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Health, Medicine, Nursing
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English (U.S.)
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HEALTH AND MEDICINE

Essay Instructions:
Your assignment for the third part of the session long project is to: 1. List three issues that patients complain about in regards to managed care. 2. Provide a general discussion of any three of the following health care laws: Consolidated Omnibus Budget Reconsolidation Act (COBRA) Employee Retirement Income Security Act (ERISA) Gag Clause Law Any Willing Provider Law
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Running head: HEALTH AND MEDICINE
Questions
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Question 1: Three issues that patients complain about in regards to managed care.
Patients were complaining that in a bid for managed care plans to reduce costs, they were denying them the right services, even in times of danger, and on the other hand provide low class care. In addition, patients complained because of restriction of which service to use by some of the programs of managing care. These restrictions finally destroy the relationship between the doctor and the patient. Patients also do not see the overall benefits as the premiums savings end up with the government and the business. Enrollees are restricted to hospitals of their choice because they have to seek treatment from hospitals within the network (Betsy, 2007). They are also restricted from the drugs of their choice and they are given drugs that are cheaper with more side-effects. If the patients fail to complain, they may end up not learning about the right medications.
Question 2: Health care laws
1). Any willing provider law.
This law requires managed care programs to allow any competent provider who is ready to accept terms and conditions of the program. It does not have to enter into a contract with all the service providers. The law allows patient to get reimbursed medical care from a provider of h/her choice provided the provider is qualified even though h/she is not contracted by the plan. Those who are for this law states that it increases continuous care and makes patients access care from a broad range of providers (Betsy, 2007). The law has on the other hand been opposed by many saying that by increasing the number of service providers, it becomes difficult to coordinate.
2). Employee Retirement Income Security Act (ERISA)
It is a law that sets standards for be...
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