Module 1 Health Care Delivery Systems Session Long Project

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The overall goal of the Session Long Project in this course is to examine health care delivery in the United States from a personal perspective, and provide recommendations for improvement.

As U.S. citizens, we have all interacted (and will continue to interact) with the delivery of health care. In fact, insurance plans/organizations are an important part of our healthcare delivery system. Most healthcare insurance plans are either an Exclusive Provider Organization (EPO), Health Maintenance Organization (HMO), or Preferred Provider Organization (PPO). It is important to note that health insurance is highly government regulated, and, as a result, is influenced by political culture.

View the following video:

JS Downey Insurance Service. (2015, April 8). Understanding HMO, PPO, and EPO plans [Video file]. Retrieved from https://www.youtube.com/watch?v=_AqIaoxouks

Read the following article:

Schroeder, S. A. (2014). Physicians, politics, and health insurance expansion. Journal of General Internal Medicine, 29(2), 267-8.

For the Module 1 Session Long Project, complete the following:

Part 1:

In at least 2 pages, explain the type of health insurance coverage you currently have (you do not need to provide the name of your insurance company):

  • Insurance Product (e.g., HMO, PPO, POS, Indemnity, or others)/Self-pay if not insured.
  • Source (employer, government, parents, or others).
  • Out-of-pocket costs: co-payments, deductibles, expenses, etc.
  • Level of coverage (e.g., 100% coverage or 80% coverage with 20% coinsurance).
  • Major limitations on choice of providers or self-pay: (a) Are you required to choose a primary care physician? (b) Are there limitations on use of out-of-network providers? (c) What are the limitations to self-pay?

Part 2:

As noted, U.S. political culture has an influence on the U.S. health care delivery system. Draft a 1- to 2-page memo to your local politician or lobbyist expressing the limitations stated in Part 1. Make recommendations on how political culture and values can either reduce these limitations or further increase them.

SLP Assignment Expectations

  1. Conduct additional research to gather sufficient information to support your response/position.
  2. Limit your paper to 3-4 pages.