The Future of US Health Care: Is Medicare Really Better at “Saving” Money?

2014 ◽  
Vol 11 (1) ◽  
Author(s):  
Aaron Edlin ◽  
Dana P. Goldman ◽  
Adam A. Leive
Keyword(s):  
Health Care ◽  
Private Insurance ◽  
Insurance Costs ◽  
The Us ◽  
The Future ◽  
Robert Reich ◽  
Medicare Costs

AbstractPaul Krugman, Robert Reich, and others see Medicare as a panacea. Krugman, for example, points out that average Medicare costs have grown only 400 percent while private insurance costs have grown 700 percent. Should the US move to Medicare for all? The case is not as clear as such statistics suggest.

scholarly journals The COVID-19 Pandemic, Donald Trump, and the Future of American Politics

2020 ◽  
Vol 11 (1) ◽  
pp. 42-57
Author(s):  
A. V. Korobkov
Keyword(s):  
Health Care ◽  
Political Stability ◽  
The United States ◽  
Political Polarization ◽  
Current Crisis ◽  
White House ◽  
National Health Care ◽  
Electoral Campaign ◽  
The Us ◽  
The Future

The United States of America was disproportionally severely affected by the COVID-19 pandemic. The current crisis exposed significant flaws in the national health care system and provoked a serious socio-economic crisis. The health care scare overlaps with the ongoing presidential electoral campaign and the extreme political polarization of the country, leading to the politicization of discussions regarding the ways and means of resolving the health care crisis and complicating the process of decision making. The pandemic is also enhancing the autarchic tendencies in the US foreign policy and it’s the increasingly anti-Chinese orientation that became visible during Donald Trump’s White House tenure. Even under these circumstances, the American elites were able to negotiate several stabilization measures designed to deal with the medical and socio-economic aspects of the current crisis. Their willingness and ability to continue such collaboration in the future will have a direct bearing on the US socio-economic and political stability.

Immigrants and Private Insurance

Pained ◽  
2020 ◽  
pp. 57-60
Author(s):  
Michael D. Stein ◽  
Sandro Galea
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Medical Expenditure ◽  
Undocumented Immigrant ◽  
Common Belief ◽  
The Us ◽  
The Common ◽  
Per Capita

This chapter assesses the accusation that immigrants, particularly undocumented immigrants, take advantage of societal resources at the expense of native-born citizens. Between 2002 and 2009, immigrants paid an estimated $115.2 billion more into Medicare than they used. Meanwhile, a 2018 Health Affairs study used data from the Medical Expenditure Panel Survey (MEPS) to measure both premiums and expenditures from private health insurance. Both documented and undocumented immigrant groups had positive net contributions, meaning they paid more toward their private insurance coverage than they spent in receiving health services. In contrast, US natives had a negative net contribution, meaning that, per capita, their expenditures on health care were greater than their premiums. Thus, these findings upend the common belief that immigrants are a drain on the US health care system. In reality, immigrants who contribute to Medicare and to private health insurers are subsidizing the health care of US citizens.

scholarly journals Disparities in Emergent Colectomy for Colorectal Cancer Contribute to Inequalities in Postoperative Morbidity and Mortality in The US Health Care System

2019 ◽  
Vol 109 (2) ◽  
pp. 102-107 ◽  
Author(s):  
F. Schlottmann ◽  
P. D. Strassle ◽  
A. L. Cairns ◽  
F. A. M. Herbella ◽  
A. Fichera ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Health Care System ◽  
Private Insurance ◽  
The United States ◽  
Socioeconomic Disparities ◽  
Wound Complications ◽  
Colorectal Cancer Surgery ◽  
The Us ◽  
Care System

Background and Aims: Colorectal cancer is the third most common cancer among both men and women in the United States. We aimed to determine racial and socioeconomic disparities in emergent colectomy rates for colorectal cancer in the US Health Care system. Material and Methods: We performed a retrospective analysis of the National Inpatient Sample including adult patients (⩾18 years) diagnosed with colorectal cancer, and who underwent colorectal resection while admitted between 2008 and 2015. Multivariable logistic and linear regression were used to assess the association between emergent admissions, compared to elective admissions, and postoperative outcomes. Results: A total of 141,641 hospitalizations were included: 93,775 (66%) were elective admissions and 47,866 (34%) were emergent admissions. Black patients were more likely to undergo emergent colectomy, compared to white patients (42% vs 32%, p < 0.0001). Medicaid and Medicare patients were also more likely to have an emergent colectomy, compared to private insurance (47% and 36% vs 25%, respectively, p < 0.0001), as were patients with low household income, compared to highest (38% vs 31%, p < 0.0001). Emergent procedures were less likely to be laparoscopic (19% vs 38%, p < 0.0001). Patients undergoing emergent colectomy were significantly more likely to have postoperative venous thromboembolism, wound complications, infection, bleeding, cardiac failure, renal failure, respiratory failure, shock, and inpatient mortality. Conclusion: There are significant racial and socioeconomic disparities in emergent colectomy rates for colorectal cancer. Efforts to reduce this disparity in colorectal cancer surgery patients should be prioritized to improve outcomes.

Icon and taboo: single-payer politics in Canada and the US

2019 ◽  
Vol 35 (1) ◽  
pp. 5-24 ◽  
Author(s):  
Carolyn Hughes Tuohy
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Profession ◽  
Private Insurance ◽  
The United States ◽  
Hospital Services ◽  
Popular Support ◽  
Single Payer ◽  
The Us ◽  
Political Economies

AbstractIn 1965 and 1966, the United States and Canada adopted single-payer models of government insurance for physician and hospital services – universal in Canada, but restricted to certain population groups in the US. At the time, the American and Canadian political economies of health care and landscapes of public opinion were remarkably similar, and the different policy designs must be understood as products of the distinctive macro-level politics of the day. Subsequently, however, the different scopes of single-payer coverage would drive the two systems in different directions. In Canada, the single-payer system became entrenched in popular support and in the nexus of interest it created between the medical profession and the state. In the US, Medicare became similarly entrenched in popular support, but did so as part of the larger multi-payer private insurance system. In the process universal single-payer coverage became politically iconic in Canada and taboo in the US.

scholarly journals Survival in Women with De Novo Metastatic Breast Cancer: A Comparison of Real-World Evidence from a Publicly-Funded Canadian Province and the United States by Insurance Status

2022 ◽  
Vol 29 (1) ◽  
pp. 383-391
Author(s):  
Marie-France Savard ◽  
Elizabeth N. Kornaga ◽  
Adriana Matutino Kahn ◽  
Sasha Lupichuk
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
De Novo ◽  
Private Insurance ◽  
Metastatic Breast ◽  
The United States ◽  
Insurance Status ◽  
The Us ◽  
Privately Insured

Metastatic breast cancer (MBC) patient outcomes may vary according to distinct health care payers and different countries. We compared 291 Alberta (AB), Canada and 9429 US patients < 65 with de novo MBC diagnosed from 2010 through 2014. Data were extracted from the provincial Breast Data Mart and from the National Cancer Institute’s SEER program. US patients were divided by insurance status (US privately insured, US Medicaid or US uninsured). Kaplan-Meier and log-rank analyses were used to assess differences in OS and hazard ratios (HR) were estimated using Cox models. Multivariate models were adjusted for age, surgical status, and biomarker profile. No difference in OS was noted between AB and US patients (HR = 0.92 (0.77–1.10), p = 0.365). Median OS was not reached for the US privately insured and AB groups, and was 11 months and 8 months for the US Medicaid and US uninsured groups, respectively. The 3-year OS rates were comparable between US privately insured and AB groups (53.28% (51.95–54.59) and 55.54% (49.49–61.16), respectively). Both groups had improved survival (p < 0.001) relative to the US Medicaid and US uninsured groups [39.32% (37.25–41.37) and 40.53% (36.20–44.81)]. Our study suggests that a universal health care system is not inferior to a private insurance-based model for de novo MBC.

scholarly journals Becoming Australian? Two different approaches to health care reform in the United States

2009 ◽  
Vol 33 (2) ◽  
pp. 303
Author(s):  
Jessica K Roydhouse
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Reform ◽  
San Francisco ◽  
Private Insurance ◽  
The United States ◽  
The State ◽  
Short Paper ◽  
Australian Health ◽  
The Us

THE ?SUBSTANTIAL PRIVATE SECTOR?1 ROLE in Australian health care has sometimes given rise to fears of ?Americanisation? of the Australian health care system, particularly in the media. For example, in 2000 Kenneth Davidson wrote, ?The USstyle health financing route being taken by the Howard Government is mad and bad.?2 The US system is the ?leading example? of ?inferior system performance?3 and is often viewed as a system to be feared and avoided. Despite spending far more per capita than any other country on health care, the United States nonetheless fails to provide equitable health care for everyone. The system is ?a paradox of excess and deprivation?,4 spending far more than other systems without providing adequate care and treatment for all. Although the US system is seen as frightening in Australia, broad historical and political similarities such as the ?strong?5 role and ?long history?5 of private insurance and powerful, vocal physicians? groups1,5 make the Australian experience a useful comparative one for US policymakers. As Altman and Jackson note, the US system will probably not develop into a fully public system, but a system combining private and public aspects along the lines of the Australian model is possible.5 Furthermore, while politicians in the US at the state and local levels have attempted to address the issue of universal or near-universal coverage for some time, previous efforts sought to expand coverage using existing programs instead of establishing a new system.6 More recently, the state of Massachusetts and the county (municipality) of San Francisco have introduced near-universal health care programs. Although introduced nearly simultaneously, their development processes and structures differ. In addition, the Massachusetts plan in particular was viewed as a potential model for future sub-national and possibly national health reforms. Thus, this short paper examines the two plans as two different approaches to health care reform in the US and compares them to the Australian system, asking the question whether or not current reform efforts in the US make the system more like that in Australia, or are likely to do so in the future.

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