Mindblown: a blog about philosophy.

The practice in health programs paid on a prepayment or capitation basis of denying or delaying the provision of services needed or demanded by enrolled members as a way of controlling costs (since income is constant whether or not services are actually used). The classic example is the denial or delay of a cataract extraction.…

The practice in health programs paid on a prepayment or capitation basis, and in health insurance, of seeking to enroll only the healthiest people as a way of controlling program costs (since income is constant whether or not services are actually used). Contrast with adverse selection. Sometimes known as creaming. A type of speeded-up reading…

Used synonymously with disease and illness, generally not clearly defined. Common in the insurance field. A state of having an illness. A feeling of wanting to vomit. Any illness or the state of not being in good health.  

In Congress, the shorter, less formal common title given an Act of Congress by its authors. Health Maintenance Organization Act of 1973, and National Health Planning and Resources Development Act of 1975 are short titles. Not all Acts have short titles. The long title, also known as the purpose clause, is a more formal statement…

Dispensing a quantity of a drug which is less than the quantity prescribed for the purpose of increasing profit by charging for the prescribed amount.  

The coordinated, or otherwise explicitly agreed upon, sharing of responsibility for provision of medical or non-medical services on the part of two or more otherwise independent hospitals or other health programs. The sharing of medical services might include, for example, an agreement that one hospital provide all pediatric care needed in a community and no…

A patient whose care is the responsibility of a health program or institution (usually a hospital). Service patients are often cared for by an individual practitioner paid by the program (typically a member of a hospital’s housestaff), but the program, not the individual, is paid for the care. Sometimes called a public or ward patient.…

In the Veterans Administration health care program, a disability incurred or aggravated in the line of duty in active military service. In this context disability includes disease. These disabilities are the primary concern of the program.  

Those received as a result of prepayment or insurance, whereby payment is made directly to the provider of services or the hospital or other medical care programs for covered services provided by them to eligible persons. Service benefits may be full service benefits, meaning that the plan fully reimburses the hospital, for example, for all…

The practice of an individual, group of individuals, employer, or organization assuming complete responsibility for losses which might be insured against, such as malpractice losses, or medical expenses and other losses due to illness. In such cases, medical expenses would most likely be financed out of current income, personal savings, a fund developed for the…