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Role that private insurance plays in healthcare

1. Include the role private insurance plays in the healthcare system, a current issue it is facing in the healthcare environment.

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2. Identify and provide links to at least two articles which address the current issue that is identified with private insurance. These articles should address the issue from at least two different points of view.

3. Find a specific organization, agency, or association that represents private insurance and document their position with respect to the private insurance issue identified in the paper. Why was this example used?

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Discussion and articles are provided in the enclosed document.

The role of private insurance in health care can be viewed from many different
positions. The role of private insurance in providing a much needed service to consumers is
one position. The role of providing a source of income for health care providers is another. Yet
another role of private insurers in health care is to provide financial benefit to its shareholders.
Because the role of private insurance in health care considers the different stakeholders, the
positions often conflict each other, in terms of which stakeholders may suffer for the benefit of
others and which stakeholders’ interests have priority over the others.
With respect to the role private insurers play in satisfying investors or shareholders, it is
becoming increasingly difficult to meet shareholder expectations. “On average, three out of
every four dollars used to purchase health care are actually paid by someone other than the
consumer who incurs the bill” (Miller, nd). The cost of purchasing health care typically falls to
individual corporations who offer group employee coverage and on insurers themselves. While
this does not mean consumers should pay more of the bill, it indicates that the costs of
administering health care are far too high.
The cost of administering health care benefits is far too high, even form the opinion of
those who pay less of the cost, the insured. In the Cato Handbook for Congress, Tom Miller
points out that employees who are covered under employer plans are dissatisfied with the
costs themselves. Many believe their employers could find a far better value for the cost.
“Approximately 48% think better health plans are available for the same cost.” While
employees may not understand the costs associated with administering health care plans; they

are as concerned about value as the other stakeholders involved.
For health care providers or organizations, working with private health care insurers
means limiting the charges for various procedures and often adjusting fees downward, so that
patients have less out of pocket expense. This can be a positive aspect of private insurance, as
usual and customary charges for various services …

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