The History of Health Insurance and Managed Care
Health insurance is any program aimed to help with medical expenses. In the United States, health insurance is public insurance under the government, such as Medicare, Children’s Health Insurance, and Medicaid or private insurance. Health insurance in the United States began in the early twentieth century. Health insurance from the mid-twentieth century involved the rapid growth of private health insurance. By 1970, seventy percent of the US population had health insurance coverage. This high percentage was influenced by the expansion of organized labor by the 1947 Taft Harley Act, which made health insurance a condition of employment, treatment of health insurance in the federal tax code, and price controls and imposition of wages during World War Ⅱ (Manchikanti et al., 2017).
In the 1940s and 1950s, the AHA Blue Cross Commission hived out of AHA, leading to the formation of the Blue Cross Association in 1960 (Manchikanti et al., 2017). In 1977, the Blue Cross Association consolidated with the Blue Shield Association to form the Blue Cross and Blue Shield Association. The association placed all its subscribers in a significant risk pool, calculated premiums by dividing the projected growth of claims by the number of subscribers, and insured only the highest-cost subscribers. The association was competed by commercial insurers who used experience rating instead of community rating to offer insurance plans to low utilizers of healthcare that consider their low claims experience. The Blue Cross and Blue Shield Association lost subscribers and, therefore, in the 1960s, changed its approach to experience rating.
Managed care is a type of health insurance available in countries such as the United States. Managed-care plans have contracts with health care providers to provide health services to their members at a subsidized cost. In the mid-twentieth century, managed care was already available in the United States; however, it got national recognition in the mid-1970s. Managed care focuses on consumer choice, individual responsibility for one’s health, and preventive medicine. Currently, 160 million Americans have managed healthcare plans (Giardino & De Jesus, 2022).
In the early days, the primary purpose of health insurance was to ensure that families and regions with low socioeconomic status could access quality and timely health services. Current health insurance in the United States is a combination of both private and public insurance, including Medicare and Medicaid. Employers who contract managed care organizations are concerned about how the changes implemented in managed care will impact the quality of healthcare and treatment provided, especially for mental health and substance abuse patients (Namburi & Tadi, 2022).
Moreover, there have been changes in health insurance aimed at reducing health care costs while improving patient outcomes and have influenced the perspective of American citizens towards insurance. Small employees are reluctant to purchase health insurance since purchasing for a small group is more expensive than purchasing for a large group. The patient protection and affordable care plan ensured collaboration to reduce expensive care. The decrease in expenses has encouraged more Americans to embrace health insurance. However, some citizens are still unable to afford insurance. The government has come up with policies such as the single-payer policy, where the government controls all resources, a managed competition plan that regulates private insurance, and a consumer-driven healthcare program where the government gives financial resources to its citizens and allows them to purchase insurance.
References
Giardino, A.P., & De Jesus, O. (2021). Managed Care. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK564410/
Manchikanti, L., Helm Ii, S., Benyamin, R. M., & Hirsch, J. A. (2017). Evolution of US Health Care Reform. Pain Physician, 20(3), 107–110. https://pubmed.ncbi.nlm.nih.gov/28339426/
Namburi, N., & Tadi, P. (2022). Managed Care Economics. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK556053/
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Question 
Health insurance began in the early part of the twentieth century as a means to protect an organization’s assets, either its financial assets or its manpower. Since the early days, health insurance evolved into a system of managed care in order to control issues such as overutilization, skyrocketing costs, limited restrictions, and low-quality care.
The History of Health Insurance and Managed Care
Using the South University Online library or the Internet, search for articles on health insurance and managed care. Based on your research, summarize your findings and answer the following questions:
Examine the main events in the history of health insurance from the mid-twentieth century to the present. Explain how these events led up to the evolution of managed care organizations.
Evaluate the purpose of health care insurance in the early days.
Evaluate the evolution of health insurance and managed care. What is the relationship between the two and how has managed care risen to prominence in today’s health care market?
Explain how the perspective of health insurance has or hasn’t changed in today’s managed care environment.
Analyze the public policy and market forces leading to the growth of managed care.
Analyze the current trends in managed care and its future in the context of health care reforms.
Complete a 2–3-page Word document that includes requirements from the grading rubric below. Format your paper in APA to include an introduction and conclusion.
As in all assignments, cite your sources in your work and provide references for the citations in APA format.
See rubrics for further understanding of assignment requirements.
Submission Details:
Submit your document to the Submissions Area by the due date assigned.