PART 1: In Chapter 8, The Market for Health Insurance “Moral Hazard” was posited as a phenomenon where a persons behavior is affected by their insurance coverage (D, 201). Describe an example of a health service that may be over or under utilized (in the face of moral hazard) given a type of insurance. You may use any one of the types of insurance plans found on pages 60 through 64. (200 words)
Book to use as reference Dewar, D. M. (2017). Essentials of Health Economics. Overview of the U.S. Healthcare System (pg. 3). Burlington, MA: Jones and Bartlett.
PART 2. Next, respond to one of your fellow student’s moral hazard posting. In no more than 150 share your opinion about the behavior and the potential impact on others consumers of the insurance plan. STUDENT POST: ” Health care organization (HMO) is a type of insurance plan where the health care provider agrees to providing health services to the insured, and in return accepts reimbursement in the form of a fixed fee. Members of an HMO are assigned a primary care provider (PCP), which acts as a pathway for members to seek out health services. For instance, if the insured needs to see a specialist then the PCP must authorize and refer the patient to the specialist. In lieu of the PCP’s authorization, the patient will be denied insurance coverage for the unauthorized health service. Due to the nature of HMO plans, health services with a PCP would be over utilized because the PCP “serves as a gatekeeper responsible for authorizing any health care provided” (Dewar, 2017).”