Managed Care and HMO
The film, John Q, is a film that illuminates the legal concepts, relationships, and issues surrounding the private health insurance system, social contract, and most importantly access to care.
This film also teaches how health insurance and managed care arrangements affect consumers and their families.
Below are three topics below addressed in the film, along with a question. Answer the question with a brief analysis of the situation.
Continuation of Coverage
In the scene in which John speaks with his Human Resources representative, he is told that he now has a $20, 000 lifetime limit on his health insurance benefits because of the switch to a more restrictive HMO plan and his reduction to part-time status.
If John had lost his factory job instead of being reduces to part-time status, what options would he have for continuation of coverage under federal law, and on what terms? What would you have done had it been you in the situation?
Public Health Care Programs
After John speaks with his human resources representative, his request for authorization for the transplant is denied, and he abandons his appeal as futile.
A succession of scenes shows John trying to secure coverage or funds elsewhere by: applying for Illinois’s Medicaid program, inquiring at the public hospital, accepting donations from friends, and selling the family’s belongings, including the refrigerator, the car, and his wife’s engagement ring.
John’s applications for public and private coverage are denied, and he unable to raise the required $75, 000 down payment. The hospital insists on releasing Mikey to die at home.
Based on the limited facts provided by the film, do you thin Mikey would have been eligible for Medicare? Medicaid? Illinois’s CHIP program?
The Uninsured and Access to Care
In the film, the intern reports that even in the emergency room, “If you ain’t got no money, you get a band aid, a foot in the #$@, and you’re out the door.” Is the intern correct? What limits, if any, exist with regard to emergency treatment?
Assignment should be well written with proper grammar, spelling, punctuation and correct APA format (includes title page, in-text citation, and references). Also, see grading rubric below
|Continuation of Coverage||33pts|
|Public Health Care Programs||33pts|
|Uninsured and Access to Care||34pts|