America's Health Care Reforms

1994 ◽  
Vol 24 (1) ◽  
pp. 32-33 ◽  
Author(s):  
Jeffrey Braithwaite ◽  
Johanna Westbrook
Keyword(s):  
Health Care ◽  
New Deal ◽  
Insurance Coverage ◽  
Bill Clinton ◽  
Health Care Insurance ◽  
American Population ◽  
Health Care Reforms ◽  
Policy Makers ◽  
Care Costs ◽  
The New Deal

President Bill Clinton is currently proposing the most sweeping changes to American social policy since the New Deal by Roosevelt in the 1930s. Major concerns about escalating health care costs, a mushrooming health care bureaucracy and a growing proportion of the American population who can no longer afford adequate health care insurance coverage have motivated Clinton's plan for health care reform. Ideas about telemedicine, the electronic medical record and more comprehensive and advanced information systems are already being canvassed during the course of the debate. Australian clinicians and policy makers are following the American debate closely. So too, should health information managers. America watching should prove interesting, stimulating and professionally rewarding.

Health Care Financing for the Child With Catastrophic Costs

PEDIATRICS ◽  
1987 ◽  
Vol 80 (5) ◽  
pp. 752-757
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Insurance Coverage ◽  
Chronically Ill ◽  
Medical Needs ◽  
Structural Problems ◽  
Medical Care Costs ◽  
Private And Public ◽  
Care Costs

PURPOSE Historically, health insurance has not treated children fairly. Insured services have been oriented to the medical needs of adults, with children's unique needs given poor coverage or, in the instance or preventive care, rare coverage. These biases inherent in private and public health insurance also manifest themselves in the coverage of catastrophic care for children. The objectives of the following recommendations are to rectify some of the structural problems of health insurance that are faced by children, to ensure access to all needed health care services for all children, and to protect families from overwhelming out-of-pocket medical care costs. PRINCIPLES To address the needs of children through 21 years of age with illnesses that lead to catastrophic costs, all insurance plans must (1) be available to all children (and pregnant women) without regard to race, religion, national origin, economic status, health or functional status, or existing health insurance coverage; (2) include participation of both private and public sectors; (3) support the development of comprehensive, community-based systems of personal health care for the chronically ill child; (4) cover a broad array of child-specific health services; (5) contain costs through managed care and other means; and (6) require some financing from the child's family in proportion to their ability to pay. DEFINITION OF CATASTROPHIC NEED The American Academy of Pediatrics (AAP) defines catastrophic need by relative economic distress. Generally, a child whose family's out-of-pocket medical care costs reach a maximum of 10% of their annual adjusted gross income as reported to the Internal Revenue Services is one who, regardless of health status, income level, or existing insurance coverage, is in need of financial support for further medical expenses.

Holes in the Health Insurance System-Who Lacks Coverage and Why

2004 ◽  
Vol 32 (3) ◽  
pp. 390-396 ◽  
Author(s):  
Catherine Hoffman ◽  
Diane Rowland ◽  
Alicia L. Carbaugh
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Insurance System ◽  
Major Health ◽  
Insurance System ◽  
Current Health ◽  
Private And Public ◽  
Care Costs

Lack of health insurance coverage is a large and growing problem for millions of American families. Rising health care costs and economic insecurity continue to threaten the bedrock of the health insurance system - employer-sponsored coverage - while states’ fiscal situations and the escalating federal deficit complicate any efforts at reform. Providing health insurance coverage to the millions of uninsured remains a major health care challenge for the nation and understanding the current health insurance environment, who the uninsured are, and why they are uninsured is critical when considering health care reform. This paper aims to define the problem of the uninsured, providing an overview of the uninsured in America and the roles and limits of private and public insurance. Following this discussion, the paper describes the current health insurance environment and examines the prospects for improving coverage.

A global New Deal

2021 ◽  
pp. 109-131
Author(s):  
Jens Steffek
Keyword(s):  
New Deal ◽  
Interwar Period ◽  
World Order ◽  
Political Influence ◽  
Policy Makers ◽  
Post War ◽  
United Nations System ◽  
Second World ◽  
The New Deal ◽  
Nations System

This chapter shows how technocratic internationalism survived the crisis of world order utopias in the 1940s and gained influence on the negotiation of the post-war order. The first section discusses the critique of modern rationalism in the war and post-war years. In the field of international thought, that critique came in the guise of a ‘realist’ backlash against the ‘idealism’ of the interwar period. The second section documents the enduring prominence of technocratic ideas during the Second World War. David Mitrany re-proposed his functional approach in his Working Peace System, a pamphlet that addressed policy-makers rather than academics. Regardless, this wartime version of Mitrany’s functionalism became the point of reference for subsequent generations of scholars. Technocratic thought gained political influence when American policy-makers projected the New Deal and its institutions onto the international plane in the founding of the United Nations system. The final section studies the co-existence of realist and technocratic figures of thought. Realist Hans J. Morgenthau came to advocate international cooperation in the field of low politics, but also multilateral control over nuclear technology. In doing so, he drew directly on Mitrany’s functionalism. E. H. Carr, the eminent British critic of utopianism, in the 1940s suggested a technocratic European planning authority and a bank of Europe to unite the continent.

scholarly journals Analysis of Health Care Billing via Quantile Variable Selection Models

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1274
Author(s):  
Tahir Ekin ◽  
Paul Damien
Keyword(s):  
Health Care ◽  
Variable Selection ◽  
Common Factors ◽  
Fraud Detection ◽  
Health Care Insurance ◽  
Billing Data ◽  
Policy Makers ◽  
Regression Framework ◽  
Selection Approach ◽  
The Common

Fraudulent billing of health care insurance programs such as Medicare is in the billions of dollars. The extent of such overpayments remains an issue despite the emerging use of analytical methods for fraud detection. This motivates policy makers to also be interested in the provider billing characteristics and understand the common factors that drive conservative and/or aggressive behavior. Statistical approaches to tackling this problem are confronted by the asymmetric and/or leptokurtic distributions of billing data. This paper is a first attempt at using a quantile regression framework and a variable selection approach for medical billing analysis. The proposed method addresses the varying impacts of (potentially different) variables at the different quantiles of the billing aggressiveness distribution. We use the mammography procedure to showcase our analysis and offer recommendations on fraud detection.

scholarly journals Barriers to Health Care for Children with Orofacial Clefts: A Systematic Literature Review and Recommendations for Research Priorities

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Nichole Nidey ◽  
George L. Wehby
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Costs ◽  
Insurance Coverage ◽  
Ethnic Disparities ◽  
Research Priorities ◽  
The United States ◽  
Barriers To Health Care ◽  
Barriers To Health ◽  
Care Costs

Background: There is a growing interest in health services research of orofacial clefts (OFC) in the United States. The objective of this study is to summarize the empirical knowledge to date about barriers to health care for children with OFC. Methods: We completed a systematic literature review to identify articles on barriers to health care for children with OFC in the United States. Pubmed, Embase, CINAHL, and Medline were searched from their dates of origin through June 2018 using a combination of key terms related to access and barriers to health care. Case reports and studies of populations outside of the United States were excluded. Results: 4079 publications were identified using our search strategy. After a title and abstract review, 18 were included in our review as they met inclusion criteria. These studies examined health care costs, health insurance coverage, access to team care, geographic barriers, adequacy of training of community-based providers in providing services to children with OFC, and socioeconomic and demographic factors. The key findings indicate much higher health care costs for children with OFC than unaffected children early in childhood, racial/ethnic disparities in certain access measures, and inadequate insurance coverage, distance to teams, and inadequate training of community-based providers in OFC-specific services as potential areas of concern. Except for studies on health care costs, the evidence is largely based on relatively small and primarily descriptive studies. Conclusions: The extant literature documents high health care costs for OFC treatments and suggests inadequate insurance coverage, long distance to cleft teams, and racial/ethnic disparities as critical factors related to access. We discuss multiple future research priorities. Among these, understanding the impacts of variation between states in mandates for private insurance benefits and generosity in Medicaid coverage on access to care as well as effects of differences in provider reimbursements are particularly understudied areas that can be meaningful for policymaking aimed at improving access and health outcomes of children with OFC. Examining access throughout childhood and later in life and employing robust designs and population-representative data are also important research and methodological extensions of the current literature.

Real Change in the USA

1995 ◽  
Vol 30 (1) ◽  
pp. 35-47 ◽  
Author(s):  
Harvey C. Mansfield
Keyword(s):  
New Deal ◽  
Presidential Election ◽  
Republican Party ◽  
Bill Clinton ◽  
Real Change ◽  
The Usa ◽  
Harry Truman ◽  
The New Deal

THE AMERICAN ELECTION OF 1994, A SMASHING NATIONAL victory for the Republican Party, was both unusual and momentous. It produced a result of startling clarity, which is unusual in the American constitutional scheme, especially for a non-presidential election; and it promises enduring dominance for the Republicans, which is momentous. The change that President Bill Clinton said he would bring in 1992, and did not bring, has been imposed on him.Not since 1946, when Harry Truman was presented with a Republican Congress, has an incumbent president been treated so roughly by the voters. But Truman lived in the era of New Deal dominance and was able to recover and be re-elected in 1948. The better analogy for the 1994 election, unfortunately for the Democrats, is probably 1930, when Herbert Hoover was repudiated by the voters and a new Democratic Congress become the prelude to the New Deal dominance that began in 1932 and now seems to have come to an end.

JIMMY CARTER, BILL CLINTON, AND THE NEW DEMOCRATIC ECONOMICS

2004 ◽  
Vol 47 (4) ◽  
pp. 1015-1039 ◽  
Author(s):  
IWAN MORGAN
Keyword(s):  
New Deal ◽  
Democratic Party ◽  
Bill Clinton ◽  
Jimmy Carter ◽  
Quarter Century ◽  
Left Behind ◽  
High Employment ◽  
The Subject ◽  
The New Deal ◽  
American Economy

Jimmy Carter's response to stagflation, the unprecedented combination of stagnation and double-digit inflation that afflicted the American economy during his presidency, made him the subject of virulent attack from liberal Democrats for betraying New Deal traditions of activist government to sustain high employment and strong economic growth. Carter found himself accused of being a do-nothing president whose name had become ‘a synonym for economic mismanagement’ like Herbert Hoover's in the 1930s.1 Liberal disenchantment fuelled Edward Kennedy's quixotic crusade to wrest the 1980 Democratic presidential nomination from Carter. ‘[H]e has left behind the best traditions of the Democratic Party’, the Massachusetts senator charged, ‘We are instructed that the New Deal is old hat and that our best hope is no deal at all.’2 A quarter-century later a more dispassionate analysis would suggest that Carter was neither a do-nothing president nor a throwback to the past in terms of economic policy. Far from being the ‘Jimmy Hoover’ of liberal obloquy, Carter was really ‘Jimmy Clinton’ because in seeking solutions for stagflation his administration laid the foundations of a new political economy that the next Democratic president would build upon.

Privatizing the Welfarist State: Health Care Reforms in Malaysia

2003 ◽  
Vol 13 (1) ◽  
pp. 87-105 ◽  
Author(s):  
Chan Chee Khoon
Keyword(s):  
Health Care ◽  
Social Services ◽  
Health Care Industry ◽  
International Capital ◽  
Health Care Reforms ◽  
Shifting Balance ◽  
Public Sector Health ◽  
Action Type ◽  
The Government ◽  
Care Costs

In Malaysia, the shifting balance between market and state has many nuances. Never a significant welfare state in the usual mold, the Malaysian state nonetheless has been a dominant social and economic presence dictated by its affirmative action-type policies, which eventually metamorphosed into state-led indigenous capitalism. Privatisation is also intimately linked with emergence of an indigenous bourgeoisie with favored access to the vast accumulation of state assets and prerogatives. Internationally, it is conditioned by the fluid relationships of converging alliances and contested compromise with international capital, including transnational health services industries. As part of its vision of a maturing, diversified economy, the Malaysian government is fostering a private-sector advanced health care industry to cater to local demand and also aimed at regional and international patrons. The assumption is that, as disposable incomes increase, a market for such services is emerging and citizens can increasingly shoulder their own health care costs. The government would remain the provider for the indigent. But the key assumption remains: the growth trajectory will see the emergence of markets for an increasingly affluent middle class. Importantly, the health care and social services market would be dramatically expanded as the downsizing of public-sector health care proceeds amid a general retreat of government from its provider and financing roles.

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