Building an Ideal Insurance Plan: Enhancing Affordability and Accessibility.The goal of your final project for this course is to create the “Ideal Insurance Plan”. This isn’t the kind of paper where you simply express how you feel about this plan, but one that has verifiable research on what has failed in the past, and why your proposal would be better.

QUESTION

The goal of your final project for this course is to create the “Ideal Insurance Plan”. This isn’t the kind of paper where you simply express how you feel about this plan, but one that has verifiable research on what has failed in the past, and why your proposal would be better. This is not a politically charged assignment, so please leave out your political narrative. This plan you (will) create is not another program for people that already receive insurance through the government. For example, I work for Washington state, so my insurance is paid for by a governmental group policy. Your insurance plan must include the cost for a premium, an annual deductible, copay, and any out of pocket cost.

For example, if you think an ideal insurance plan would include cosmetic surgery, what percentage of the procedure do you think it should cover? Please remember that this plan should be for the average consumer, and a great alternative to the typical plan available to the public. Please consider a sliding scale for premiums, however. Let’s say that you work for a small clinic as a new Medical Assistant and you’re making $44,000 a year. Is it fair that your premium would be 10% of someone that makes $444,000 a year? (I hope you thought, “yes”.) This plan is designed for working people making less than $50,000 a year and do not qualify for state coverage. It also can be an alternative to some group policies that offer the least amount of coverage.

I’ve attached the rubrics on this announcement, so you should look closely at them in order to do well on this final project.

As a pointer, here are some things to consider for your final project:

1) Have an opening paragraph which includes a thesis statement.

2) Your project will have a main body, and a vault solid conclusion paragraph reinforcing why your insurance plan is so reasonable.

3) Your project must be solid enough to withstand scrutiny and a line of questioning which allows you to defend your position. (I may ask you questions about your work, which is why this is due on 06/21/20.)

4) Your work must be devoid of personal statements such as, “I think”, or “I feel”.

5) Consider a three dimensional approach to the economic feasibility of your plan.

6) Make mention of who qualifies for your plan, and how it differs from existing models.

7) Through your research you may want to compare plans that were successful in the past. This should be in the US, however.

8) Mention your selling points to our government and consider whether it would pass; devoid of who is running the senate floor at the time.

9) Who would run your insurance plan? Is it the government, state, or a private company?

10) Who would preside over this agency? (Only if it’s a private entity.)

ANSWER

Building an Ideal Insurance Plan: Enhancing Affordability and Accessibility

Introduction

The aim of this project is to create an ideal insurance plan that offers comprehensive coverage, promotes affordability, and ensures accessibility for working individuals earning less than $50,000 a year. This plan seeks to address the limitations and failures of existing models while providing a viable alternative for those who do not qualify for state coverage or have limited options through group policies. By incorporating extensive research and analysis, this proposal aims to present a robust insurance plan that can withstand scrutiny and bring tangible benefits to the average consumer.

Comprehensive Coverage and Affordability

The ideal insurance plan should cover essential medical services, including preventive care, hospitalization, prescription drugs, mental health, and chronic disease management.
To enhance affordability, a sliding scale for premiums based on income is essential. This approach ensures that individuals with lower incomes pay a smaller percentage of their earnings as premiums compared to those with higher incomes.
Cost-sharing mechanisms, such as deductibles and copays, should be structured in a way that strikes a balance between financial responsibility and preventing excessive out-of-pocket burdens.

Differentiating Qualification and Existing Models

Eligibility for this plan would be determined based on income criteria, specifically targeting individuals earning less than $50,000 a year who do not qualify for state coverage and those seeking alternatives to limited group policies.
The plan’s distinction lies in its comprehensive coverage, affordability through income-based premiums, and a focus on providing a viable option for working individuals who fall within the specified income bracket.

 Drawing from Successful Past Plans

Research and analysis of successful insurance plans in the United States can provide valuable insights for crafting an effective and sustainable model.
For example, the Children’s Health Insurance Program (CHIP) demonstrated the benefits of income-based eligibility criteria and comprehensive coverage for a specific population. Adopting similar principles could contribute to the success of the proposed insurance plan.

 Economic Feasibility and Selling Points

The economic feasibility of the plan will be addressed through a three-dimensional approach:
Conducting actuarial assessments to determine appropriate premium rates and cost-sharing structures that balance affordability and sustainability.
Exploring strategic partnerships with healthcare providers to negotiate favorable rates and contain costs.
Utilizing technology and digital solutions to streamline administrative processes and minimize overhead expenses.
Key selling points for the government include improved public health outcomes, reduced financial burdens on individuals, and increased access to necessary healthcare services, ultimately leading to a more productive and economically stable society.

Administration and Oversight

To ensure efficient operations and accountability, the proposed insurance plan could be administered by a public-private partnership. This approach combines the government’s regulatory oversight with the expertise and efficiency of a private entity.
A governing body comprising representatives from government, healthcare professionals, and consumer advocacy groups would oversee the insurance plan’s administration and ensure transparency, compliance, and equitable distribution of resources.

Conclusion

The creation of an ideal insurance plan that prioritizes comprehensive coverage, affordability, and accessibility is crucial in addressing the limitations of existing models. By adopting a three-dimensional economic approach, incorporating successful past plans, and focusing on income-based premiums, this proposal provides a feasible solution for working individuals earning less than $50,000 a year. The plan’s potential benefits include improved public health outcomes, reduced financial burdens, and increased access to essential healthcare services. By considering these factors and addressing potential challenges, this ideal insurance plan offers a viable alternative that can withstand scrutiny and contribute to a more inclusive and equitable healthcare system.