Literature DB >> 22068620

Necessary health care and basic needs: health insurance plans and essential benefits.

Andrew Ward1, Pamela Jo Johnson.   

Abstract

According to HealthCare.gov, by improving access to quality health for all Americans, the Affordable Care Act (ACA) will reduce disparities in health insurance coverage. One way this will happen under the provisions of the ACA is by creating a new health insurance marketplace (a health insurance exchange) by 2014 in which "all people will have a choice for quality, affordable health insurance even if a job loss, job switch, move or illness occurs". This does not mean that everyone will have whatever insurance coverage he or she wants. The provisions of the ACA require that each of the four benefit categories of plans (known as bronze, silver, gold and platinum) provides no less than the benefits available in an "essential health benefits package". However, without a clear understanding of what criteria must be satisfied for health care to be essential, the ACA's requirement is much too vague and open to multiple, potentially conflicting interpretations. Indeed, without such understanding, in the rush to provide health insurance coverage to as many people as is economically feasible, we may replace one kind of disparity (lack of health insurance) with another kind of disparity (lack of adequate health insurance). Thus, this paper explores the concept of "essential benefits", arguing that the "essential health benefits package" in the ACA should be one that optimally satisfies the basic needs of the people covered.

Entities:  

Mesh:

Year:  2013        PMID: 22068620     DOI: 10.1007/s10728-011-0197-5

Source DB:  PubMed          Journal:  Health Care Anal        ISSN: 1065-3058


  18 in total

1.  Normal functioning and the treatment-enhancement distinction.

Authors:  N Daniels
Journal:  Camb Q Healthc Ethics       Date:  2000       Impact factor: 1.284

2.  Health care and the prospective Pareto principle.

Authors:  Allan Gibbard
Journal:  Ethics       Date:  1984-01

3.  Defining an "adequate" package of health care benefits.

Authors:  Paul E Kalb
Journal:  Univ PA Law Rev       Date:  1992-05

4.  The rise and fall of managed care.

Authors:  David Mechanic
Journal:  J Health Soc Behav       Date:  2004

Review 5.  Clinical practice. Idiopathic short stature.

Authors:  Mary M Lee
Journal:  N Engl J Med       Date:  2006-06-15       Impact factor: 91.245

6.  The health care resource allocation debate. Defining our terms.

Authors:  D C Hadorn; R H Brook
Journal:  JAMA       Date:  1991-12-18       Impact factor: 56.272

7.  Medical necessity and defined coverage benefits in the Oregon Health Plan.

Authors:  P A Glassman; P D Jacobson; S Asch
Journal:  Am J Public Health       Date:  1997-06       Impact factor: 9.308

8.  Needs, need, needing.

Authors:  D Wiggins; S Dermen
Journal:  J Med Ethics       Date:  1987-06       Impact factor: 2.903

9.  Toward justice in health care.

Authors:  R Bayer; D Callahan; A L Caplan; B Jennings
Journal:  Am J Public Health       Date:  1988-05       Impact factor: 9.308

10.  The moral foundation of the clinical duties of care: needs, duties and human rights.

Authors:  L Doyal
Journal:  Bioethics       Date:  2001-10       Impact factor: 1.898

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