Unit 4 Market for Health Insurance and Competition Essay

unit of measurement 4 Market for Health Insurance and Competition - Essay Exampleby Congressional cipher Office, the health market challenges the federal and state governments as health tutorship premiums continue to take an upwardly trend. More to these, health care costs seem to exceed the growth of Ameri rotter income, then qualification it very expensive to afford health care in America. Consequent to these, fewer individuals get to cypher for the service, following the high cost involved. These factors compel the government to take measures that regulate the operation of the health market, thus ensuring that the insurance companies do non exercise their market power in a manner that can harm consumers, as well as the economy. Such measures include the evaluation of insurers who undertake mergers and acquisitions, to ensure that monopolies do non rule the health sector.The medical loss ratio refers to a statistical measurement of the part of the total premium revenue fr om health plans that get to be devoted to clinical services. In another(prenominal) words, the MLR relates to the portion of the premium revenue from health insurance plans paid to settle medical claims. Therefore, this ratio does not serve as a measure of the quality of care provided as premiums paid and expenditures incurred do not indicate the quality of care being given to individuals. Other measures, such as patient ecstasy surveys, and severity-adjusted clinical outcomes, provide better measures for gauging health performance. Consequently, the MLR should not be used to measure health performance, as it would lead to biased results (Austin, 43).Risk-adjusted premiums help in determining the expected treatment cost that an insured person would incur, if they were to fall ill. Higher rates exist for elderly individuals, compared to the younger population (Feldstein, 245). This ensures that insurance providers do not choose to insure healthier patients, and leave out the sick patients. Consequent to this, individuals who need health care most get to access insurance, and effective