scholarly journals COVID-19 a health reform catalyst? —Analyzing single-payer options in the U.S.: Considering economic values, recent proposals, and existing models from abroad

2020 ◽  
Vol 9 (4) ◽  
pp. 10 ◽  
Author(s):  
Alan Parnell ◽  
Krzysztof Goniewicz ◽  
Amir Khorram-Manesh ◽  
Fredrick M. Burkle ◽  
Ahmed Al-Wathinani ◽  
...  
Keyword(s):  
Free Market ◽  
Universal Coverage ◽  
The United States ◽  
Fee For Service ◽  
Health Coverage ◽  
Industrialized Countries ◽  
Economic Values ◽  
Market Values ◽  
Single Payer ◽  
The U.S

The United States has continued to face severe health coverage and spending challenges that have been attributed to a fragmented multi-payer and fee-for-service delivery system which has become even more exposed by the COVID-19 pandemic. Legislators and healthcare professionals have tried to answer the challenges faced by the U.S. health system through the introduction of several state and federal proposals for a “Medicare-for-all” like system, which have failed to be adopted likely due to the lack of consideration for free-market economic values. Looking to existing models abroad can provide the U.S. with different ways to understand how to achieve the benefits of single-payer models with universal coverage while maintaining the integrity of free-market values. The health systems in wealthy, industrialized countries are closely referenced in this article because of the variation of methods in which each achieves a single-payer/universal coverage model as well as the contrast in their health outcomes compared to that of the U.S. The biggest considerations for any reform effort to achieve an efficient single-payer system with universal coverage is the maintenance of private health insurers and the degree to which expanded government influence would be accepted. The future state of health care remains uncertain and unstable as a result of the COVID-19 pandemic, therefore a window of opportunity exists now for leveraging this uncertainty to achieve reform.

How Single-payer Stacks Up: Evaluating Different Models of Universal Health Coverage on Cost, Access, and Quality

2018 ◽  
Vol 48 (3) ◽  
pp. 568-585 ◽  
Author(s):  
Ashley Fox ◽  
Roland Poirier
Keyword(s):  
United States ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Universal Coverage ◽  
The United States ◽  
Health Coverage ◽  
Single Payer ◽  
Access And Quality ◽  
Universal Health

Described as “universal prepayment,” the national health insurance (or single-payer) model of universal health coverage is increasingly promoted by international actors as a means of raising revenue for health care and improving social risk protection in low- and middle-income countries. Likewise, in the United States, the recent failed efforts to repeal and replace the Affordable Care Act have renewed debate about where to go next with health reform and arguably opened the door for a single-payer, Medicare-for-All plan, an alternative once considered politically infeasible. Policy debates about single-payer or national health insurance in the United States and abroad have relied heavily on Canada’s system as an ideal-typical single-payer system but have not systematically examined health system performance indicators across different universal coverage models. Using available cross-national data, we categorize countries with universal coverage into those best exemplifying national health insurance (single-payer), national health service, and social health insurance models and compare them to the United States in terms of cost, access, and quality. Through this comparison, we find that many critiques of single-payer are based on misconceptions or are factually incorrect, but also that single-payer is not the only option for achieving universal coverage in the United States and internationally.

Gold Value Clauses and Public Policy

1970 ◽  
Vol 5 (2) ◽  
pp. 155-169
Author(s):  
Eliahu Hirschberg
Keyword(s):  
Public Policy ◽  
Free Market ◽  
Market Price ◽  
The United States ◽  
European Continent ◽  
The Past ◽  
Tier System ◽  
Free Market Price ◽  
Joint Resolution ◽  
The U.S

Gold value clauses are rarely used in England. In the United States, before the Joint Resolution of both Houses of Congress of January 5, 1933, which abrogated gold clauses in the U.S. retrospectively and prospectively, declaring them to be against public policy, gold coin clauses were a common occurrence. In the past on the European continent much use has been made of gold value clauses.In England gold value clauses may assume greater importance in the future. Lately, the two-tier system of gold prices has been introduced, one between Central Banks and another at the free market price. In an individual gold value clause, the question of which price is recognized by the parties, who probably did not in fact foresee the possibility of the creation of a two-tier system, is one of construction. Even today, a party to a gold value clause which refers to the free market price may gain a profit, if there is an appreciation of the price of gold on the free market above the U.S. government minimum level of $35.00 per ounce.

scholarly journals Evaluating Medicare Performance: Perceptions of Performance Pre- and Post- ACA

2020 ◽  
Vol 7 (2) ◽  
pp. 28
Author(s):  
Ashleigh Chinelo Oguagha ◽  
Nickesha Joan Lambert
Keyword(s):  
Low Income ◽  
Medicare Beneficiary ◽  
National Level ◽  
Life Time ◽  
The Elderly ◽  
The United States ◽  
Health Coverage ◽  
Single Payer ◽  
Before And After ◽  
Performance Perceptions

Medicare is a national single-payer system that provides health coverage for the elderly, disabled, and terminally ill in the United States. Rising enrollment, costs, and decreases in financing options may affect the way Medicare performs. This study aimed to investigate participants’ perceptions of Medicare performance before and after the Affordable Care Act. A 3-part questionnaire was created and validated for use in this study. Respondents affiliated with several social work agencies were invited via email to participate in this study. 287 out of 519 invited questionnaires were used in data analyses. 27.5% of respondents reported being currently enrolled in Medicare, while 33.2% reported lifetime enrollment. Overall, retired/disabled, elderly and low-income participants reported currently or ever using Medicare. One’s perception of Medicare performance was determined by their status as a Medicare beneficiary. Medicare service efficacy was rated more positively over-time by current and life-time enrollees; additionally, Medicare performance was determined to be better in 2013 than in 2009. Ultimately, this study showed that health service and financial fairness factors are indicative of Medicare performance. Additional research should explore possible implications for the healthcare field as well as formulate a broad range of possible management and/or improvement strategies. Lastly, differences in performance across years can inform decision-makers and bolster the fundamental foundation of health policies at the state and national level.

Analogical Framing: How Policy Comparisons Alter Political Support for Health Care Reform

2020 ◽  
Vol 48 (5) ◽  
pp. 596-611
Author(s):  
Jason Barabas ◽  
Benjamin Carter ◽  
Kevin Shan
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
The United States ◽  
Political Support ◽  
Health Coverage ◽  
Individual Health ◽  
Single Payer ◽  
Public Debates ◽  
Democrats And Republicans ◽  
Political Persuasion

Analogies have captivated philosophers for millennia, yet their effects on modern public opinion preferences remain largely unexplored. Nevertheless, the lack of evidence as to whether analogies aid in political persuasion has not stopped politicians from using these rhetorical devices in public debates. To examine such strategic attempts to garner political support, we conducted survey experiments in the United States that featured the analogical arguments being used by Democrats and Republicans as well as some of the policy rationales that accompanied their appeals. The results revealed that analogies—especially those that also provided the underlying policy logic—increased support for individual health coverage mandates, the Affordable Care Act (ACA), and even single payer national health proposals. However, we demonstrated that rebutting flawed analogies was also possible. Thus, within the health care arena, framing proposals with analogies can alter policy preferences significantly, providing a way to deliver policy rationales persuasively.

The Ethical Neutrality of Prospective Payments: Justice Issues

1996 ◽  
Vol 5 (4) ◽  
pp. 570-578
Author(s):  
Jean McDowell
Keyword(s):  
United States ◽  
Healthcare System ◽  
West Coast ◽  
Healthcare Delivery ◽  
The United States ◽  
Fee For Service ◽  
Reimbursement Mechanisms ◽  
The West ◽  
The Past ◽  
The U.S

The U.S. healthcare system has been subject to unprecedented scrutiny over the past three years; one of the results of this scrutiny has been recognition of the serious problems that exist in both healthcare delivery and reimbursement mechanisms. While the verbal debate in Washington has essentially ceased, within the healthcare community a historic shift has taken place in the way healthcare reimbursement is structured: increasingly, traditional fee-for-service reimbursement methods are being replaced with capitation reimbursement methods. While this phenomenon originated on the West Coast, it has spread to all geographic sectors of the United States in varying degrees and can be expected to dominate the funding patterns of healthcare over the next decade.

Inequality

2013 ◽  
Author(s):  
Stephanie Moller ◽  
Joya Misra
Keyword(s):  
United States ◽  
Income Inequality ◽  
The United States ◽  
Social Policies ◽  
Industrialized Countries ◽  
Race And Gender ◽  
Disadvantaged Groups ◽  
Limited Effectiveness ◽  
And Gender ◽  
The U.S

Social policy plays a central role in redistributing resources to ensure greater equality or at least increased opportunities for members of disadvantaged groups. This essay considers how the U.S. welfare state redistributes incomes through social policies, while reinforcing other forms of stratification. The essay begins by comparing inequality in the United States to other advanced industrialized countries, and shows that the level of income inequality is higher in the United States than in most of these nations. It then presents data on inequality in the United States by race and gender. Finally, it discusses how specific policies alter levels of inequality by redistributing income or institutionalizing sources of income inequality. In general, U.S. social policies help to reduce inequality, but they have limited effectiveness, particularly in comparison to other advanced industrialized countries, in reducing inequality by race, class, gender, and family structure.

The U.S. Generalized System of Preferences for Developing Countries: International Innovation and the Art of the Possible

1978 ◽  
Vol 72 (3) ◽  
pp. 513-541 ◽  
Author(s):  
Thomas R. Graham
Keyword(s):  
United States ◽  
Developing Countries ◽  
The United States ◽  
Industrialized Countries ◽  
Generalized System ◽  
Generalized System Of Preferences ◽  
The U.S

On January 1, 1976, some 2,700 articles from 137 developing countries and territories became eligible to enter the United States free of import duties. By this overnight elimination of tariffs that had ranged as high as 28 percent, on articles as diverse as sausage and spacecraft, from countries as different as Brazil and Bangladesh, the United States became the twenty-third and most recent industrialized country to implement a “Generalized System of Preferences” (GSP), permitting imports from developing countries to enter at lower rates of duty than those applicable to the same products from industrialized countries.

scholarly journals Facilitators and barriers to advancing binational health coverage strategies for undocumented Mexican migrants in the United States of America

2019 ◽  
Author(s):  
Armando Arredondo ◽  
Emanuel Orozco ◽  
Ana Lucia Recaman ◽  
Alejandra Azar
Keyword(s):  
United States ◽  
United States Of America ◽  
Social Protection ◽  
The United States ◽  
Undocumented Migrants ◽  
Health Coverage ◽  
Social Actors ◽  
Facilitators And Barriers ◽  
The Impact ◽  
The U.S

Abstract Background: Within the framework of a new national health program with emphasis on universal coverage strategies and in the context of revision/adjustments to the North American Free Trade Agreement (NAFTA/TEMEC), the present study aimed to identify barriers, facilitators and challenges for the development of strategies on social protection in the health of migrants and their families. Material and methods: Evaluative research based on a qualitative analysis with a cross-sectional design. The techniques of documentary analysis, applied political analysis (mapping of actors), in-depth interviews and case studies were used. In the first stage, key actors were mapped at the federal level and senior executives and health officials, federal deputies, senators and members of the Mexican foreign service were interviewed. In the second stage, field work was carried out in the state of Guanajuato and California; State health service officials, state government officials, municipal officials, health unit workers, representatives of CSOs and relatives of migrants were interviewed. The analysis of the interviews was carried out through the ATLAS-Ti software, as well as the mapping of actors and feasibility analysis through the POLICY MAKER software. Results: The main results allowed to identify indicators on barriers and facilitators regarding social actors, binational agreements under NAFTA/TEMEC, institutional spaces, interaction between social actors, as well as the impact and type of relations for a greater advance in binational health policies. Several obstacles were reported, including the fears that undocumented emigrants have in the U.S. of being arrested and deported if they use public health services in the U.S. The stakeholders also believed that many Mexican emigrants do not have a culture that values health insurance. Conclusions: In the context of reforms and adjustments of health systems that are being discussed in parallel in the revision and adjustments of NAFTA/TEMEC (United States of America, Mexico and Canada), the facilitators and barriers identified can be used to strengthen the development of bi-national strategies with different schemes of social protection in the health of undocumented migrants and their families on both sides of the border.

scholarly journals INTERDEPENDENCE AND NETWORK OVERSIGHT IN 1990S INTERNET GOVERNANCE

2021 ◽  
Author(s):  
Meghan Grosse
Keyword(s):  
United States ◽  
Free Market ◽  
The United States ◽  
United States Government ◽  
The Internet ◽  
United States Department ◽  
Internet Governance ◽  
Little Rock ◽  
Close Relationship ◽  
The U.S

In October 2016, the contract between the United States Department of Commerce and the Internet Corporation for Assigned Names and Numbers (ICANN) officially expired. This contract represented a long-standing and close relationship between the United States government and ICANN, a relationship that positioned the U.S. as a kind of linchpin in determining the shape and coordination of the global, extraterritorial internet. This research seeks to address the question: what interests and values shaped ICANN at the time of its establishment and in what ways do debates about this system reflect broader concerns about the U.S.-centric nature of early internet governance policy? I address this question using archival analysis focusing on the Ira Magaziner Electronic Commerce papers at the Clinton Presidential Library in Little Rock, Arkansas. In examining this archive, there are repeated concerns about the U.S.-centric nature of early internet governance policy, concerns that were clear as early as the mid-1990s and which remained at issue with the oversight of ICANN until 2016. While espousing the values of competitive free-market, the internet governance policy promoted by the U.S. government during the Clinton Administration raised concerns about the concentration of power and potentially monopolistic control of the network by a single nation. Understanding the foundations of debates around oversight and multistakeholderism that took place as early as the 1990s helps us better understand more recent changes in internet governance and also help contextualize and ground discussions about how to best create a truly representative global internet in the future.

E-Auctioning by The U. S. Federal Communications Commission

2011 ◽  
pp. 2508-2517
Author(s):  
Trevor R. Roycroft
Keyword(s):  
United States ◽  
Free Market ◽  
The United States ◽  
Spectrum Management ◽  
Federal Communications Commission ◽  
Market Mechanism ◽  
Free Market Economy ◽  
Government Control ◽  
Valuable Resource ◽  
The U.S

Market economies rest on a foundation of the private ownership of resources. Certain resources, however, have been managed outside of the market mechanism, even in the United States’ decidedly pro-free-market economy. The management of radio frequencies, or spectrum, is a prime example of government control of a valuable resource. Spectrum management is practiced by governments around the globe, and the experience of the U.S. Federal Communications Commission (FCC) provides a valuable illustration of how management of this resource may be improved through the use of electronic resources.

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