U.S. than in other countries. In many countries, prices for medicines and healthcare are at least partially regulated by the government, whereas prices depend on market forces. In the United States, one of the medical insurance groups that provide health services for a fixed annual fee is the Health Maintenance Organization (HMO).
Health Maintenance Organization (HMO) Jun 9
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Most companies in the U.S. give their employees health insurance at an affordable price. But for those who work on their own or for employees of companies that do not provide health insurance, HMO provides or arranges for managed health care and health insurance. HMO then acts as a point of contact between health care providers and self-funded health or benefit plans on a prepaid basis.
Is healthcare expensive or cheap in your country?
HMOs often require their members to select a primary care physician, a doctor who acts as a gatekeeper for direct access to medical services. A primary care physician (PCP) is usually an internist, family, or general practitioner. A patient needs a referral from the PCP to see a specialist, except in medical emergencies. The PCP can only authorize this referral if the HMO instructions allow it.
Are specialist doctors expensive in your country or city? When was the last time you saw one?
The HMO also manages care through utilization assessment. This means they monitor doctors to see if they provide more or fewer services to their patients than other doctors.
What do you think are the characteristics of an excellent doctor?
Several studies indicate that private Health Maintenance Organization plans do not provide significant cost savings compared to other plans. Some argue that HMOs, especially for-profits, actually increase administrative costs.
How do you and your family pay for health care?
On December 1, 2006, the Mexican government created the Health Insurance for a New Generation and called it "Life Insurance for Babies." It was followed by an announcement by President Felipe Calderon, who stated that at the current rate, Mexico would have universal health coverage by 2011. In August 2012, Mexico achieved universal healthcare coverage.
Can universal health care be achieved in a country?
When it comes to HMO regulation in the United States, it is regulated at both the state and federal levels. The states license them under a Certificate of Authority (COA) license rather than an insurance license.
Why do you believe the U.S. health regulations are so important?