Index IntroductionCovering CostsSimilarities and DifferencesPros and ConsPolicies and PaymentSolutionsConclusionReferencesIntroductionManaged Care and Medicare have both influenced how hospitals make healthcare financial decisions, including underpayment for services and the refusal of requests. Cost shifting and cross-subsidization are among these decisions. There are policies in place that use these methods. While both offer advantages and disadvantages, they also have similarities and differences. These issues place hospitals at a crossroads where they must decide the most efficient way to provide services in a competitive market in the midst of a health crisis. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay Cover Your Costs When discussing healthcare decisions you need to think about today's healthcare issues. This affects the uninsured and underinsured population. How do these populations influence healthcare today? Is there inequality between insured, uninsured, Medicare, and managed care? Hospitals and the government face daily decisions such as: How to provide the best care at the best price? These decisions have a cascading effect on insurance companies, hospitals, employers, patients, employees and the government. Who is affected by these decisions? Who pays for these losses? These issues are an ongoing debate, including in the political arena. Is there one strategy that works better than the other? It is important to understand that hospitals are much like any other business. Businesses provide a service to consumers, and hospitals provide medical care and services to the community and individuals for a fee. These accusations are not free, just like everything else in this world. These taxes have to be absorbed somewhere. Hospitals must take action to keep their doors open. Similarities and Differences Cost shifting and cross-subsidization are two strategies at the center of this debate. Cost shifting and cross-subsidization: how to distinguish their synonymies and anomalies? Both cost shifting and cross-subsidization are the product of uninsured and underinsured population effects. Both can be used to offset losses and unprofitable services provided. Both methods are influenced by health policies. Cross-subsidies are often thought to produce no profit for the hospital, but they can still work if there is a significant amount of profit made in other areas to cushion unprofitable cases. Cost shifting continues to be part of today's issues in healthcare as it is responsible for raising prices for one group and less for others in order to maximize profits (Frakt, 2011). Cost shifting manifests itself through costs such as doctor visits, drug costs, private pay, and self-pay consumers. These costs have to be absorbed somewhere. This cost shifting affects many people on a daily basis. Cross-subsidization is a strategy that a facility incurs with losses such as mandatory emergency care because these people cannot be turned away and are treated without insurance, but are unable to pay for the services incurred and these losses are compensated through profitable procedures . and Cons Between these two strategies, how do you decide which is the best choice? Are these strategies considered ethical? What are the pros and cons of these two strategies? An opinion on this topic tendsmore towards the cons. One of the benefits of cost shifting is its ability to be competitive in the healthcare industry. Cost shifting results in higher premiums and prices for the insured to combat the losses of the uninsured. This is a negative outcome for employers and employees who face higher costs. Many families simply cannot bear the burden of these costs. The increase in the cost of living and the increase in insurance premiums lead to a shift in costs, putting some businesses out of the market and forcing families to no longer take out insurance because they cannot afford the increased costs. Cross-subsidies were beneficial to congress because of Medicare reimbursements. Much research suggests that cross-subsidization continues to prove unsuccessful and will require more poor patients and cross-subsidization (Banks, Foreman, & Keeler, 1999). Some believe that the answer to healthcare problems in the United States today is to adopt universal healthcare. Cross-subsidy is considered a strategy to support universal healthcare. Policies and Payments These two strategies have been implemented across US healthcare policies over the years. Studies suggest that the state has an important role in determining the policies and changes needed in healthcare (Stabile & Thomson, 2014). One policy that addresses inpatient and outpatient visits is the Medicare DRG (“Review of the Medicare DRG Window Policy,” 2020). There have been several policies in the healthcare sector to improve costs and care. The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, provided for continuation of insurance under certain circumstances such as job loss and life-changing circumstances. The Balanced Budget Act of 1997 (BBA) provides evidence that Medicare was able to use the cost-shifting method to alleviate costs and pass this surplus on to private payers. This cost shifting has created higher premiums and costs for the private payer population. How have Medicare and managed care affected our healthcare today as we know it? It is important to distinguish the roles that Medicare and managed care have played in cost shifting and cross-subsidization. They have played an important role in how healthcare is viewed today. In the past, Medicare has been seen as the money tree and the winner of the congressional prize has benefited from the decreasing deficit. Research indicates that Medicare has played a significant role in the issues facing health care in the United States today. When hospitals suffer losses to Medicare, the remaining balance is transferred to private insurance to offset those losses. This has resulted in increased prices and premiums for the private taxpayer population. Costs were shifted from an area that was under budget. This effect has played a significant role in the dispossession of healthcare as we know it today. To that end, this has created burdens for many and has played a huge role in the rising healthcare costs we face today. Managed care has played an important role in reducing the rise of healthcare increases due to the competitiveness of the healthcare industry. Important questions need to be considered: Do we as a nation benefit from these healthcare policies and regulations? What do these policies and sanctions mean for the healthcare sector? Are new policies on the way that will be the answer to our health crisis? These questions are pertinent in examining current policies and uniting for/10754