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"SOCIAL HEALTH INSURANCE"
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Catastrophic care : how American health care killed my father--and how we can fix it
\"A visionary and completely original investigation that will change the way we think about health care: how and why it is failing, why expanding insurance coverage will only make things worse, and how it can be transformed into a transparent, affordable, successful system. In 2007, David Goldhill's father died from a series of infections acquired in a well-regarded New York hospital. The bill was for several hundred thousand dollars--and Medicare paid it. These circumstances left Goldhill angry and determined to understand how it was possible that world-class technology and well-trained personnel could result in such simple, inexcusable carelessness--and how a business that failed so miserably could be rewarded with full payment. Catastrophic Care is the eye-opening result. Goldhill explicates a health-care system that now costs nearly $2.5 trillion annually, bars many from treatment, provides inconsistent quality of care, offers negligible customer service, and in which an estimated 200,000 Americans die each year from errors. Above all, he exposes the fundamental fallacy of our entire system--that Medicare and insurance coverage make care cheaper and improve our health--and suggests a comprehensive new approach that could produce better results at more acceptable costs immediately by giving us, the patients, a real role in the process. \"-- Provided by publisher.
Book
Beyond Medicine
In Beyond Medicine
, Paul V. Dutton provides a penetrating historical analysis
of why countless studies show that Americans are far less healthy
than their European counterparts.
Dutton argues that Europeans are healthier than Americans
because beginning in the late nineteenth century European nations
began construction of health systems that focused not only on
medical care but the broad social determinants of health: where and
how we live, work, play, and age. European leaders also created
social safety nets that became integral to national economic
policy. In contrast, US leaders often viewed investments to improve
the social determinants of health and safety-net programs as a
competing priority to economic growth.
Beyond Medicine compares the US to three European
social democracies-France, Germany, and Sweden-in order to explain
how, in differing ways, each protects the health of infants and
children, working-age adults, and the elderly. Unlike most
comparative health system analyses, Dutton draws on history to find
answers to our most nettlesome health policy questions.
eBook
Conceiving normalcy : rhetoric, law, and the double binds of infertility
In Conceiving Normalcy, Elizabeth C. Britt uses a Massachusetts statute requiring insurance coverage for infertility as a lens through which the work of rhetoric in complex cultural processes can be better understood. Countering the commonsensical notion that mandatory insurance coverage functions primarily to relieve the problem of infertility, Britt argues instead that the coverage serves to expose its contours.
Book
Ties that Enable
Ties that Enable is written for students, providers, and advocates seeking to understand how best to improve mental health care – be it for themselves, their loved ones, their clients, or for the wider community. The authors integrate their knowledge of mental health care as researchers, teachers, and advocates and rely on the experiences of people living with severe mental health problems to help understand the sources of community solidarity. Communities are the primary source of social solidarity, and given the diversity of communities, solutions to the problems faced by individuals living with severe mental health problems must start with community level initiatives. “Ties that Enable” examines the role of a faith-based community group in providing a sense of place and belonging as well as reinforcing a valued social identity. The authors argue that mental health reform efforts need to move beyond a focus on individual recovery to more complex understandings of the meaning of community care. In addition, mental health care needs to move from a medical model to a social model which sees the roots of mental illness and recovery as lying in society, not the individual. It is our society’s inability to provide inclusive supportive environments which restrict the ability of individuals to recover. This book provides insights into how communities and system level reforms can promote justice and the higher ideals we aspire to as a society.
eBook
Get what's yours for Medicare : maximize your coverage, minimize your costs
\"Explains for those 65 and older how to make [choices] in the annual Medicare enrollment period to maximize your health coverage without overpaying\"-- Provided by publisher.
Book
Scaling up affordable health insurance
As the world recently turned its attention to the struggle of expanding health insurance coverage for 40 million people in the United States, it is important not to forget the 4 billion people in low- and middle-income countries that face the same hardship. Millions of the poor have already fallen back into poverty as a result of the ongoing global financial crisis. Millions more are at risk before full recovery. It is the poor and most vulnerable that are at greatest risk due to lack of protection against the impoverishing effects of illness. The research for this volume shows that, when properly designed and coupled with public subsidies, health insurance can contribute to the well-being of poor and middle-class households, not just the rich. And it can contribute to development goals such as improved access to health care, better financial protection against the cost of illness, and reduced social exclusion. Opponents vilify health insurance as an evil to be avoided at all cost. To them, health insurance leads to overconsumption of care, escalating costs-especially administrative costs-fraud and abuse, shunting of scarce resources away from the poor, cream skimming, adverse selection, moral hazard, and an inequitable health care system. Today many low-and middle-income countries are no longer listening to this dichotomized debate between vertical and horizontal approaches to health care. Instead, they are experimenting with new and innovative approaches to health care financing. Health insurance is becoming a new paradigm for reaching the Millennium Development Goals (MDGs). They emphasize the need to combine several instruments to achieve three major development objectives in health care financing: 1) sustainable access to needed health care; 2) greater financial protection against the impoverishing cost of illness; and 3) reduction in social exclusion from organized health financing instruments. The use of insurance was recommended to pay for less frequent, higher-cost risks and subsidies to cover affordability for poorer patients to higher-frequency, lower-cost health problems.
eBook
Social health insurance for developing nations
Specialist groups have often advised health ministers and other decision makers in developing countries on the use of social health insurance (SHI) as a way of mobilizing revenue for health, reforming health sector performance, and providing universal coverage. This book reviews the specific design and implementation challenges facing SHI in low- and middle-income countries and presents case studies on Ghana, Kenya, Philippines, Colombia, and Thailand.
eBook
A Triple-Difference Approach to Re-Evaluating the Impact of China’s New Cooperative Medical Scheme on Incidences of Chronic Diseases Among Older Adults in Rural Communities
This paper re-evaluates the impacts of China's New Cooperative Medicine Scheme (NCMS), a social health insurance program targeting China's rural population, on the incidences of chronic diseases among its enrollees. Although coverage under the NCMS expanded rapidly following its implementation in 2003, previous studies have failed to reach a consensus on its health impacts. Existing conflicting results may be due to methodological problems such as implausible identification assumptions and the failure to focus on the most relevant beneficiaries.
Drawing on data from a longitudinal sample from the China Health and Nutrition Survey (CHNS), we focus on a subgroup of patients over the age of 55 years to re-estimate the NCMS's impact on incidences of chronic disease among enrollees. We adopt a triple-difference (difference-in-difference-in-differences) method, relaxing the parallel-trend assumption commonly invoked in the previous double-difference (difference-in-differences) studies.
Our triple-difference estimates suggest that the NCMS has significantly reduced the incidences of apoplexy and diabetes among rural residents aged 55 years or older. The impacts of the NCMS on chronic disease are underestimated by the commonly adopted double-difference method. The triple-difference method allows evaluations to focus on the most relevant subgroups for detecting program impacts.
Our findings that the NCMS has significantly positive impacts on elderly enrollees' incidences of chronic diseases also suggest the need for examining its impacts on other vulnerable groups, such as low-income individuals, young children, and individuals with poor health conditions.
Journal Article
Assessment of the design and implementation challenges of the National Health Insurance Scheme in Nigeria: a qualitative study among sub-national level actors, healthcare and insurance providers
Background
Health insurance is an important mechanism to prevent financial hardship in the process of accessing health care. Since the launch of Nigeria’s National Health Insurance Scheme (NHIS) in 2005, only 5% of Nigerians have health insurance and 70% still finance their healthcare through Out-Of-Pocket (OOP) expenditure. Understanding the contextualized perspectives of stakeholders involved in NHIS is critical to advancing and implementing necessary reforms for expanding health insurance coverage at national and sub-national levels in Nigeria. This study explored the perspectives of sub-national level actors/stakeholders on the design and implementation challenges of Nigeria’s NHIS.
Methods
A descriptive case study design was used in this research. Data were collected in Ibadan, Oyo State in 2016 from health insurance regulators, healthcare providers, and policymakers. Key informant interviews (KII) were conducted among purposively selected stakeholders to examine their perspectives on the design and implementation challenges of Nigeria’s National Health Insurance Scheme. Data were analysed using inductive and deductive thematic approaches with the aid of NVIVO software package version 11.
Results
Implementation challenges identified include abject poverty, low level of awareness, low interest (in the scheme), superstitious beliefs, inefficient mode of payment, drug stock-out, weak administrative and supervisory capacity. The scheme is believed to have provided more coverage for the formal sector, its voluntary nature and lack of legal framework at the subnational levels were seen as the overarching policy challenge. Only NHIS staff currently make required financial co-contribution into the scheme, as all other federal employees are been paid for by the (federal) government.
Conclusions
Sub-national governments should create legal frameworks establishing compulsory health insurance schemes at the subnational levels. Effective and efficient platforms to get the informal sector enrolled in the scheme is desirable. CBHI schemes and the currently approved state supported health insurance programmes may provide a more acceptable platform than NHIS especially among the rural informal sector. These other two should be promoted. Awareness and education should also be raised to enlighten citizens. Stakeholders need to address these gaps as well as poverty.
Journal Article