In: Nursing
Q:What happens in the event that state and federal
health insurance regulations conflict?
A:The regulation of employment-based health
benefits by state governments and the federal government intersect
and diverge in complex ways.States regulate health and other
insurers. State regulation varies widely in both scope and
intensity but may cover insurer formation, taxation and operation,
insurance contracts and rates, unfair insurance practices, and
other types of insuring organizations such as health maintenance
organizations (HMOs), preferred provider organizations (PPOs), and
related managed care organizations (MCOs). Federal laws, on the
other hand, regulate employee health benefits. Most significant is
the Employee Retirement Income Security Act of 1974 (ERISA). It is
primarily concerned with reporting, disclosure, and fiduciary
duties related to the establishment and administration of employee
health benefit plans. Federal tax policies, anti-discrimination
laws, coordination with Medicare, and concurrent federal regulation
of some HMOs also affect employee health benefits. State regulation
of health benefits arises from the historic role of the states as
regulators of insurance. Federal regulation of health benefits
arises from the federal role in taxation and in regulating the
relationships between employers and employees. Compared to current
federal regulation of health benefits, state insurance regulation
tends to be more extensive and explicit.
Do you think that conflicts between state and federal governments
cause healthcare to be delivered inefficiently?
Q) Do you think that conflicts between state and federal governments cause healthcare to be delivered inefficiently?
Ans) There can be two scenarios :
Positive Scenario:
A) Conflict between state and federal government can be beneficial because if any of the two governments took wrong decision, another government can challenge it in welfare of people.
B) Sometimes the conflict turned out to be positive competition among state and federal government, as they would be in competition for making good decisions according to their respective powers to take credit among people.
Negative Scenario :
A) The conflicts among them will affect the implementation of schemes of health insurance sectors.
B) As federal government is a link between relations of employees and if due to any dispute between state and federal government, there is delay in health insurance schemes implantation that will cause harm to violation of employees rights.
C) There could be increase in the misuse of the public tax money if there is dispute between state and federal pont.
CONCLUSION :
Concluding my point, we need to know that any conflict would cause harm to employee and public. So that would degrade the Health Insurance Regulations.