Unequal Coverage

2017 ◽  
Keyword(s):  
Affordable Care Act ◽  
Insurance Coverage ◽  
The United States ◽  
Lessons Learned ◽  
Citizenship Status ◽  
Role Of Government ◽  
Care Workers ◽  
The Everyday ◽  
The Law

Unequal Coverage documents the everyday experiences of individuals across the United States as they attempted to access coverage and care in the five years following the passage of the Affordable Care Act (ACA). The contributors to this edited volume employ research methods rooted in ethnography and focused on how reform was actually experienced on the ground by frontline health care workers, the newly insured, and those who remained uninsured. The book argues that while the ACA did extend social protections to some groups previously excluded from health insurance, its design- and controversy-plagued implementation also created new forms of exclusion. Access to affordable coverage options were highly segmented by state of residence, income, and citizenship status. To explain and contextualize the stratified experiences of health reform that the book’s authors documented across nine states, Unequal Coverage explores interrelated themes from medical anthropology: stratified citizenship, risk, and responsibility. In the years since its enactment, some 20 million uninsured Americans gained access to insurance coverage. And yet, the law remained unpopular and politically vulnerable. This book illustrates lessons learned from the contentious implementation of the ACA and reveals how the law became a flashpoint for battles over inequality, fairness, and the role of government.

Propagated Fish in Resource Management

2004 ◽  
Keyword(s):  
Federal Government ◽  
Native Species ◽  
The United States ◽  
Lessons Learned ◽  
Role Of Government ◽  
Private And Public ◽  
Selection Of Species ◽  
Aquaculture Development ◽  
Selection Of

<em>Abstract.</em>—Aquaculture development in the United States continues its expansion from freshwater into coastal and nearshore oceanic environments. As it does so, the selection of species to culture and the location of culture operations are generating much debate about the role of government entities, especially agriculture and conservation agencies, in the management of this development. Many in the industry argue that regulations are already too onerous, subsidies are too few, governmental encouragement is too little, and that the best way to correct these problems is to place all control over the development in governmental agriculture agencies. Others argue that the potential environmental impacts of aquaculture could be so adverse, or at least so uncertain that conservation agencies need to impose even more controls. This debate occurred in Texas in the 1980s as private aquaculture sought to increase the culture of nonindigenous species, in both private and public waters. The potential effects on native species in public waters led to legislation that attempted to balance economic development with environmental safeguards. However, only Texas was affected by the statute and subsequent regulations. Since the potential environmental affects of aquaculture development will undoubtedly cross local, state, and tribal boundaries, it is now felt by many that the regulation of the species cultured and sites selected should be a federal issue. The same questions about who within the federal government should have responsibility for managing aquaculture development require resolution. This paper will examine lessons learned from the Texas experience for possible application in the federal arena.

scholarly journals Obamacare 2012: Prognosis Unclear for Interventional Pain Management

2012 ◽  
Vol 5;15 (5;9) ◽  
pp. E629-E640
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
United States ◽  
Pain Management ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Patient Protection ◽  
Medical Education And Training ◽  
Interventional Pain Management

The Patient Protection and Affordable Care Act (ACA), informally referred to as ObamaCare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. ACA has substantially changed the landscape of medical practice in the United States and continues to influence all sectors, in particular evolving specialties such as interventional pain management. ObamaCare has been signed into law amidst major political fallouts, has sustained a Supreme Court challenge and emerged bruised, but still very much alive. While proponents argue that ObamaCare will provide insurance for almost everyone, with an improvement in the quality of and reduction in the cost of health care, opponents criticize it as being a massive bureaucracy laden with penalties and taxes, that will ultimately eliminate personal medicine and individual practices. Based on the 2 years since the passage of ACA in 2010, the prognosis for interventional pain management is unclear. The damage sustained to interventional pain management and the majority of medicine practices is irreparable. ObamaCare may provide insurance for all, but with cuts in Medicare to fund ObamaCare, a limited expansion of Medicaid, the inadequate funding of exchanges, declining employer health insurance coverage and skyrocketing disability claims, the coverage will be practically nonexistent. ObamaCare is composed of numerous organizations and bureaucracies charged with controlling the practice of medicine through the extension of regulations. Apart from cutting reimbursements and reducing access to interventional pain management, administration officials are determined to increase the role of midlevel practitioners and reduce the role of individual physicians by liberalizing the scope of practice regulations and introducing proposals to reduce medical education and training. Key words: Patient Protection and Affordable Care Act, ObamaCare, interventional pain management, Patient-Centered Outcomes Research Institute, Independent Payment Advisory Board, Centers for Medicare and Medicaid Services, Accountable Care Organizations, Medicare, Medicaid

Conclusion

2017 ◽  
Author(s):  
Jessica M. Mulligan ◽  
Heide Castañeda
Keyword(s):  
United States ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Lessons Learned ◽  
Ethnographic Studies ◽  
The Law

Jessica M. Mulligan and Heide Castañeda’s conclusion evaluates why the ACA remained so controversial years after its passage and presents four lessons learned from the ethnographic studies collected in the book. The authors conclude that people in the United States want and need affordable health insurance coverage. However, stratified approaches to expanding access have the result of generating resentment. Coupled with difficult enrollment processes and barriers to accessing coverage, the law became unpopular and unusable for many. Finally, the outright exclusion of groups such as immigrants—to appeal to nationalists—had direct impacts on the law’s success. These lessons are best understood through the frameworks of stratified citizenship (how different groups are viewed as deserving based on a gradation of rights and opportunities), notions of risk, and the devolution of responsibility onto individuals.

The Patient Protection and Affordable Care Act, Public Health, and the Elusive Target of Human Rights

2011 ◽  
Vol 39 (3) ◽  
pp. 340-354 ◽  
Author(s):  
Lance Gable
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Patient Protection ◽  
The Law ◽  
The Impact

The passage of the Patient Protection and Affordable Care Act (ACA) in March 2010 represents a significant turning point in the evolution of health care law and policy in the United States. By establishing a legal infrastructure that seeks to achieve universal health insurance coverage in the United States, the ACA targets some of the major impediments to accessing needed health care for millions of Americans and by extension attempts to strengthen the health system to support key determinants of health. Yet, like many newly passed legislative provisions, the ultimate effects and significance of the ACA remain uncertain. Those charged with implementing the ACA face formidable obstacles — indeed, some of the same obstacles that have been erected to impede other major pieces of social legislation in the past — including entrenched political opposition, constitutional challenges, and what will likely be a prolonged struggle over the content and direction of how the law is implemented. As these debates continue, it is nevertheless important to begin to assess the impact that the ACA has already had on health law in the United States and to consider the likely effects that the law will have on public health going forward.

The Impact of the Affordable Care Act Medicaid Expansions on the Sources of Health Insurance Coverage of Undergraduate Students in the United States

2021 ◽  
pp. 107755872110158
Author(s):  
Priyanka Anand ◽  
Dora Gicheva
Keyword(s):  
United States ◽  
Health Insurance ◽  
Undergraduate Students ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Medicaid Expansions

This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions—that is, some students substituted their private and employer-sponsored coverage for Medicaid.

DIGITAL FINANCIAL TOOLS FOR SOCIALIZING PRIVATE LAW

2021 ◽  
pp. 208-224
Author(s):  
Julia S. Kharitonova ◽  
◽  
Larisa V. Sannikova ◽  
Keyword(s):  
Public Relations ◽  
The United States ◽  
Legal Regulation ◽  
Private Law ◽  
Property Relations ◽  
The World ◽  
The Law ◽  
Private Investors ◽  
The Way

Nowadays, the law is being transformed as a regulator of relations. The idea of strengthe-ning the regulatory role of technologies in the field of streamlining public relations is making much headway in the world. This trend is most pronounced in the area of regulation of private relations. The way of such access to the market as crowdfunding is becoming increasingly widespread. The issuing of the so-called secured tokens is becoming popular for both small businesses and private investors. The trust in new ways of attracting investments is condi-tioned by the applied technology - the use of blockchain as a decentralized transparent data-base management system. Under these conditions, there is such a phenomenon as the democ-ratization of property relations. Every individual receives unlimited opportunities to invest via technologies. Thus, legal scholars all over the world face the question about the role of the law and law in these relations? We believe that we are dealing with such a worldwide trend of regulating public relations as the socialization of the law. Specific examples of issuing tokens in Russia and abroad show the main global trends in the transformation of private law. The platformization of economics leads to the tokenization and democratization of property relations. In this aspect, the aim of lawyers should be to create a comfortable legal environment for the implementation of projects aimed at democratizing property relations in Russia. The socialization of private law is aimed at achieving social jus-tice and is manifested in the creation of mechanisms to protect the rights of the weak party and rules to protect private investors. Globalization requires the study of both Russian and foreign law. To confirm their hypothesis, the authors conducted a detailed analysis of the legislation of Russia, Europe and the United States to identify the norms allowing to see the process of socialization of law in the above field. The generalization of Russian and foreign experience showed that when searching for proper legal regulation, the states elect one of the policies. In some countries, direct regulation of ICOs and related emission relations are being created, in others, it is about the extension of the existing legislation to a new changing tokenization relationship. The European Union countries are seeking to develop common rules to create a regulatory environment to attract investors to the crypto industry and protect them. Asian countries are predominantly developing national legislation in isolation from one another, but most of them are following a unified course to encourage investment in crypto assets while introducing strict rules against fraud on financial markets. The emphasis on the protection of the rights of investors or shareholders, token holders by setting a framework, including private law mechanisms, can be called common to all approaches. This is the aim of private law on the way to social justice.

Introduction

2017 ◽  
Author(s):  
Jessica M. Mulligan ◽  
Heide Castañeda
Keyword(s):  
Health Policy ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Demographic Characteristics ◽  
Social Identities ◽  
Immigration Status ◽  
Anthropological Approach ◽  
The Law

In this chapter, Jessica M. Mulligan and Heide Castañeda provide an overview of the Affordable Care Act focused on the coverage expansions that were at the heart of the law. The authors outline the ethnographic methods used in the book, arguing that an anthropological approach provides an experience-near perspective on implementation that too often is absent in mainstream treatments of health policy. The central theoretical concerns of the book are also introduced: stratified citizenship, risk, and responsibility. The term stratified citizenship describes how certain social identities and demographic characteristics—such as immigration status, income, gender, race, and state of residence—mediated how people were included or excluded from health insurance coverage through the ACA. Exposure to risks as well as inclusion in the new responsibilities created by the law were also unequally distributed.

Development of the Medical Interpreting Profession in the US

2020 ◽  
pp. 1-25
Author(s):  
Holly M. Mikkelson
Keyword(s):  
United States ◽  
Labor Market ◽  
The United States ◽  
Role Of Government ◽  
The Us ◽  
Medical Interpreters ◽  
Medical Interpreting ◽  
Further Development

This chapter traces the development of the medical interpreting profession in the United States as a case study. It begins with the conception of interpreters as volunteer helpers or dual-role medical professionals who happened to have some knowledge of languages other than English. Then it examines the emergence of training programs for medical interpreters, incipient efforts to impose standards by means of certification tests, the role of government in providing language access in health care, and the beginning of a labor market for paid medical interpreters. The chapter concludes with a description of the current situation of professional medical interpreting in the United States, in terms of training, certification and the labor market, and makes recommendations for further development.

Toward a dynamic capability theory of economic growth

2019 ◽  
Vol 29 (4) ◽  
pp. 1047-1065 ◽  
Author(s):  
David Sainsbury
Keyword(s):  
Economic Growth ◽  
Economic Development ◽  
Value Added ◽  
The United States ◽  
Dynamic Capability ◽  
Alexander Hamilton ◽  
Role Of Government ◽  
Windows Of Opportunity ◽  
The Uk

Abstract New theories of economic growth that are policy-relevant and connect with the histories of success and failure in economic development are urgently needed. This article compares the neoclassical (or market efficiency) school of thought with the production-capability school of thought which included Alexander Hamilton, Friedrich List, and Joseph Schumpeter. Many affirmative, industrial policy steps by governments to promote economic development have been historically recorded—including in the UK and the United States. Meanwhile the neoclassical school has ignored the role of government in helping to create competitive advantage. It has also chosen to ignore how firms are formed, how technologies are acquired, and how industries emerge. The dynamic capability theory of economic growth developed here assigns the central role in economic growth to firms but also an important role to governments. The rate at which a country’s economy grows depends critically on whether its firms can build the capabilities to generate and take advantage of “windows of opportunity” that exist for innovation and new markets, and whether over time they are able to enhance their capabilities to move into higher value-added activities.1

Community Services: Contrasts Between Resident and Nonresident Landowners in the Adirondack Region of New York

1975 ◽  
Vol 4 (2) ◽  
pp. 132-142
Author(s):  
Robert G. Craig ◽  
Harry P. Mapp
Keyword(s):  
United States ◽  
New York ◽  
World War Ii ◽  
The United States ◽  
Community Services ◽  
World War ◽  
Revolutionary Change ◽  
Role Of Government ◽  
The Public

“There is more than enough evidence to show that the states and localities, far from being weak sisters, have actually been carrying the brunt of domestic governmental progress in the United States ever since the end of World War II … Moreover, they have been largely responsible for undertaking the truly revolutionary change in the role of government in the United States that has occurred over the past decade.”–Daniel J. Elazar, The Public Interest

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