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The Patient Protection and Affordable Care Act (PPACA) mandates coverage of “preventive” services like immunizations, alcohol misuse screening and counseling, blood pressure screening, depression screening, diet counseling, obesity screening and counseling, tobacco use screening, anemia screening, Breastfeeding comprehensive support and counseling, folic acid supplements, and iron supplements and more (Buff, Terrell, 2014). As patients do not pay for medical care at the point of service, reduces price sensitivity due to health insurance (Buff, Terrell, 2014). The German Knappschaftverein, around 1260s began with insurance for illness (Buff, Terrell, 2014). After World War II, the market changed radically, and hospitals had created Blue Cross in 1939 and doctors started Blue Shield later (Goodman, 1993).

Third parties supply the majority of medical payments in the U.S., and insurance companies pay for these services using patients’ monthly premium payments (Buff, Terrell, 2014). As others bear the cost, there is a tendency to overconsume medical care and is an example of moral hazard (Buff, Terrell, 2014). Third-party payment for health care has increased dramatically since 1960 and the out of pocket share paid directly by consumers fell from 49 percent in 1960 to 21 percent in 1988 (Danzon, 1993). The third-party payment distorts the market for health care and quality of attention and services affect. As insurance is an extremely competent field and which makes more money. Wealthy country insist on using third-party intermediaries to purchase health care because to keep the country healthy. We carve out a separate payment program for our older citizens because of them have more health problems and need care.

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