...Health Care Reform Project Part 1 David Chambliss HCS/440 - Economics January 12, 2016 Professor Kamal Faour Health Care Reform Project Part 1 The Price of Progress: Drugs In The Health Care Market This is a review of the above fore mentioned article. The U.S. health care system in the new century comes with good and bad news both stemming from the same source; medical innovation. The good news: life expectancy and health status in the United States are improving; infant mortality is declining and disability rates among the elderly have been falling. These improvements all point to one source: major pharmaceutical breakthroughs in the 1990s. The bad news: This medical progress is expensive meaning better medicine increases cost in the long run. Debate over our specific choices seems always to devolve back to a list of competing alternatives: restrict patient access; shift costs to the recipients of progress; shift risk to providers; or share through higher premiums the cost increases. . Unnecessary Regulations That Increase Prescription Drug Cost This is a review of the above fore mentioned article. As drug coverage has become more widespread, so too have calls to impose additional regulations on drug plans and the firms managing them. A reason sometimes given for increasing drug plan regulation is the need for transparency to prevent drug plan managers from excessive mark-ups for drugs at the expense of patients and health plans. In the...
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...Economic Impact of Providing Medical Care to an Aging Population In today’s world the aging population is rapidly growing, and with falling fertility rates and the constant increase of the human life span, the United States is preparing for the realization that the fastest growing populace is what the nation considers to be senior citizens. For health care organizations any type of demographic change will automatically bring economic and social challenges. Almost 80 million babies were born in the United States from January 1946 through December 1964. This segment of the population is known as the Baby Boomers. In 2011 the first wave of Baby Boomers began reaching age 65, the age of entitlement. Every day from today for the next 16 years approximately 10,000 Baby Boomers will turn age 65 and become entitled to Medicare (www.politifact.com, 2011). With an increasingly older population come the need for a greater number of prescription drugs, a greater number of medical office visits in order to extend the aged quality of life, and a greater need for long term care. 80 million Americans within the next 16 years will receive some form of government funding for health care adding to the already fraught health care economy. Ageing population puts strain on medical costs: Bernanke warns of ‘fiscal crisis’ With more than 10,000 Baby Boomers reaching the age of retirement and Medicare eligibility every day for the next decade and a half the nation’s and states’ government are facing...
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...This paperwork contains HCS 440 Week 4 Individual - Economic Issues Simulation Paper General Questions - General General Questions Review the Health Care Economics Issues HMO Simulation exercise posted on your student web page. Follow the Wk 4 WEB LINK “Understanding Economic Issues for HMO’s”. This exercise is for your learning experience only. Do not post any screen short from the exercise as part of your assignment. Economic Issues Simulation Paper Prepare a 1,050- to ,1400 paper in which you present a profile of each company including the demographics of the employees, the health care risk factors (potential areas of high utilization), and the premiums the company is willing to pay. Apply each plan, Castor Standard and Castor Enhanced to each company, Constructit and E-editor, to determine which plan best meets the healthcare needs of the employees – ignore Dearden. As a representative of Castor insurance, your job is to maximize profit and minimize risk for the company. Based on your analysis of potential utilization, give at least two reasons why each plan could be selected for each company. Then select one of the two companies and state which plan you would select to sell to that company? What are the reasons for this decision? Why did you not select the other plan offered? Your paper should be organized so that each question serves as a subheading followed by the discussion, i.e. Two Reasons Why Each Plan Could Be Selected, Which...
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... | | |College of Natural Sciences | | |HCS/440 Version 5 | | |Economics: The Financing of Health Care | Copyright © 2010, 2007, 2005, 2004, 2002, 2000 by University of Phoenix. All rights reserved. Course Description This course provides an overview of the economics of health care. The various payers are examined, including private, state, and federal entities. Issues such as the cost effectiveness of prevention, the management of patients and their diseases, as well as the cost of treatment settings are discussed. Third party reimbursement from various sources, ranging from for-profit insurance carriers to charitable donations, are reviewed. The health care system's use of grant funding and research dollars is described. Policies Faculty and students/learners will be held responsible for understanding and adhering to all policies contained within the following two documents: • University policies: You must be logged into the student website to view this document. • Instructor policies: This document is posted in the Course Materials forum. University policies are subject to change...
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...There are several rationales for or against government intervention in or regulation of the health care industry in the United States. This section will focus on the grounds on which government intervention in or regulation of the health care industry in the United States might be justified. The overriding objective in regulation was, and continues to be, rate setting (Folland, Goodman, & Stano, 2010) in the health care industry. Generally, markets are problematic in health care because markets do not provide goods efficiently or equitably. Though markets usually work well, however, there are many circumstances in which market forces, left to them, will fail to maximize economic and social welfare, and, as a consequence, there will be a case for government interventions (Hayes, et al., 2011). Its primary goal is to limit the high price-cost margins that would otherwise be expected (Folland, Goodman, & Stano, 2010), along with promoting the best minimal quality levels while reducing waste and abuse of expenditures. Recent review from Cochrane Database of Systematic Reviews identified four main categories of market failure that might justify government intervention: intervention externalities; imperfect information; demerit goods; time-inconsistent preferences (a situation in which an individual’s preferences change over time without any change in information (Hayes, et al., 2011). An example of demerit good is something that is seen as intrinsically unhealthy, degrading or...
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...Health care reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes enacted in 2010: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010 , which amended the PPACA and became law on March 30, 2010. Future reforms and ideas continue to be proposed, with notable arguments including a single-payer system and a reduction in fee-for-service medical care. The PPACA includes a new agency, the Center for Medicare and Medicaid Innovation, which is intended to research reform ideas through pilot projects. ------------------------------------------------- History of national reform efforts Here is a summary of reform achievements at the national level in the United States. * 1965 President Lyndon Johnson enacted legislation that introduced Medicare, covering both hospital and general medical insurance for senior citizens paid for by a Federal employment tax over the working life of the retiree, and Medicaid permitted the Federal government to partially fund a program for the poor, with the program managed and co-financed by the individual states. * 1985 The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) amended the Employee Retirement Income Security Act of 1974 (ERISA) to give some employees the ability to continue health insurance coverage after...
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...Health Care Reform Project Part II Margaret Rovaris HCS/440 June 29, 2015 Bruce Nave Health Care Reform Project Part II There are definitely ways that the U.S. can stop the rise of healthcare costs. In today’s society we are seeing and experiencing the work being done in that very economic crises within the affordable care act, Medicaid and Medicare, and managed care plans. With just these three healthcare reform plans, financial strain on families have decreased. When it comes to the economic crisis of Managed Care Plans and health care insurance, three possible solutions are more states coming abroad with the idea of managed care plans, Get back to the goals of improving health care while holding down the costs, and lifting the limitations on the people’s choice of doctors and services. Manage care is a plan that was put into place in hopes of lowering healthcare expenditures and getting more people on health Insurance. It may become a possibility to get back to that goal if some states in the U.S. will acknowledge how effective a managed healthcare plan can be for their people and their healthcare revenue. In all, affordable healthcare will boost up the states revenue by improving the financial conditions of the people of that state. They could get out of medical debt and potentially by a house, or something else that can help towards the states and taxes revenue. “Another possibility is that those who obtained coverage may have been in a better position...
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...Running head: COST AND QUALITY ANALYSIS Healthcare cost and quality Grand Canyon University July 24th, 2012 Ethics, Policy, and Finance in the Health Care System Sally L. Clark A challenge that the healthcare nation is facing is to provide the quality of care that is expected and obtain low healthcare cost. Working hand in hand with the private sector and government is in hopes of improving the quality of care that each patient deserves and maintaining the cost so that research can continue. The purpose of this paper is to look into relationships between healthcare cost and quality healthcare. Differences in HealthCare Cost and Quality Working in the healthcare system, you often wonder if the nation works on quality of care or do they work more on cost of healthcare. Quality of care is an important role in achieving the best healthcare. Cost of healthcare is based on incentives that support the effectiveness while curving the spending growth (MacReady, 2012). Reform needs to be provided a baseline in evaluating healthcare delivery systems for a broader success of payments and delivery models with payment providers (2012, p.2). Sometimes higher cost effects quality of care. Some decisions need to be made that may affect the “clinical and fiscal health of the nation” (2012 p.1). Differentiating Roles and Major Activities Public and Private agencies plays an important role on how healthcare is delivered. The Commonwealth Fund...
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...and public organizations has been on Health Care Reform. Most notably it has become at the front center of most political debates and campaigns. Many politicians use healthcare reform as a main political platform due to the high amount of attention that has been placed on the issue in recent years. For example, SEIU(Service Employees International Union) has focused a majority of its’ efforts on healthcare reform. Organizations working to achieve health care for all face a complicated swirl of factors: which policy solutions to support, which allies to work with, and which compromises and timetables to accept(Stern, 2007). SEIU works to help other individuals organize unions to help in the efforts in creating affordable healthcare for all. In 2002, SEIU launched Americans for Health Care (AHC). AHC is the largest grassroots organizing project on health care in the United States. According to Stern(2007), AHC has worked to be the catalyst for grassroots campaigns in twenty states and to date have signed up nearly 500,000 committed "Health Care Voters" across the United States. AHC affiliates have focused a majority of their efforts on passing and creating affordable health care legislation in Colorado, Connecticut, Maine, Maryland, New Hampshire, Rhode Island, Oregon, and Washington, D.C. These efforts have also included the historic Fair Share Health Care bill in Maryland, and Maine's Dirigo health plan, a landmark comprehensive reform package. AHC also helped repeal SBl...
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...Analysis of Contemporary Health Care Issue Katy Sforza Grand Canyon University: HCA - 530 2-5-13 Analysis of Contemporary Health Care Issue National health care expenses in the United States have been on the rise more rapidly than the national financial system for countless years, however several United States citizens are still lacking adequate health care. Sadly, health care spending is only going to rise and many people in the United States may have to make complicated decisions involving health care and additional responsibilities in their everyday lives if we do not start to reform. By reforming, it is hoped that America will see an increase to high-quality, affordable health care for all. Not only are private sector insurances enduring challenges due to health care spending, but Medicaid and Medicare are also. The Health Care Reform Act is hoping to drive down the cost or at least maintain the cost of health care spending. The reform is hoping to offer a delivery system that works better for clinicians and provider organizations by reducing their administrative burdens and helping them collaborate to improve care. The achievement of this reform will hopefully lead to assessable development in outcomes of care, and in the general health of the American people. Profit/Non-profit Although the provision of health services is dominated by not-for-profit organizations, there are many for-profit organizations as well that are affected by health care spending. With the...
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...National Health Reform - Decreased Cost in Medicare and Medicaid: How Does it Impacts Nursing Home Care in New York State by Vina Aileen Bonner HCA 621 Utica College Fixing medical care and health insurance in the United States has been a public policy concern for about a century. Presidents such as Theodore Roosevelt, Harry S. Truman, John F. Kennedy, Richard Nixon, Jimmy Carter and Bill Clinton focused on the National Health Reform, but only President Barack Obama achieved the health care reform. Health care costs are increasing while the access to health care is declining. The occupationally based health insurance system is greatly stressed. Medicare and Medicaid are consuming more of the federal budget. According to the White House’s budget for U.S. Department of Health and Human Services (HHS), President Obama’s proposal would save nearly $360 billion in Medicare and Medicaid over the next 10 years: $56 billion would come through Medicaid reforms. Medicare is a federal health insurance program providing health care benefits to all Americans age 65 and over. Medicare is a significant part of the reason the national debt is soaring out of control. It is an open-ended program for provided for millions of senior citizens and people with disabilities. Medicare is growing faster than Social Security and more expensive in the next 25 years. Nationally, health care experts believe that as much as third of all health care spending – about $800 billion in...
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...Social Science a Medicine 54 (2002) 1255–1266 Health sector reform and public sector health worker motivation: a conceptual framework Lynne Miller Francoa,*, Sara Bennettb, Ruth Kanferc a University Research Co., LLC, Partnerships for Health Reform Project, 4800 Montgomery Lane, Bethesda MD 20814, USA b Abt Associates, Partnerships for Health Reform Project, 4800 Montgomery Lane, Bethesda MD 20814, USA c Georgia Institute of Technology, Atlanta, GA 30332, USA Abstract Motivation in the work context can be defined as an individual’s degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers’ willingness to apply themselves to their tasks. Resource availability and worker competence are essential but not sufficient to ensure desired worker performance. While financial incentives may be important determinants of worker motivation, they alone cannot and have not resolved all worker motivation problems. Worker motivation is a complex process and crosses many disciplinary boundaries, including economics, psychology, organizational development, human resource management, and sociology. This paper discusses the many layers of influences upon health worker motivation: the internal individual-level determinants, determinants that operate at organizational (work context) level, and determinants stemming from interactions...
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...defensive medicine—range from $55.6 billion annually to $200 billion annually (NCSL, 2011). Medical malpractice reform, also known as tort reform, includes strategies to limit medical malpractice costs, deter medical errors, and ensure that patients who are injured by medical negligence are fairly compensated. Tort reform has the potential to reduce health care expenditures by reducing the number of malpractice claims, the average size of malpractice awards and tort liability system administrative costs. It also may lead to fewer instances of defensive medicine where physicians order tests and procedures not primarily to ensure the health of the patient but as a safeguard against possible medical malpractice liability (NCSL, 2011). Medical malpractice reform proponents argue that tort reforms—such as limiting malpractice awards, tightening statutes of limitations for filing claims, increasing expert witness standards, and screening cases before they go to trial—not only reduce overall medical care spending but also increase access to care (NCSL, 2011). Strategies to improve malpractice claims include limiting awards; placing stricter limits on statutes of limitations; establishing minimum qualifications for expert witnesses; periodic payment provisions; modified Collateral Source Rules; Attorney Contingent fee limits; and other medical Liability related reforms such as patient compensations/injury funds, pre-trial alternative dispute resolution and screening panels, frivolous...
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...People’s Republic of China in 1949, the country was recovering from the chaos of long conflicts both internally and with Japan. As a result, Chinese health conditions had declined, with health indicators at the lowest level compared with other countries at a comparable level of development (World Bank, 2004). In this period, communist party who have the whip hand support the model of the 20th century communism ideology, and trust people should to be represented by the government, should have all production together: without the private department. Formation of the Chinese healthcare system. Therefore, since 1949, the Chinese government has gradually established a free medical care, labor insurance and cooperative medical care system as the main content of the health care system, and initially formed a socialist country's health care system. The government owned, funded, and ran all health care facilities, including large hospitals in urban areas and small township clinics in the countryside. All providers were employees of the state. Meanwhile, private health practice and private ownership of health facilities disappeared along with other private business. Development of Chinese healthcare system In 1950, at the First National Health Work Conference, the central government announced four fundamental principles for medical and health work: service for workers, peasants,...
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...Running Head: Health Care Reform Proposal Ethel Sloan Professor Tiriza York Grand Canyon University Date: April 20, 2012 Health Care Financial Reform Proposal The financial future of the health care industry is faltering. Financing Issues are among the most difficult problems in health care. The impact of health care reform initiatives from 2010 forward is yet to be realized. The impact on health care may take several years before health care can be reformed the way it should be. There are several problems on the horizon that is effecting the health care system. There is quality of health care, continuous rising of health care, and the developing of electronic medical records transparency. The impact of health care involves a selected choice of rules to Patient Protection and Affordable Care Act that the Senate-passed health insurance reform bill. Health care reform indicates health care industries must do more with less if they want to keep competive. In addition, this means health care industries need to become incredibly effective (Cleverly, W. O., Song, P. H., & Cleverly, J. O., 2011). On February 17, 2009, According the the Centers for Medicare and Medicaid Act The American Recovery and Reinvestment Act authorizes the Centers to provide reimbursement incentive for physicians, hospitals, and providers who are successful in becoming meaningful users of an electronic health care records(Cleverly...
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