Question

Health Economics Discussion

Write 2 SUBSTANTIVE questions/comments about any of these topics mentioned at the bottom.

An example of a non-substantive post: What are the differences between difference between copayments and deductibles?

An example of a substantive post: How do deductibles, coinsurance and copays work? Based on my understanding by reading the S&N (2013), deductibles, coinsurance and copays are all examples of cost sharing for the amounts the patients and health insurance company pay for health care expenses. A deductible is a fixed amount (e.g., $500 or $1000) a patient must pay during a specific given time period (e.g., one year) before their health insurance benefits begin to cover the costs. Coinsurance is your share of the costs of a health care service. It's usually paid as a percentage of total amount (20% of doctor visit) for services. You start paying coinsurance after you've paid your plan's deductible.A copay is a fixed amount paid by a patient to see a health care provider (e.g., $20 for visiting a doctor or physical therapist), with the remaining balance covered by the person's insurance company (S&N, 2013). Are copayments and deductibles exist in any single-payer system?

Topics:

Structure, conduct, performance, and market analysis

Government, health, and medical care

The hospital. services industry

Pharmaceutical industry

Answer 1

1. Pharmaceutical industry, the discovery, development, and manufacture of drugs and medications (pharmaceuticals) by public and private organizations.

The modern era of the pharmaceutical industry—of isolation and purification of compounds, chemical synthesis, and computer-aided drug design—is considered to have begun in the 19th century, thousands of years after intuition and trial and error led humans to believe that plants, animals, and minerals contained medicinal properties. The unification of research in the 20th century in fields such as chemistry and physiology increased the understanding of basic drug-discovery processes. Identifying new drug targets, attaining regulatory approval from government agencies, and refining techniques in drug discovery and development are among the challenges that face the pharmaceutical industry today. The continual evolution and advancement of the pharmaceutical industry is fundamental in the control and elimination of disease around the world.

In the latter part of the 19th century a number of important new classes of pharmaceuticals were developed. In 1869 chloral hydratebecame the first synthetic sedative-hypnotic (sleep-producing) drug. In 1879 it was discovered that organic nitrates such as nitroglycerin could relax blood vessels, eventually leading to the use of these organic nitrates in the treatment of heart problems. In 1875 several salts of salicylic acid were developed for their antipyretic (fever-reducing) action. Salicylate-like preparations in the form of willow bark extracts (which contain salicin) had been in use for at least 100 years prior to the identification and synthesis of the purified compounds. In 1879 the artificial sweetener saccharin was introduced. In 1886 acetanilide, the first analgesic-antipyretic drug (relieving pain and fever), was introduced, but later, in 1887, it was replaced by the less toxic phenacetin. In 1899 aspirin (acetylsalicylic acid) became the most effective and popular anti-inflammatory, analgesic-antipyretic drug for at least the next 60 years. Cocaine, derived from the coca leaf, was the only known local anesthetic until about 1900, when the synthetic compound benzocaine was introduced. Benzocaine was the first of many local anesthetics with similar chemical structures and led to the synthesis and introduction of a variety of compounds with more efficacy and less toxicity.

Transitions in drug discovery

In the late 19th and early 20th centuries, a number of social, cultural, and technical changes of importance to pharmaceutical discovery, development, and manufacturing were taking place. One of the most important changes occurred when universities began to encourage their faculties to form a more coherent understanding of existing information. Some chemists developed new and improved ways to separate chemicals from minerals, plants, and animals, while others developed ways to synthesize novel compounds. Biologists did research to improve understanding of the processes fundamental to life in species of microbes, plants, and animals. Developments in science were happening at a greatly accelerated rate, and the way in which pharmacists and physicians were educated changed. Prior to this transformation the primary means of educating physicians and pharmacists had been through apprenticeships.

2. A copay (or copayment) is a flat fee that you pay on the spot each time you go to your doctor or fill a prescription. For example, if you hurt your back and go see your doctor, or you need a refill of your child's asthma medicine, the amount you pay for that visit or medicine is your copay. Your copay amount is printed right on your health plan ID card. Copays cover your portion of the cost of a doctor's visit or medication.

A deductible is the amount you pay each year for most eligible medical services or medications before your health plan begins to share in the cost of covered services. For example, if you have a $2,000 yearly deductible, you'll need to pay the first $2,000 of your total eligible medical costs before your plan helps to pay.

3. A copay is a fixed amount you pay for a health care service, usually when you receive the service. The amount can vary by the type of service.

Your plan determines what your copay is for different types of services, and when you have one. You may have a copay before you’ve finished paying toward your deductible. You may also have a copay after you pay your deductible, and when you owe coinsurance.

If your plan’s deductible is $1,500, you’ll pay 100 percent of eligible health care expenses until the bills total $1,500. After that, you share the cost with your plan by paying coinsurance.