Consumer Driven Health Plans (CDHPs) are medical insurance plans which allow a person to pay for certain medical services directly, rather than pay premiums to the insurer, who in turn caters for the expenses. Basically they save the consumer from paying high premiums in a comprehensive health insurance cover (Eagle et.al., 2009). The consumer is given the option of selecting which service to pay for based on their needs (Balser Group, 2013). High Deductable Health Plans on the other hand attract low premiums but the consumer has to bare more out of pocket expenses than in conventional health insurance policies (McKenzie and Pinger, 2013). Ideally the plan is geared at covering high cost medical care, while the consumer is left to cater for the low cost care (Eagle et.al., 2009).
These plans have changed healthcare service reimbursement majorly through the Health Reimbursement Arrangements. Under the HRAs, the employee (consumer) is reimbursed by the employer for out of pocket medical expenses incurred, provided they were incurred for qualified medical expenses. This is unlike the conventional health insurance cover where the employee is not reimbursed for out of pocket expenses considered as deductibles by the insurer. The plans have also changed reimbursement for institutional care by introducing the prospective payment system, which reimburses the care giver a set amount, irrespective of the actual amount incurred.
Institutional Review Boards are committees composed of scientists and non scientists, which oversee the use of human test subjects for scientific research. Their key role is to ensure that any scientific research carried out on human test subjects is safe, ethical, and beneficial to the society (Bankert and Amdur, 2006). To this end, they have authority to approve, disapprove, or modify a proposed research. They may additionally assist in recruitment and retention of test subjects, access to the findings of the research, among other activities.
Accordingly, the rationale for their existence can be summarized into two; to ensure the welfare of human test subjects and to ensure the efficacy of the research conducted. They therefore act as a watchdog for such scientific research. Their existence ensures that biomedical, behavioral, and clinical research activities are conducted within the confines of ethics, and that the benefits of the research outweigh the risks involved (Walshe and Smith, 2011). This has impacted these activities positively and negatively. Positively, they have improved the standards and quality of these activities. Negatively, to some extent they constrain certain research activities while favoring others. This has been a problem mostly with for profit IRBs, which tend to favor research activities that are economically beneficial to them (Murphy, 2004).
Balser Group (2013). Mandated Benefits: 2013 Compliance. NY: Aspen Publishers. Print.
Bankert, E. A. and Amdur, R. J. (Eds.) (2006). Institutional Review Board: Management and
Function. MA: Jones & Bartlett Publishers. Print.
Eagle, S., Brassington, C., & Goretti, C. (2009). The Professional Medical Assistant: An
Integrative, Teamwork-Based Approach. PA: F.A. Davis Company. Print.
McKenzie, J. F. and Pinger, R. R. (2013). An Introduction to Community Health (Brief Edition).
MA: Jones & Bartlett Publishers. Print.
Murphy, T. F. (2004). Case Studies in Biomedical Research Ethics. Massachusetts: MIT Press.
Walshe, K. and Smith, J. (Eds.) (2011). HealthCare Management (2nd Edition). New York: Open