The Ongoing U.S. Health Care Crisis: A Data Update

2018 ◽  
Vol 48 (2) ◽  
pp. 209-222 ◽  
Author(s):  
David U. Himmelstein ◽  
Steffie Woolhandler ◽  
Mark Almberg ◽  
Clare Fauke
Keyword(s):  
United States ◽  
Health Care ◽  
Health Policy ◽  
Medical Care ◽  
Affordable Care Act ◽  
Cost Sharing ◽  
The United States ◽  
Health Care Crisis ◽  
Corporate Takeover ◽  
Data Update

While efforts to repeal the Affordable Care Act were narrowly defeated, grave problems in health care persist. Twenty-eight million remain uninsured, a number that is likely to increase. Millions more who have coverage cannot afford care because of high cost-sharing requirements. Meanwhile, the corporate takeover of medical care in the United States is at a gallop. This article provides a brief précis of recent data on U.S. health policy.

The U.S. Health Care Crisis Continues: A Data Snapshot

2017 ◽  
Vol 48 (1) ◽  
pp. 28-41 ◽  
Author(s):  
David U. Himmelstein ◽  
Steffie Woolhandler ◽  
Mark Almberg ◽  
Clare Fauke
Keyword(s):  
United States ◽  
Health Care ◽  
Health Policy ◽  
Medical Care ◽  
Affordable Care Act ◽  
Cost Sharing ◽  
The United States ◽  
Health Care Crisis ◽  
Corporate Takeover ◽  
The U.S

Despite implementation of the Affordable Care Act in 2014, the U.S. health care crisis continues. While coverage has been expanded, 28 million people remain uninsured, and tens of millions who have coverage are unable to afford care because of high cost-sharing requirements. Moreover, many with coverage have a sharply restricted choice of physicians and hospitals, and the corporate takeover of medical care in the United States is proceeding rapidly. This article provides a brief précis of recent data on U.S. health policy.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

Trends in the Contribution of Emergency Departments to the Provision of Hospital-Associated Health Care in the USA

2017 ◽  
Vol 48 (2) ◽  
pp. 267-288 ◽  
Author(s):  
David Marcozzi ◽  
Brendan Carr ◽  
Aisha Liferidge ◽  
Nicole Baehr ◽  
Brian Browne
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Emergency Departments ◽  
The United States ◽  
National Hospital ◽  
Patient Centered ◽  
National Hospital Discharge Survey ◽  
Delivery Of Care ◽  
The Usa

Traditional approaches to assessing the health of populations focus on the use of primary care and the delivery of care through patient-centered homes, managed care resources, and accountable care organizations. The use of emergency departments (EDs) has largely not been given consideration in these models. Our study aimed to determine the contribution of EDs to the health care received by Americans between 1996 and 2010 and to compare it with the contribution of outpatient and inpatient services using National Hospital Ambulatory Medical Care Survey and National Hospital Discharge Survey databases. We found that EDs contributed an average of 47.7% of the hospital-associated medical care delivered in the United States, and this percentage increased steadily over the 14-year study period. EDs are a major source of medical care in the United States, especially for vulnerable populations, and this contribution increased throughout the study period. Including emergency care within health reform and population health efforts would prove valuable to supporting the health of the nation.

Psychological, Social and Technical Factors Influencing Electronic Medical Records Systems Adoption by U.S. Physicians: A Systematic Model

2020 ◽  
Author(s):  
Raghid El-Yafouri ◽  
Leslie Klieb ◽  
Valérie Sabatier
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Service Providers ◽  
Financial Burden ◽  
The United States ◽  
Care Providers ◽  
Intention To Adopt

Abstract Background: Wide adoption of electronic medical records (EMR) systems in the United States can lead to better quality medical care at a lower cost. Despite the laws and financial subsidies by the U.S. government for service providers and suppliers, the adoption has been slow. Understanding the EMR adoption drivers for physicians and the role of policymaking can translate into increased adoption rate and enhanced information sharing between medical care providers. Methods: Physicians across the United States were surveyed to gather primary data on their psychological, social, and technical perceptions toward EMR systems. This quantitative study builds on the Theory of Planned Behavior, the Technology Acceptance Model, and the Diffusion of Innovation theory to propose, test, and validate an innovation adoption model for the health care industry. 382 responses were collected and data were analyzed via linear regression to uncover the effects of 12 variables on the intention to adopt EMR systems.Results: Regression model testing uncovers that government policymaking or mandates and other social factors have little or negligible effect on physicians’ intention to adopt an innovation. Rather, physicians are directly driven by their attitudes and ability to control, and indirectly motivated by their knowledge of the innovation, the financial ability to acquire the system, the holistic benefits to their industry, and the relative advancement of the system compared to others.Conclusions: A unidirectional mandate from the government is not sufficient for physicians to adopt an innovation. Government, health care associations, and EMR system vendors can benefit from our findings by working toward increasing the physicians’ knowledge of the proposed innovation, socializing how medical care providers and the overall industry can benefit from EMR system adoption, and solving for the financial burden of system implementation and sustainment.

The Simple Reality of Our Complex System: The Future of Health Care

2018 ◽  
Vol 46 (4) ◽  
pp. 825-828 ◽  
Author(s):  
Sylvia Mathews Burwell
Keyword(s):  
Complex System ◽  
United States ◽  
Health Care ◽  
Health Care System ◽  
Delivery System ◽  
Affordable Care Act ◽  
The United States ◽  
System Reform ◽  
The Future ◽  
Delivery System Reform

The incredible complexity of the United States health care system can be connected to three simple outcomes: access, affordability, and quality. We should measure our progress against these three measures. While historic progress on access was made through implementation of the Affordable Care Act, the next area of focus for more results across all three measures is delivery system reform.

Medical Expenditures on and by Immigrant Populations in the United States: A Systematic Review

2018 ◽  
Vol 48 (4) ◽  
pp. 601-621 ◽  
Author(s):  
Lila Flavin ◽  
Leah Zallman ◽  
Danny McCormick ◽  
J. Wesley Boyd
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Policy ◽  
Age Groups ◽  
Health Care Expenditures ◽  
The United States ◽  
Public And Private ◽  
Health Insurance Markets ◽  
Private And Public

In health care policy debates, discussion centers around the often-misperceived costs of providing medical care to immigrants. This review seeks to compare health care expenditures of U.S. immigrants to those of U.S.-born individuals and evaluate the role which immigrants play in the rising cost of health care. We systematically examined all post-2000, peer-reviewed studies in PubMed related to health care expenditures by immigrants written in English in the United States. The reviewers extracted data independently using a standardized approach. Immigrants’ overall expenditures were one-half to two-thirds those of U.S.-born individuals, across all assessed age groups, regardless of immigration status. Per capita expenditures from private and public insurance sources were lower for immigrants, particularly expenditures for undocumented immigrants. Immigrant individuals made larger out-of-pocket health care payments compared to U.S.-born individuals. Overall, immigrants almost certainly paid more toward medical expenses than they withdrew, providing a low-risk pool that subsidized the public and private health insurance markets. We conclude that insurance and medical care should be made more available to immigrants rather than less so.

Catholic Church Advocacy and the Affordable Care Act

2019 ◽  
Author(s):  
Jeanine Kraybill
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Catholic Church ◽  
Health Care Policy ◽  
Common Ground ◽  
The United States ◽  
Universal Health Care ◽  
The Government ◽  
Universal Health

The American Catholic Church has a long history in health care. At the turn of 19th century, Catholic nuns began developing the United States’ first hospital and health care systems, amassing a high level of professionalization and expertise in the field. The bishops also have a well-established record advocating for healthcare, stemming back to 1919 with the Bishops’ Program for Social Reconstruction, which called for affordable and comprehensive care, particularly for the poor and vulnerable. Moving into the latter part of the 20th century, the bishops continued to push for health care reform. However, in the aftermath of Roe v. Wade (1973), the American bishops insisted that any reform or form of universal health care be consistent with the Church’s teaching against abortion, contraception, and euthanasia. The bishops were also adamant that health care policy respect religious liberty and freedom of conscience. In 1993, these concerns caused the bishops to pull their support for the Clinton Administration’s Health Security Act, since the bill covered abortion as a medical and pregnancy-related service. The debate over health care in the 1990s served as a precursor for the United States Conference of Catholic Bishops’ (USCCB) opposition to the Obama Administration’s Affordable Care Act (ACA) and the Department of Health and Human Services’ (HHS) contraception mandate. The ACA also highlighted a divide within the Church on health care among religious leaders. For example, progressive female religious leadership organizations, such as the Leadership Conference of Women Religious (LCWR) and their affiliate NETWORK (a Catholic social justice lobby), took a different position than the bishops and supported the ACA, believing it had enough protections against federally funded abortion. Though some argue this divide lead to institutional scrutiny of the sisters affiliated with the LCWR and NETWORK, both the bishops and the nuns have held common ground on lobbying the government for affordable, comprehensive, and universal health care.

Transportation Barriers to Health Care in the United States: Findings From the National Health Interview Survey, 1997–2017

2020 ◽  
Vol 110 (6) ◽  
pp. 815-822 ◽  
Author(s):  
Mary K. Wolfe ◽  
Noreen C. McDonald ◽  
G. Mark Holmes
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
National Health ◽  
National Health Interview Survey ◽  
The United States ◽  
Health Interview Survey ◽  
Transportation Barriers ◽  
Interview Survey ◽  
Barriers To Health

Objectives. To quantify the number of people in the US who delay medical care annually because of lack of available transportation and to examine the differential prevalence of this barrier for adults across sociodemographic characteristics and patient populations. Methods. We used data from the National Health Interview Survey (1997–2017) to examine this barrier over time and across groups. We used joinpoint regression analysis to identify significant changes in trends and multivariate analysis to examine correlates of this barrier for the year 2017. Results. In 2017, 5.8 million persons in the United States (1.8%) delayed medical care because they did not have transportation. The proportion reporting transportation barriers increased between 2003 and 2009 with no significant trends before or after this window within our study period. We found that Hispanic people, those living below the poverty threshold, Medicaid recipients, and people with a functional limitation had greater odds of reporting a transportation barrier after we controlled for other sociodemographic and health characteristics. Conclusions. Transportation barriers to health care have a disproportionate impact on individuals who are poor and who have chronic conditions. Our study documents a significant problem in access to health care during a time of rapidly changing transportation technology.

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