scholarly journals Making Medicare Complicated: The Consequences of Privatization

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 252-252
Author(s):  
Pamela Herd
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Social Insurance ◽  
Prescription Drug Coverage ◽  
Medicare Advantage ◽  
Policy Changes ◽  
Public Programs ◽  
Access To Health ◽  
Care Costs ◽  
Private Sector Involvement

Abstract Starting with policy changes in the 1980s, Medicare has largely become privatized, with nearly 40 percent of beneficiaries enrolled in private Medicare Advantage plans and another 30 percent with private supplemental coverage, including for prescription drug coverage. As a result, Medicare has become laden with administrative burdens and barriers. Beneficiaries are faced with a confusing array of plans and coverage options when they enroll, and are expected to choose a new plan every year. The choice they make has large implications for their health care costs, as well as their actual access to health care. While we typically think that targeted policies are burdensome and social insurance programs are accessible, Medicare contradicts this easy categorization. Instead, it demonstrates how private sector involvement in public programs can increase complexity and increase burdens for beneficiaries.

scholarly journals Medical-Legal Partnerships: Addressing Competency Needs Through Lawyers

2009 ◽  
Vol 1 (2) ◽  
pp. 304-309 ◽  
Author(s):  
Edward Paul ◽  
Danya Fortess Fullerton ◽  
Ellen Cohen ◽  
Ellen Lawton ◽  
Anne Ryan ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Well Being ◽  
Public Programs ◽  
Skill Sets ◽  
Legal Professionals ◽  
Access To Health ◽  
Patient Health ◽  
Access To Food ◽  
Attending Physicians

Abstract Background Many low- and moderate-income individuals and families have at least one unmet legal need (for example, unsafe housing conditions, lack of access to food and/or income support, lack of access to health care), which, if left unaddressed, can have harmful consequences on health. Eighty unique medical-legal partnership programs, serving over 180 clinics and hospitals nationwide, seek to combine the strengths of medical and legal professionals to address patients' legal needs before they become crises. Each partnership is adapted to serve the specific needs of its own patient base. Intervention This article describes innovative, residency-based medical-legal partnership educational experiences in pediatrics, internal medicine, and family medicine at 3 different sites (Boston, Massachusetts; Newark, New Jersey; and Tucson, Arizona). This article addresses how these 3 programs have been designed to meet the Accreditation Council for Graduate Medical Education's 6 competencies, along with suggested methods for evaluating the effectiveness of these programs. Training is a core component of medical-legal partnership, and most medical-legal partnerships have developed curricula for resident education in a variety of formats, including noon conferences, grand rounds, poverty simulations and day-long special sessions. Discussion Medical-legal partnerships combine the skill sets of medical professionals and lawyers to teach social determinants of health by training residents and attending physicians to identify and help address unmet legal needs. Medical-legal partnership doctors and lawyers treat health disparities and improve patient health and well-being by ensuring that public programs, regulations, and laws created to benefit health and improve access to health care are implemented and enforced.

scholarly journals Impact of Health Level on Agricultural Productivity in Cameroon

2020 ◽  
pp. 17-25
Author(s):  
Eric Joel Tchinda Kamdem
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Access To Health Care ◽  
Agricultural Productivity ◽  
Household Survey ◽  
Public Authorities ◽  
The Public ◽  
Access To Health ◽  
Agricultural Yields ◽  
Care Costs

The objective of this study is to assess the effect of health on agricultural productivity in Cameroon. To achieve this objective, we use the techniques of Propensity Score Matching on data from the fourth Cameroonian household survey (ECAM 4). The results of the analysis show that healthy farmers produce on average than farmers in fragile health. Indeed, healthy farmers produce an average of FCFA 583,601 per hectare. This effect is statistically significant at the 5% threshold. Due to the fact that the level of health improves agricultural yields, we recommend to the public authorities, to facilitate farmers' access to health care through a reduction in health care costs, but also through a multiplication of health centers in rural areas.

scholarly journals Comparing Health Care Financial Burden With an Alternative Measure of Unaffordability

2017 ◽  
Vol 54 ◽  
pp. 004695801773296
Author(s):  
Edward S. Kielb ◽  
Corwin N. Rhyan ◽  
James A. Lee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Plan ◽  
Low Income ◽  
Access To Health Care ◽  
Financial Burden ◽  
Access To Health ◽  
Care Costs

Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care. We find that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher incomes or Medicare coverage. To better understand the relationship between out-of-pocket (OOP) spending and access, we used the 2011-2014 Medical Expenditure Panel Survey (MEPS) data and a logistic model to analyze the likelihood of avoiding or delaying needed medical care based on health insurance design and other individual and family characteristics. We find that avoiding or delaying medical care is strongly correlated with coverage under a high-deductible health plan, and with depression, poor perceived health, or poverty. However, it is relatively independent of the percent of income spent on OOP costs, making the percent of income spent on OOP costs by itself a poor measure of health care unaffordability. Individuals who spend a small percentage of their income on health care costs may still be extremely burdened by their health plan when financial concerns prevent access to health care. This work emphasizes the importance of insurance design as a predictor of access and the need to expand the definition of financial barriers to care beyond expenditures, particularly for the low-income, privately insured population.

Why Public Programs Matter — And Will Continue to Matter — Even after Health Reform

2008 ◽  
Vol 36 (4) ◽  
pp. 670-676
Author(s):  
Elizabeth J. Fowler ◽  
Timothy Stoltzfus Jost
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Access To Health Care ◽  
Comprehensive Health Care ◽  
Public Programs ◽  
Access To Health ◽  
Comprehensive Health ◽  
Reducing Costs ◽  
Opinion Polls ◽  
Recent Attention

As we write this paper in spring 2008, many are hopeful that November’s election will open the door to some form of comprehensive health care reform. In all likelihood, we will elect a president who has campaigned to a greater or lesser extent on promises of improving access to health care, improving quality, and reducing costs. Equally important, it seems likely that the 111th Congress is preparing to undertake meaningful health care reform. And perhaps most important, despite recent attention to energy issues and the economy, opinion polls consistently show that the American public continues to rank health care as one of the two or three most important domestic issues in the fall elections and supports comprehensive health care reform.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

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