Glossary |
Our glossary of terms explains the jargon and defines the common acronyms you will come across at Health Care Reform Plans. Please email us at
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| Medicaid | Medicaid is a state-administered federal program in the United States set up to pay for medical services for qualifying low-income individuals and families. It is a program set up by the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS). For coverage, people must apply to the Medicaid program and meet certain requirements of eligibility (which vary from state to state), including age, disability, income resources, and status as a citizen or lawful immigrant. (See cms.hhs.gov/MedicaidGenInfo.) (See Centers for Medicare & Medicaid Services.)
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| Medical malpractice reform | The Medical malpractice reform movement is supported by healthcare providers who wish to address the rising cost of medical liability insurance. They say that frivolous lawsuits and exorbitant settlements are penalizing doctors unfairly and discouraging doctors from choosing high risk specialties, such as obstetrics.
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| Medicare | Medicare is a program administered by the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS). The largest health insurance program in the country, Medicare is a health insurance program for people 65 years of age or older and people with kidney failure. According to the Medicare website, the program covers nearly 40 million people. (See medicare.gov.) (See Centers for Medicare & Medicaid Services.)
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| Medicare Advantage Plans | Medicare Advantage Plans are health plan options offered through the Medicare program. Advantage plans may be HMOs, PPOs, private Fee-for-Service plans, or Medicare Special Needs Plans. They differ from the original Medicare plan in that patients may receive extra benefits and lower co-payments but may be required to go to doctors and hospitals that are part of the given plan. (See medicare.gov/Choices/Advantage.asp.) (See Medicare.)
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| Nanny government | “Nanny government” is the disparaging term assigned, mainly by conservatives and Republican politicians (such as Republican U.S. presidential candidate Rudy Giuliani), to plans for universal healthcare—especially those put forth by the Democratic candidates. Critics such as Giuliani argue that to pay for universal care, the United States would have to significantly raise taxes, a move that would decrease revenue and discourage investors. They also argue that government run programs are typically very inefficient compared to what the private sector, or business, achieves.
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| National Health Insurance Exchange | A National Health Insurance Exchange is part of Democratic U.S. presidential candidate Barack Obama’s universal healthcare plan. The Exchange would “act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plan.” These standards would “ensure fairness and make individual coverage more affordable and accessible.” Under the plan, “Insurers would have to issue every applicant a policy, and charge fair and stable premiums,” as required by the Exchange, and would have to justify any above-average premium increases.” The role of the Exchange would also be “to evaluate plans and provide information about differences between them.” (See barackobama.com/issues/healthcare.)
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| National health systems | National health systems are typically government-funded institutions—such as those in Canada and the United Kingdom--that provide medical care to its citizens, generally for a small co-payment.
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| Pandemic flu | Pandemic flu is, according the U.S. government’s pandemic flu website, “a virulent human flu that causes a global outbreak, or pandemic, of serious illness. Because there is little natural immunity, the disease can spread easily from person to person.” (See pandemicflu.gov/index.html.)
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| pay- for-performance | A pay- for-performance program is one in which healthcare providers—clinicians, hospitals, and other facilities--are rewarded for the quality of the services they provide for their patients. In the United States, more than half of all commercial health maintenance organizations are using this system and Centers for Medicare & Medicaid Services (CMS) plans are now required to do so as well. Critics of the system cite the difficulty of adequately measuring performance.
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| Payer | Payer (See Payor.)
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Glossary 
