What S Behind Out Of Control Us Health Care Spending
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What S Behind Out Of Control Us Health Care Spending
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Author : Dr. Edgar A. Peden
language : en
Publisher: Xlibris Corporation
Release Date : 2014-10-30
What S Behind Out Of Control Us Health Care Spending written by Dr. Edgar A. Peden and has been published by Xlibris Corporation this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-10-30 with Business & Economics categories.
In 1948 Americans spent five percent of total consumption on health care. Six decades later (2009) this had risen to twenty-one percent. What happened? Why did the percentage continue to grow? And given current factors and trajectories, this probably will continue in the foreseeable future. The problem is that a larger health care percentage results in a smaller percentage of other valued consumption: housing, food, education, transportation, and so on. Finally, add health cares bureaucratic burden. Often getting health care seems more like an Inquisition than purchasing products and services from friendly merchants and medical providers. Addressing these concerns, this study examines the post-war economic history of health care spending is examined, using evolutionary economic theory and an econometric model analyzing 19482009 data. Important causes of health care spending growth include: 1. the initial rule change permitting employers to exclude employee health insurance premiums from taxation, 2. a feedback pattern wherein greater insurance generates greater spending, which then generates greater insurance demand, 3. a growing federal presence, such as the Medicare and Medicaid programs, and 4. the rise of both private and public managed care services. With an ever-growing percentage of health care dollars paid by insurance, it is becoming ever-more bureaucratic, with rules governing every aspect of health care practices. The conundrum is how to get those consuming health care to become more responsible, while providing a safety net for everyone needing health care, even for those without an ability to pay. The Conclusion discusses these issues.
What S Behind Out Of Control Us Health Care Spending
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Author : Dr. Edgar A. Peden
language : en
Publisher: Xlibris Corporation
Release Date : 2014-10-30
What S Behind Out Of Control Us Health Care Spending written by Dr. Edgar A. Peden and has been published by Xlibris Corporation this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-10-30 with Business & Economics categories.
In 1948 Americans spent five percent of total consumption on health care. Six decades later (2009) this had risen to twenty-one percent. What happened? Why did the percentage continue to grow? And given current factors and trajectories, this probably will continue in the foreseeable future. The problem is that a larger health care percentage results in a smaller percentage of other valued consumption: housing, food, education, transportation, and so on. Finally, add health care's bureaucratic burden. Often getting health care seems more like an Inquisition than purchasing products and services from friendly merchants and medical providers. Addressing these concerns, this study examines the post-war economic history of health care spending is examined, using evolutionary economic theory and an econometric model analyzing 1948--2009 data. Important causes of health care spending growth include: 1. the initial rule change permitting employers to exclude employee health insurance premiums from taxation, 2. a feedback pattern wherein greater insurance generates greater spending, which then generates greater insurance demand, 3. a growing federal presence, such as the Medicare and Medicaid programs, and 4. the rise of both private and public managed care services. With an ever-growing percentage of health care dollars paid by insurance, it is becoming ever-more bureaucratic, with rules governing every aspect of health care practices. The conundrum is how to get those consuming health care to become more responsible, while providing a safety net for everyone needing health care, even for those without an ability to pay. The 'Conclusion' discusses these issues.
An American Sickness
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Author : Elisabeth Rosenthal
language : en
Publisher: Penguin
Release Date : 2017-04-11
An American Sickness written by Elisabeth Rosenthal and has been published by Penguin this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-04-11 with Medical categories.
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
Crossing The Global Quality Chasm
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2019-01-27
Crossing The Global Quality Chasm written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-01-27 with Medical categories.
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Explaining Divergent Levels Of Longevity In High Income Countries
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Author : National Research Council
language : en
Publisher: National Academies Press
Release Date : 2011-06-27
Explaining Divergent Levels Of Longevity In High Income Countries written by National Research Council and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-06-27 with Social Science categories.
During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages-cancer and cardiovascular disease-available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which-unlike randomized controlled trials-are subject to many biases.
Employment And Health Benefits
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Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 1993-02-01
Employment And Health Benefits written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1993-02-01 with Medical categories.
The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.
Health Care Utilization As A Proxy In Disability Determination
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2018-04-02
Health Care Utilization As A Proxy In Disability Determination written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-04-02 with Medical categories.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
The American Health Care Paradox
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Author : Elizabeth H. Bradley
language : en
Publisher: PublicAffairs
Release Date : 2013-11-05
The American Health Care Paradox written by Elizabeth H. Bradley and has been published by PublicAffairs this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-11-05 with Political Science categories.
Foreword by Harvey V. Fineberg, President of the Institute of Medicine For decades, experts have puzzled over why the US spends more on health care but suffers poorer outcomes than other industrialized nations. Now Elizabeth H. Bradley and Lauren A. Taylor marshal extensive research, including a comparative study of health care data from thirty countries, and get to the root of this paradox: We've left out of our tally the most impactful expenditures countries make to improve the health of their populations-investments in social services. In The American Health Care Paradox, Bradley and Taylor illuminate how narrow definitions of "health care," archaic divisions in the distribution of health and social services, and our allergy to government programs combine to create needless suffering in individual lives, even as health care spending continues to soar. They show us how and why the US health care "system" developed as it did; examine the constraints on, and possibilities for, reform; and profile inspiring new initiatives from around the world. Offering a unique and clarifying perspective on the problems the Affordable Care Act won't solve, this book also points a new way forward.
Best Care At Lower Cost
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Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 2013-05-10
Best Care At Lower Cost written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-05-10 with Medical categories.
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
Big Med
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Author : David Dranove
language : en
Publisher: University of Chicago Press
Release Date : 2022-11-18
Big Med written by David Dranove and has been published by University of Chicago Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2022-11-18 with Business & Economics categories.
There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.