Paper on Problem Solving: Insurance Status and the Medical Bill Difficulties

Q1: Summary of the Problems in the Case Study

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From the case study, it is evident that there is a strong relationship between insurance status and the medical bill difficulties. One in five of those having health insurance through individual purchase (22%), employer (19%) and Medicaid (18%) report problems in paying medical bills. Among the self-insured individuals, their plans deducible make a difference in affording the health care bills. However, those with higher medical bills are more likely to report medical bill problems compared to those in plans with the lower deductible (26% versus 15%). An individual having greater health needs and poor health records also experience difficulties in medical health problems. This can be confirmed by the huge percentage of people who cannot complete their daily activities due to their disability. It is also an issue that the problem of paying the medical bills is most common among the moderate or lower incomes. About 37% of annual household incomes below $50,000 report having medical problems compared to a population of 26% that their annual income ranges between $500000-$100000 and the remaining portion that earns above $100000. Furthermore, women are more likely to report such problems as well as adults aged below 30 years compared to those that are aged between 30-64 years. It is important to note that race, gender, and ethnicity are not statistically significant predictors of problems paying medical bills. The case and the Excel data have indeed shown that the higher rates of reported medical problems among Hispanics, Blacks, and Women are associated with the variation in the insurance status and income between various groups and their counterparts.

Q2: Strategies for Solving the Problem

Because these problems are as a result of the relationship between a type of medical insurance and the medical debt, the first strategy that can be implemented is to educate the public on the right insurance covers to take and the ways the public can help manage their medical bills. This can be done through the social media, broadcast media and billboards. Another strategy is making the public to prioritize their insurance verification. This entails checking the insurance eligibility and coverage.

Q3 other solutions

Another feasible solution that can be embraced to mitigate the problem of paying insurance coverage is by making the patients analyze their account receivables. The patients need to be aware by their net income and how much they can spend on insurance without causing a strain on their finances. Being that quality health is a basic need; they need to allocate a portion of their income to cater for medical expenses and the best way to attain this by buying a medical insurance coverage. However, the medical insurance selected should be proportional to their income. It should be affordable and that do not stretch their income. They need to ensure that the coverage does not include a large junk of their income. There are a variety of medical insurance covers. Thus, they need to get enlightened on the different types of covers and select the best cover that suits their needs and is congruent to their income. For example, it is not advisable for a low-income earner to take up life assurance since this might cause a significant stretch on their income. They should thus settle for more affordable offers.

Q4 Analysis of the Solutions

The graphs below show the insurance types for those who had difficulties paying their medical bills. The deductible level for who have self-sponsored coverage or with employer-sponsored coverage (46%) was as follows: higher deductible plan (22%), lower deductible plans (22%) and unknown deductible plans (2%). It was evident that 75% of those who were insured confessed that they had to pay for their deductibles or insurance copays. The solution to this is reducing the coinsurance to levels that are affordable to those insured. From the charts below, I believe that Pareto diagram is the best for presenting the data as it gives more than two sets of data.

Pie chart for insurance types

Bar graph showing insurance types

Pareto diagram showing the insurance status of those who had difficulties paying their medical bills

From the graphs, it can be concluded that employer insurance coverage makes up the largest type of insurance taken up. This is probably because it is a legal requirement that employers ensure that their employees are insured. Thus, this forces most people to take up insurance thus, the uninsured forms the second highest group. This is probably propagated by the fact that they have less requisite knowledge on insurance or their income cannot satisfactorily support an insurance coverage program thus, opt not to be insured.

Q5 Solution

The best solution to mitigate this problem is to increase patient and citizen sensitization on the need of securing an insurance coverage plan. They need to be aware that life is uncertain and sometimes sickness can knock in when they are not financially prepared and in such situations plays an integral role. I believe when people are well educated on the need to have an insurance plan, they will take these plans. Similarly, these insurance coverage plans need to be affordable and take into account the low-income earners in the society so that every person can be able to take up these insurance programs.

Q6 Review the results about the problem

Based on the presented figures, it can be deduced that important measures and approaches are being embraced to help patients settle their medical bills. Insurance programs are one of the approaches implemented. However, a large number of patients do not opt for it. Thus the problem is still a menace. While credit has to be given to the great measures undertaken, I think there is still a lot that needs to be done to solve this problem conclusively. The government needs to increase its budgetary allocation on health and even partner with private healthcare institutions to offer subsidized health care services. Employers should also be made to cater for the health needs of their employees.