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of people under the age of 65 were uninsured in 2017. (Self-pay or self-insured) (unassigned,
no doctor)
About 8%
of people under the age of 65 were uninsured in 2019
Out of pocket health care payments for insured patients are
, • Copayments
• Coinsurance
• Deductibles
Copayments
• Tend to decrease utilization- "First dollars" spent if present
• Tiered copayment amounts tend to steer patients towards lower cost products and services.
Coinsurance
Intended to steer patients toward providers with lower rates and / or less intense treatment
(encouraging a patient to seek treatments with lower cost rather than just fewer visits). This
strategy relies on the sophistication level of the patient.
Deductibles
• Common in casualty insurance to minimize claims for minor incidents where the expecting
is that adverse events are rare and transaction cost are high
•About 80% of employer sponsored plans have a deductible and the average amount across
plans is about $3,655 (2019)
Medicare
Discovered by President Lyndon Johnson
Medicare 4 major coverages
• Part A: Hospital
• Part B: Medical insurance- mostly Doctors,
Physicians
• Part C: Medicare Advantage (MCO)-
managed care
• Part D: Medicare Prescription Drug
Coverage- lower cost of medication
Medicaid