A comprehensive assessment of the cost of multiple sclerosis in the United States

1998 ◽  
Vol 4 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Kathryn Whetten-Goldstein ◽  
Frank A Sloan ◽  
Larry B Goldstein ◽  
Elizabeth D Kulas
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Insurance ◽  
Informal Care ◽  
Annual Cost ◽  
Lifetime Cost ◽  
The United States ◽  
Personal Health ◽  
Secondary Sources ◽  
The Cost

Comprehensive data on the costs of multiple sclerosis is sparse. We conducted a survey of 606 persons with MS who were members of the National Multiple Sclerosis Society to obtain data on their cost of personal health services, other services, equipment, and earnings. Compensation of such cost in the form of health insurance, income support, and other subsidies was measured. Survey data and data from several secondary sources was used to measure costs incurred by comparable persons without MS. Based on the 1994 data, the annual cost of MS was estimated at over $34 000 per person, translating into a conservative estimate of national annual cost of $6.8 billion, and a total lifetime cost per case of $2.2 million. Major components of cost were earnings loss and informal care. Virtually all persons with MS had health insurance, mostly Medicare/Medicaid. Health insurance covered 51 per cent of costs for services, excluding informal care. On average, compensation for earnings loss was 27 per cent. MS is very costly to the individual, health care system, and society. Much of the cost (57 per cent) is in the form of burdens other than personal health care, including earnings loss, equipment and alternations, and formal and informal care. These costs often are not calculated.

scholarly journals Health, United States, 2019

2021 ◽  
Author(s):  
Renee Gindi ◽  
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Health Status ◽  
Insurance Coverage ◽  
Health Care Expenditures ◽  
The United States ◽  
Care Utilization ◽  
Personal Health ◽  
Health Statistics

Health, United States, 2019 is the 43rd report on the health status of the nation and is submitted by the Secretary of the Department of Health and Human Services to the President and the Congress of the United States in compliance with Section 308 of the Public Health Service Act. This report was compiled by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC). The Health, United States series presents an annual overview of national trends in key health indicators. The 2019 report presents trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal health care expenditures in a 20-figure chartbook. The Health, United States, 2019 Chartbook is supplemented by several other products including Trend Tables, an At-a-Glance table, and Appendixes available for download on the Health, United States website at: https://www.cdc.gov/nchs/hus/ index.htm. The Health, United States, 2019 Chartbook contains 20 figures and 20 tables on health and health care in the United States. Examining trends in health informs the development, implementation, and evaluation of health policies and programs. The first section (Figures 1–13) focuses on health status and determinants: life expectancy, infant mortality, selected causes of death, overdose deaths, suicide, maternal mortality, teen births, preterm births, use of tobacco products, asthma, hypertension, heart disease and cancer, and functional limitations. The second section (Figures 14–15) presents trends in health care utilization: use of mammography and colorectal tests and unmet medical needs. The third section (Figures 16–17) focuses on health care resources: availability of physicians and dentists. The fourth section (Figures 18–20) describes trends in personal health care expenditures, health insurance coverage, and supplemental insurance coverage among Medicare beneficiaries. The Highlights section summarizes major findings from the Chartbook. Suggested citation: National Center for Health Statistics. Health, United States, 2019. Hyattsville, MD. 2021.

How Can the U.S. Government Control Physicians' Fees under National Health Insurance? A Lesson from the French System

1974 ◽  
Vol 4 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Laurence C. Thorsen
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Prescription Drugs ◽  
The United States ◽  
Care Hospital ◽  
Government Control ◽  
The Government ◽  
The Cost

The French national health insurance program covers most of the cost of medical and dental care, hospital care, and prescription drugs. The portion of health care costs borne by the patient varied widely prior to 1960 because of the failure of the government to control physicians' and dentists' fees adequately. In 1960, using expanded regulatory powers, the French government under DeGaulle applied controls on fees by imposing penalties on physicians and dentists who refused to be bound by annual contracts between their local associations and the social security system. The result is uniform fees and less rapid increases in the cost of health care. Control of costs is achieved at the expense of traditional professional independence, but it has made the system workable and is thus instructive for the United States as we consider moving toward national health insurance.

Health Care Cost Containment in Large American Cities

1989 ◽  
Vol 18 (1) ◽  
pp. 87-100 ◽  
Author(s):  
Perry Moore
Keyword(s):  
Health Care ◽  
Cost Containment ◽  
Local Governments ◽  
Health Care Cost ◽  
The United States ◽  
Public Agencies ◽  
The Public ◽  
Survey Results ◽  
The Cost ◽  
American Cities

This research provides information about the health care cost containment efforts of local governments and agencies across the United States, particularly in large American cities. Survey results indicate that while the public sector lags behind the private sector, public agencies are beginning to match the cost containment efforts of private employers. While initiation of these efforts represents considerable recent progress, their tangible benefits are not yet apparent.

Health Care, Health Insurance, and the Distribution of American Incomes

2010 ◽  
Vol 13 (1) ◽  
Author(s):  
Gary Burtless ◽  
Pavel Svaton
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Panel Study ◽  
The United States ◽  
Medical Expenditure ◽  
Cash Income ◽  
Health Coverage ◽  
Money Income ◽  
Health Care Consumption ◽  
The Impact

Cash income offers an incomplete picture of the resources available to finance household consumption. Most American families are covered by an insurance plan that pays for some or all of the health care they consume. Only a comparatively small percentage of families pays for the full cost of this insurance out of their cash incomes. As health care has claimed a growing share of consumption, the percentage of care that is financed out of household incomes has declined. Because health care consumption is more important for some groups in the population than others, the growth in spending and changes in the payment system for medical care have reduced the value of standard income measures for assessing relative incomes of the rich and poor and the young and old. More than a seventh of total personal consumption now consists of health care that is purchased with government insurance and employer contributions to employee health plans. This paper combines health care spending and insurance reimbursement data in the Medical Expenditure Panel Study and money income and health coverage data in the Current Population Survey to assess the impact of health insurance on the distribution of income. Our estimates imply that gross money income significantly understates the resources available to finance household purchases. The estimates imply that a more complete measure of resources would show less inequality than the income measures that are currently used. The addition of estimates of the value of health insurance to countable incomes reduces measured inequality in the population and the income gap between young and old. If the analysis were extended over a longer period, it would show a sizeable impact of insurance on inequality trends in the United States.

Impact of Health Plan Deductibles and Health Insurance Marketplace Enrollment on Health Care Experiences

2018 ◽  
Vol 77 (5) ◽  
pp. 483-497
Author(s):  
Weiwei Chen ◽  
Timothy F. Page
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
The United States ◽  
Health Plans ◽  
Medical Needs ◽  
Care Access ◽  
Health Care Experiences ◽  
Monitoring Survey ◽  
Using Data ◽  
The Impact

High-deductible health plans (HDHPs) have become increasingly prevalent among employer-sponsored health plans and plans offered through the Health Insurance Marketplace in the United States. This study examined the impact of deductible levels on health care experiences in terms of care access, affordability, routine checkup, out-of-pocket cost, and satisfaction using data from the Health Reform Monitoring Survey. The study also tested whether the experiences of Marketplace enrollees differed from off-Marketplace individuals, controlling for deductible levels. Results from multivariable and propensity score weighted regression models showed that many of the outcomes were adversely affected by deductible levels and Marketplace enrollment. These results highlight the importance of efforts to help individuals choose the plan that fits both their medical needs and their budgets. The study also calls for more attention to improving provider acceptance of HDHPs and Marketplace plans as these plans become increasingly common over time.

Rhetorical Federalism: The Role of State Resistance in Health Care Decision-Making

2011 ◽  
Vol 39 (S1) ◽  
pp. 73-76
Author(s):  
Elizabeth Weeks Leonard
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
The United States ◽  
Administrative Capacity ◽  
Limited Government ◽  
Local Diversity ◽  
Patient Protection ◽  
Health Care Regulation ◽  
State Resistance

The Patient Protection and Affordable Care Act (ACA) represents the most significant reform of the United States health care system in decades. ACA also substantially amplifies the federal role in health care regulation. Among other provisions, ACA expands government health care programs, imposes detailed federal standards for commercial health insurance policies, creates national requirements on employers and individuals, and enlists state administrative capacity to implement various federal reforms. In response, a persistent voice in the protracted, contentious debate surrounding ACA was, and continues to be, resistance from states. The rhetoric of federalism — states’ rights, reserved powers, state sovereignty, limited government, and local diversity — resonates deeply even around provisions of ACA that do not specifically implicate state interests. For example, the loudest and most persistent state objections target the new mandate that individuals maintain health insurance, a requirement imposed by ACA and enforced through federal tax penalties.

Health, disability, and life insurance experiences of working-age persons with multiple sclerosis

2007 ◽  
Vol 13 (4) ◽  
pp. 534-546 ◽  
Author(s):  
LI Iezzoni ◽  
L. Ngo
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Insurance ◽  
Life Insurance ◽  
College Education ◽  
Employment Decisions ◽  
Public Programs ◽  
Considerable Difficulty ◽  
Telephone Interviews ◽  
Working Age

Working-age Americans with multiple sclerosis (MS) may face considerable financial insecurities when they become unable to work and lack the health, disability, and life insurance typically offered through employers. In order to estimate the rates of having these insurance policies, as well as how insurance status affects reports of financial stress, we conducted half-hour telephone interviews with 983 working-age persons across the US, who reported being diagnosed with MS. The interviews occurred from May through November 2005, and among the sampled individuals contacted and confirmed eligible, 93.2% completed the interview. The study population was largely female (78.9%), Caucasian (86.4%), married (68.6%), with at least some college education (71.5%), and unemployed (60.2%). Overall, 96.3% had some health insurance (40.3% with public health insurance, primarily Medicare), 56.7% had long-term disability insurance (36.4% with public programs), and 68.3% had life insurance. Notably, 27.4% indicated that, since being diagnosed with MS, health insurance concerns had significantly affected employment decisions. In addition, 16.4% reported considerable difficulty paying for health care, 27.4% put off or postponed seeking needed health care because of costs, and 22.3% delayed filling prescriptions, skipped medication doses, or split pills because of costs. Overall, 26.6% reported considerable worries about affording even basic necessities, such as food, utilities, and housing. Multiple Sclerosis 2007; 13: 534-546. http://msj.sagepub.com

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