United States of America - The US Government warns health insurance industry on mergers

2010 ◽  
Vol 23 (7) ◽  
Keyword(s):  
United States ◽  
Health Insurance ◽  
United States Of America ◽  
Insurance Industry ◽  
The Us ◽  
Us Government ◽  
Health Insurance Industry

Commentary on Canadian Health Insurance: Lessons for the United States

1993 ◽  
Vol 23 (1) ◽  
pp. 45-62 ◽  
Author(s):  
Theodore R. Marmor
Keyword(s):  
United States ◽  
Health Insurance ◽  
Insurance Industry ◽  
The United States ◽  
Congressional Hearings ◽  
Government Accounting ◽  
American Health Care ◽  
National Comparison ◽  
Health Insurance Industry ◽  
The Government

The Government Accounting Office's comparatively favorable report on Canada's National Health Insurance program (Medicare) prompted a firestorm of reaction: criticism from the health insurance industry primarily and praise from advocates of single-payer models of American reform particularly. Congressional hearings aired this controversy, and this article is a revised version of the author's testimony to the Government Operations Committee, June 18, 1991. The author examines the legitimacy of cross-national comparison as a general analytic tool and the lessons to be learned from North American health care comparisons in particular. In the final section he critically discusses two sets of myths about Canada's experience with universal health insurance: those regarding the desirability of the Canadian system itself and those questioning the transplantability (adaptability) of the model to the United States.

scholarly journals Paying a Premium on Your Premium? Consolidation in the US Health Insurance Industry

2012 ◽  
Vol 102 (2) ◽  
pp. 1161-1185 ◽  
Author(s):  
Leemore Dafny ◽  
Mark Duggan ◽  
Subramaniam Ramanarayanan
Keyword(s):  
Health Insurance ◽  
Healthcare Workers ◽  
Causal Effect ◽  
Insurance Industry ◽  
Local Concentration ◽  
Differential Impact ◽  
The Us ◽  
Health Insurance Industry ◽  
Using Data ◽  
Large Groups

We examine whether and to what extent consolidation in the US health insurance industry has contributed to higher employer-sponsored insurance premiums. We exploit the differential impact across local markets of a national merger of two insurers to identify the causal effect of concentration on premiums. Using data for large groups, we estimate premiums in average markets were approximately seven percentage points higher by 2007 due to increases in local concentration from 1998–2006. We also find evidence consolidation facilitates the exercise of monopsonistic power vis-à-vis physicians, leading to reductions in their absolute employment and earnings relative to other healthcare workers. JEL: G22, I13

Capitalizing on Illness: The Health Insurance Industry

1974 ◽  
Vol 4 (4) ◽  
pp. 583-598 ◽  
Author(s):  
Thomas Bodenheimer ◽  
Steven Cummings ◽  
Elizabeth Harding
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Low Income ◽  
Access To Health Care ◽  
Insurance Industry ◽  
Private Insurance ◽  
The United States ◽  
Insurance Companies ◽  
Health Insurance Industry

The private health insurance industry in the United States began as a money-collection mechanism for hospitals and doctors, and has evolved into an important profit-making sector of the economy. Blue Cross is dominated by hospital representatives and serves to channel money into the nation's hospitals. Physicians control Blue Shield and are its principal beneficiaries. And commercial insurance companies are closely linked to banks and industrial corporations through the country's large financial empires. Some effects of this elite control over the health insurance industry have been inadequate and distorted insurance coverage, discrimination against the elderly, the sick, and the poor, and rapidly rising medical costs. In addition, the control of Medicare and Medicaid by private insurance institutions has contributed to the enormous inflation produced by these programs. Though governments, consumers, and even the insurance industry itself are beginning to apply controls to the unprecedented medical inflation of the late 1960s, these controls tend to limit access to health care, especially for low-income people. Unless insurance companies are barred from the health care field and a public financing mechanism based on progressive taxation is introduced, health care will never be an equal right for everyone in the United States.

scholarly journals Caring for the Poor and Vulnerable: A Virtue Analysis of Mandated Health Insurance Compared with Healthcare Sharing Ministries

2020 ◽  
pp. 002436392094979
Author(s):  
Ezra Sullivan
Keyword(s):  
United States ◽  
Health Insurance ◽  
Patient Autonomy ◽  
The United States ◽  
For Profit ◽  
Catholic Faith ◽  
The Us ◽  
Us Government ◽  
Moral Problems ◽  
The Individual

In the present time, what has been called the “medical–industrial insurance complex” in the United States needs reform. As health insurance in the United States remains inaccessible to millions of people, and as prices continue to rise, questions arise about the most moral ways to ensure delivery of health care especially to the most vulnerable populations. In this essay, I offer a virtue analysis of the moral implications of health insurance mandated by the US Government in contrast to an increasingly popular alternative to insurance, namely, healthcare sharing ministries. In part 1, I list some of the moral problems entangled with US Government-mandated health insurance, including injustice, disrespect for patient autonomy, limitations on patient freedom, exploitation of patients for profit, undermining of conscience rights, cooperation with evil, and scandal. In part 2, I discuss the issue of risk and then list some potential moral advantages to healthcare ministries, including respect for patient autonomy, conscience, and the religious freedom to witness to the Catholic faith in charity and solidarity. Summary: Mandated health insurance the United States presents some moral challenges for conscientious Catholics, whereas healthcare sharing ministries appear to ameliorate some of these issues. Ultimately, the individual should have freedom to choose either insurance or healthcare sharing, given the different benefits and risks entailed by both.

Pathways to Legalization: Undocumented Mexican Immigrants in the US/Mexico Borderlands, 1942–1956

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Ana Elizabeth Rosas
Keyword(s):  
United States ◽  
Family Relationships ◽  
Mexican Immigrants ◽  
Extended Family ◽  
The United States ◽  
Mexican Immigrant ◽  
Agricultural Laborers ◽  
The Us ◽  
Us Government ◽  
Contract Laborers

In the 1940s, curbing undocumented Mexican immigrant entry into the United States became a US government priority because of an alleged immigration surge, which was blamed for the unemployment of an estimated 252,000 US domestic agricultural laborers. Publicly committed to asserting its control of undocumented Mexican immigrant entry, the US government used Operation Wetback, a binational INS border-enforcement operation, to strike a delicate balance between satisfying US growers’ unending demands for surplus Mexican immigrant labor and responding to the jobs lost by US domestic agricultural laborers. Yet Operation Wetback would also unintentionally and unexpectedly fuel a distinctly transnational pathway to legalization, marriage, and extended family formation for some Mexican immigrants.On July 12, 1951, US president Harry S. Truman’s signing of Public Law 78 initiated such a pathway for an estimated 125,000 undocumented Mexican immigrant laborers throughout the United States. This law was an extension the Bracero Program, a labor agreement between the Mexican and US governments that authorized the temporary contracting of braceros (male Mexican contract laborers) for labor in agricultural production and railroad maintenance. It was formative to undocumented Mexican immigrant laborers’ transnational pursuit of decisively personal goals in both Mexico and the United States.Section 501 of this law, which allowed employers to sponsor certain undocumented laborers, became a transnational pathway toward formalizing extended family relationships between braceros and Mexican American women. This article seeks to begin a discussion on how Operation Wetback unwittingly inspired a distinctly transnational approach to personal extended family relationships in Mexico and the United States among individuals of Mexican descent and varying legal statuses, a social matrix that remains relatively unexplored.

scholarly journals Health Insurance as a Healthcare Financing Mechanism in India: Key Strategic Insights and a Business Model Perspective

2021 ◽  
pp. 025609092110270
Author(s):  
Rohit Kumar ◽  
Aditya Duggirala
Keyword(s):  
Health Insurance ◽  
Business Model ◽  
Critical Success Factors ◽  
Success Factors ◽  
Insurance Industry ◽  
Insurance Companies ◽  
Healthcare Financing ◽  
Strategic Choices ◽  
Critical Success ◽  
Health Insurance Industry

This study provides strategic insights and a business model perspective on health insurance as a vehicle for financing healthcare. It uses both primary (expert interview) and secondary data to investigate the overall disease burden and healthcare industry trends and track healthcare financing through the health insurance mechanism in India. To identify the critical success factors and to gain a business model perspective within the health insurance industry, telephonic and face-to-face interviews were held with 27 experts in the healthcare, insurance, and strategic management field. The study’s findings suggest that the growth of health insurance as a healthcare financing mechanism in India has been challenged continuously and impacted by multiple changes in the health insurance and healthcare industry over the last decade. One of the critical challenges faced by insurance companies is the high incurred claim ratio. We find the Indian health insurance industry to be very competitive and that the focus on critical success factors can help insurance companies gain a competitive advantage. The health insurance business model is unique, with varying configurations, and broadly comprises strategic choices and consequences. In this article, drawing from the strategic management literature on the resource-based view (RBV) and insights gained from the interviews of healthcare and health insurance experts, we highlight the six critical success factors relevant for competing in the health insurance business. We also list five strategic choices that can help health insurance companies improve their profitability and gain a sustained competitive advantage. We recommend that the insurance companies design and develop an innovative business model centred around lowering the claim ratio and simultaneously increasing the customer willingness to pay. To increase the customer willingness to pay and reduce the claim ratio, the insurance companies should focus on the six critical success factors and invest in the five strategic choices.

scholarly journals Drug prices in Latin American countries: the case of rheumatoid arthritis Biosimilars

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Gabriela Bittencourt Gonzalez Mosegui ◽  
Fernando Antõnanzas ◽  
Cid Manso de Mello Vianna ◽  
Paula Rojas
Keyword(s):  
Rheumatoid Arthritis ◽  
United States ◽  
Latin American ◽  
United States Of America ◽  
Purchasing Power Parity ◽  
The United States ◽  
Power Parity ◽  
Drug Prices ◽  
The Us ◽  
Latin American Countries

Abstract Background The objective of this paper is to analyze the prices of biological drugs in the treatment of Rheumatoid Arthritis (RA) in three Latin American countries (Brazil, Colombia and Mexico), as well as in Spain and the United States of America (US), from the point of market entry of biosimilars. Methods We analyzed products authorized for commercialization in the last 20 years, in Brazil, Colombia, and Mexico, comparing them to the United States of America (USA) and Spain. For this analysis, we sought the prices and registries of drugs marketed between 1999 and October 1, 2019, in the regulatory agencies’ databases. The pricing between countries was based on purchasing power parity (PPP). Results The US authorized the commercialization of 13 distinct biologicals and four biosimilars in the period. Spain and Brazil marketed 14 biopharmaceuticals for RA, ten original, four biosimilars. Colombia and Mexico have authorized three biosimilars in addition to the ten biological ones. For biological drug prices, the US is the most expensive country. Spain’s price behavior seems intermediate when compared to the three LA countries. Brazil has the highest LA prices, followed by Mexico and Colombia, which has the lowest prices. Spain has the lowest values in PPP, compared to LA countries, while the US has the highest prices. Conclusion The economic effort that LA countries make to access these medicines is much higher than the US and Spain. The use of the PPP ensured a better understanding of the actual access to these inputs in the countries analyzed.

scholarly journals The Need for Integrating the Back End of the Nuclear Fuel Cycle in the United States of America

MRS Advances ◽  
2018 ◽  
Vol 3 (19) ◽  
pp. 991-1003 ◽  
Author(s):  
Evaristo J. Bonano ◽  
Elena A. Kalinina ◽  
Peter N. Swift
Keyword(s):  
United States ◽  
Nuclear Fuel ◽  
United States Of America ◽  
Spent Nuclear Fuel ◽  
Fuel Cycle ◽  
Nuclear Fuel Cycle ◽  
The United States ◽  
Spent Fuel ◽  
Dry Storage ◽  
The Us

ABSTRACTCurrent practice for commercial spent nuclear fuel management in the United States of America (US) includes storage of spent fuel in both pools and dry storage cask systems at nuclear power plants. Most storage pools are filled to their operational capacity, and management of the approximately 2,200 metric tons of spent fuel newly discharged each year requires transferring older and cooler fuel from pools into dry storage. In the absence of a repository that can accept spent fuel for permanent disposal, projections indicate that the US will have approximately 134,000 metric tons of spent fuel in dry storage by mid-century when the last plants in the current reactor fleet are decommissioned. Current designs for storage systems rely on large dual-purpose (storage and transportation) canisters that are not optimized for disposal. Various options exist in the US for improving integration of management practices across the entire back end of the nuclear fuel cycle.

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