Community Health Nursing
Affordable Care Act
The systems function based on the health insurance plan of an individual. The plan is categorized into three metals i.e. gold, silver, bronze and platinum for most people. A special plan “catastrophic plan” is also available which caters for some people. The plan splits health insurance cost based on a specific metal. In each plan category, the insurance company pays a certain percentage and the rest is paid by the individual. A survey conducted on a typical population shows the estimated average cost that is split between the insurance company and an individual. In bronze category the insurance company pays an estimated cost of 60% whereas the individual pays 40%. In silver category, the estimated percentage cost paid by an individual is 30% and the insurance company pays the remaining 70%. In the gold category, the insurance company pays an estimate of 80% and the individual pays 20% of the total cost. The estimated percentage paid by the insurance company in the platinum category is 90% and the individual pays 10% of the total cost (Authors of healthcare.gov, 2016).
The customer cost and services that are offered vary in every metal tier. The Bronze category is characterized by the lowest monthly premium but it incurs the highest cost when someone requires medical care. The deductible paid by an individual in the bronze plan in a year can be thousands of dollars before the insurance plans pays. This type of plan is the most favorable choice for individuals who want a way to cover themselves from worst medical scenarios at low cost. This is because the monthly premium is low but the individual is asked to pay for most routine care. The monthly premium and needed cost during for medical care in the silver category are moderate. In the silver plan, the deductible an individual pays are lower compared to the bronze plan before the insurance company starts to pay. The silver plan is advantageous to individuals who qualify for cost-sharing reductions since they earn extra savings. In this plan, an individual can save a lot of money per year when using lots of medical care. This choice of plan, best suits individuals who qualify for extra saving. It is also favorable for individuals who wants a cover for their routine care and don’t qualify for extra saving and are willing to pay a monthly premium that is slightly higher than bronze. The gold plan has a monthly premium that is high but when an individual requires medical care the cost is low. The deductible paid by an individual in the gold plan are normally low before the insurance company starts to pay. This plan best suits individuals who want more cost covered during medical care but are willing to pay a higher monthly cost.
The platinum plan is characterized by the highest monthly premium but the lowest cost during medical care. The deductibles in this plans are the lowest hence the insurance company pays its required cost earlier than other plans. This plan best suits individuals who seek a lot of medicals care and wants all medical costs covered but are willing to pay a monthly premium that is high. In all the three plans individuals are provided with free preventive care. Some of these plans also give services freely or at a discountable cost before they meet their deductibles. The monthly premiums are low in all metal categories based on an individual’s income. Through this, individual’s saves a lot of money on their monthly premium. Individuals who fill out applications for marketplace insurance can find out their qualifications for extra savings. The catastrophic health plan is characterized by monthly premiums that are low but deductibles that are very high ($6850) (Authors of healthcare.gov, 2016). This health plan is an affordable way for individuals who want protection against worst cases medical scenarios. In this plan, the individuals pay expenses for their routine medication. Individuals who qualify for a catastrophic medical plan are displayed in marketplaces when applying and comparing the plans.
Cultural Assessment of Korea Descent
The Korean ethnic population was found in great numbers in Hollywood, California. It was estimated in a certain local are the ethnic group formed 23% of the population (Clark, 2008). The Korean descent people had a cultural shock when encountering with health care systems that were scientific. The problems that were faced were based on lack of their ethnic meals in hospitals, language barrier and lack of their family members in the health sector. These problems affected their access to health care since most of them didn’t believe in scientific systems of health. Due to this, a Korean Care Centre (KCC) had to be created by Hollywood Presbyterian Medical Centre.
The KCC had to employ Korean bilingual nurses and provide Korean meals in the health center and also provide Korean television and newspapers. The medical center had also to accommodate family member from Korean descent who did the traditional role to the ill patient. These modifications to the health center were very extensive in order to meet the population’s needs. If these modifications were not made it appears that their cultural practices, beliefs, language barrier and perspective would have greatly impacted the population’s health care access (Authors of web.stanford.edu, 2016). The ethnic group believes negatively affected the health care since they believed in traditional methods of treatment. Their religions don’t embrace scientific systems of health which also impacted care access to the population. Elders greatly influence the beliefs of the population as they mostly rely on traditional methods.
Case Study Financing Care for the Underserved
The health status of migrant groups in United States is influenced by their social economic factors in the country. Their health statuses are greatly influenced by poverty and lack of an insurance cover for their health. Between 2007 and 2011 study shows that the income of a median household in united states declined by 8.1% with the migrants facing higher decline rates. The migrant’s rates included 25.8% for blacks, 25.3% for Hispanics, 12.2% for whites and 12.5% for Asians. This led to high levels of poverty among migrants. Due to this most migrants lacked money to seek medical care. Most migrants in United States lacked medical insurance. Studies conducted in 2009 showed most migrants were not insured starting with Hispanic at 32%, blacks at 21% and Asians at 17% (Clark, 2008). Due to this most migrants could not access medical care hence their health status greatly declined.
Healthcare for this population would be financed through government funded care. This would help the migrant’s access medical since in this type of health care funding works for people who are not insured. The government would care for their health care hence improving their health status. Through this program, the migrants would fall under Medicaid program which would address their medical needs. The Medicaid program is all inclusive and supports quality services to all communities (Authors of medicaid.gov, 2016). It is also efficient, culturally competent, transparent, coordinated and a sustainable type of health care.
Health care to migrants cannot be appropriately cared for by the Fee-For-Service or Managed Care Arrangement plan. This is because studies show that this plan has a low quality of care when compared to the non-managed care plan. The hypothesis statement stated that the managed care plan compromises the quality of care. The plan was aimed at reducing access and services so as to provide effective care. Studies also show that the quality of results after medical care widely varied and was specific to a certain population (Petroski, 2008). This means that some population received poor care compared to others hence this plan was biased towards a certain population.
Authors of healthcare.gov,. (2016). Understanding Marketplace health insurance categories. HealthCare.gov. Retrieved 20 October 2016, from https://wwwv.healthcare.go/choose-a-plan/plans-categories/
Authors of medicaid.gov,. (2016). Long Term Services and Supports | Medicaid.gov. Medicaid.gov. Retrieved 21 October 2016, from https://www.medicaid.gov/medicaid/ltss/index.html
Authors of web.stanford.edu,. (2016). Health and Health care of Korean American. Web.stanford.edu. Retrieved 21 October 2016, from http://web.stanford.edu/group/ethnoger/korean.html
Clark, M. (2008). Community health nursing. Upper Saddle River, N.J.: Pearson Prentice Hall.
Petroski, J. G. (2008). Fee-for-service Versus Managed Care Plan Performance: A Longitudinal Study of Medicare Patients’ Self-reported Health Status. ProQuest.