Financial Aspects of Health Care Delivery

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Financial Aspects of Health Care Delivery
Jentry Pippin
HCS/310
April 23, 2012
Emilie Smith

Health care expenditures in the United States continue to soar with health care costs accounting for 17% of the country’s gross domestic product (GDP) (http://www.usgovernmentspending.com) [If this URL is in a citation, it should not appear here but rather on the references page] . The United States, along with Turkey and Mexico, are the only countries without universal health coverage. Americans are primarily insured through employer paid health care benefits. Other sources of coverage for health care include government insurance, and private insurance. This paper [When writing an introduction, some approaches are best avoided. Avoid starting sentences with “The purpose of this essay is . . .” or This paper will . . .” or any similar flat announcement of your intention or topic.] will compare how inmate care and private insurance have influenced the cost of health care in the United States as part of the GDP. It will also compare inmate care and private insurance to government insurance and employer group insurance.

Inmates are “the only segment of the US population with a constitutional right to receive adequate physical and mental health care” (Ofogh, 2011, p. 81). This law was passed in 1976 as a result of the Estelle v Gamble Supreme Court decision. The ruling was based on the Eighthth Amendment guarantee against cruel and unusual punishment. Prior to this court decision health care in prisons was minimal to none.

Before the 1970s, much inmate health care was provided by other inmates, correctional officers and the occasional physician. The first documentation of correctional nursing may be a 1975 article by Rena Murtha, a director of nursing for a large correctional system (http://www.nursinglink.monster.com).

The prison population has quadrupled in the last 30 years. The majority of inmates are primarily poor males. “Ninety percent of the 10 million Americans who pass through local and county jails each year have no health insurance of any kind (Wang et al., 2008)” [A citation goes outside the cited information but inside the sentence--the period goes after the citation, the quotation mark before the citation] (Ofogh, 2011, p. 9). The Federal Bureau of Prisons (BOP) funds inmate health care. Funding is not set aside but provided as medical expenses occur. “From fiscal year (FY) 2000 through FY 2007, the BOP obligated about $4.7 billion to inmate health care (http://www.justice.gov) [URL should not appear here but rather on the references page] . Care is primarily managed by in-house medical providers and contracted medical providers. A small segment of the prison population is entitled to Medicare and Medicaid programs. Inmates are given a limited benefit package. The benefit package is based on guidelines set by health maintenance organizations (HMOs) or preferred provider organizations (PPOs).
HMOs have a network of providers that require enrollees to select a primary care physician (PCP) within the network. PCPs manage and coordinate all health care and make referrals to specialists for care outside of their general care. PPOs differ from HMOs in that they have a network of preferred providers that enrollees may choose. Patients are not required to choose a PCP and they do not need referrals to receive services from other providers in the network. Any services received outside of the HMO or PPO plan require patients to pay for their own services. An increase in the prison population will eventually create a...
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