Universal healthcare for the US is an important issue to be discussed and toggled with in the near future of healthcare in the US. It is a remarkable idea especially for the many who at present lack adequate healthcare delivery. Though as far away as universal healthcare may seem for the US, there are steps being taken foward and ideas are being presented. One such idea to help limit the healthcare disparity in the US is the CoverTN, which is being test-driven in Tennessee. The goal and initiatives of the CoverTN is to work at offering and making sure everyone has a at least a basic health plan instead of working towards having a perfect health plan which will give the best of care to a limited few and the rest will be trying to attain that one perfect plan. This plan is especially available to those who are self-employed, or who work for small businesses that can’t afford a traditional policy.

“It is not free health care. Rather it is a limited plan with shared costs. In devising this plan, we didn’t start out the usual way–by defining what benefits we wanted–but instead set how much we wanted to pay. And then we began a competitive-bidding process to see how much health care we could buy. We initially set the amount we would pay at an average of $150 a month, and split the responsibility for that premium three ways. The company would be responsible for $50, the individual would for $50, and the state for the final $50.”

“CoverTN emphasizes covering these front-end costs of the following: free checkups, free mammograms and $15 doctor visits without deductibles. It achieves its savings on the back end, with relatively low limits on hospital stays and an overall $25,000 benefit limit in any one year, however it does not cover truly catastrophic events.”

When the uninsured Tennesseans were asked what they cared about with a health plan was that it would include: a doctor’s visit, prescriptions, a short hospital stay.

To help with the onset of demanding prices for pharmaceutical drugs the CoverTN has manufactured a largely generic prescription program. “It’s worked surprisingly well. Physicians have typically been able to select suitable medications for their patients, and patient satisfaction has been high and complaints few.

A feature that has been monitored closely with the CoverTN and is an obvious criticism for a health insurance such as this is what happens to patients that exceed the benefit limits. “What we’re finding is that even in health care, when people know that there are limits, they work to manage their costs. This year, as of the first nine months, only four people out of the more than 15,000 people covered had hit the maximum overall limit of $25,000, and only three had exceeded the separate in-patient hospital limits. A larger number, under 4%, hit the quarterly pharmacy limits durgin those first nine months. Even those who go over the benfit limits get the significant advantage of being able to piggy back their personal expenditures on the contracts CoverTN has negotiated. By doing this, they often can cut their costs on uncovered health care in half”

Although this is not a comprehensive or complete health care coverage for its users, it has been an answer to many uninsured Tennesseans.

For the full story on the article,”What Tennessee Is Doing About Health Insurance”, you can find it on page A13 of the Saturday/Sunday, November 22-23, 2008 edition of the Washington Post.

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