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Paradoxes of Health Insurance Plans


Image: Arenamontanus under CC 3.0

If a person needs nursing care–and an at-home nurse would be equally effective and less costly than a residential nursing home–why would some health insurance plans only cover the full cost of the latter?

It seems very strange, but it happens under Medicare health insurance. Private options often follow suit, with payments to doctors and hospitals that provide negative incentives.

Proponents of reform believe that a bundled payment system (with strict quality control to avoid too much cost cutting) would reduce wasteful medical care. It would also result in more competitive price bidding, which some experts believe could save Medicare up to 8% per year–money that could be used to fund the healthcare reform legislation.

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