Texas Healthcare Systems

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Texas Healthcare Systems

Health care in the U.S is financed by a combination of public and private sources. Providers deliver service to patients and get paid either by the private health plans or are reimbursed by the government programs (Medicaid, Veterans Administration, The Military, Federal Government Employee Insurance Program and Medicare).For example in Texas in Texas, the federal government currently pays $0.58 for every $0.42cents the state spends on Medicaid and $0.70 for every $0.30 the state spends on Children's Health Insurance Program (CHIP)
As this financing and reimbursement is quite complex, payers are usually involved to handle these transactions between health plans or government programs on the one hand and providers on the other.
This network comprising payers and providers is called a Healthcare System.
Texas has the highest number of people who are uninsured in the nation with more than 24 percent of the population lacking healthcare plan coverage (THA 2013).
The effect of this disparity is that the health care costs for the uninsured and under insured end up being shouldered by those who have private health plans. For example it is estimated that $1,800 is shifted from a typical family annual premium to cover the uninsured. Secondly, inadequate government funding through Medicaid creates a situation where the providers shift the costs to those who have private insurance.
As there is no "free" or "uncompensated" care, someone has to pay for any care provided. Where care has been provided to an uninsured or underinsured person, a portion of the cost is shifted
to those with insurance, and another portion is subsidized by the provider. Local taxpayers also subsidize care to those without coverage.

It is for this reason that the Patient Protection and Affordable Care Act (PPACA) of 2010 was enacted to reduce the burden of uninsured on those with health plans.
The goals of this Act include:
• Expanding coverage
• Reducing costs through efficiency and quality improvement
• Making private health insurance more affordable and accessible
To facilitate implementation, the following systems have been put in place around the country, Texas inclusive:
• In order to make the insurance market more competitive and affordable for as many people as possible to join, state and federal health insurance exchanges have been created.
• Subsidies have also been introduced to help working families afford health care insurance
• The personal mandate creates a further motivation for individuals to buy insurance
• Tax credits and penalties will encourage businesses to offer coverage to employees.
The advantages of having insurance by any individual include the following:
• Access to preventive and primary care which contributes to better health outcomes and lower costs
• A healthy quality life
• Insurance ...