...ROMNEYCARE An In-‐Depth Analysis of the Massachusetts Healthcare Reform The American Healthcare System Final Research Report By Sara Mahmood, DDS and Camille Debi 1.0 Introduction In 2006, the state of Massachusetts initiated a health care overhaul by passing a reform law with the central tenet of providing healthcare to all of its residents. Widely popular and objectively successful, the law has been dubbed “Romneycare,” named after then Governor Mitt Romney who signed the legislation into action. The law mandates that nearly every resident of Massachusetts obtain a minimum level of insurance coverage and provides free health insurance for residents earning less than 150% of the federal poverty level. It also mandates employers with more than 10 full-time employees to provide health insurance. Among its many outcomes, the law established an independent public authority with the official title of “the Commonwealth Health Insurance Connector Authority”. However, it is commonly referred to as “the Connector”. The Connector acts as an insurance broker, essentially, offering free, highly subsidized and full-price private insurance plans to residents. The website serves as a portal for Massachusetts residents that allows them to access many of the Connector’s resources, as well as the ability to register online for an insurance policy. Although it has been amended significantly since...
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...and Affordable Care Act (PPACA) is one of the most substantial reforms in Medicare since 1965. This is now considered the law of the land according to Douglas Holtz-Eaton. The PPACA portrays a “coverage first” strategy. “Sadly, a review a of the state’s experience bodes poorly for the future of national reform.” (Point/Counterpoint 177) There are two major driving factors in which could propose a threat for this reform. The first factor is it costs too much. Many decades ago, healthcare spending was at a minimum and not the focal point of American citizens. The statics show during 1970, national health expenditures were $1,300 per person and consumed 7 cents out of every national dollar, 7% of the GDP. Since the 1970, the spending per person has grown 2% more each year than income per captia. Therefore, healthcare costs have been increasing at such a high rate and will continue to threaten many decades to come. The second factor is the skyrocket of health insurance. This obviously is not mindboggling due to the fact that it is a reaction to the rapid increase of healthcare. Insurance costs have tripled over the past decade, making it hard for the average citizen to afford such outrageous premiums. As a result, less and less people are opting out of health insurance, which is no longer an option due to the new federal law making health insurance mandatory. The PPACA reform is looked upon with a “cost first” approach. This approach allows quality care to be inexpensive...
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...The first is abortion in its own and the second being the leadership of the governor. Through these two topics, it shows how the governor had signed the bills for abortion in Wisconsin in secrecy. The bill consists of multiple parts of procedures the doctor needs to perform before following through with the abortion. One bill is that doctors need to ask the patient alone if they want the abortion or if they have to oblige. The second bill is that no medical expense paid from insurance agencies unless the pregnancy is through rape, incest, or of people who need it medically. According to "Controversial Abortion Bill Among Several Walker Quietly Signed Into Law" (2012), "Another bill comes into play with Health Care Reform in 2014, banning abortion coverage sold through a health insurance exchange, except in cases of rape, incest or medical necessity” (para. 11). I do support the cause of why the governor is doing this; however, he is doing it for the wrong reasons. He signed these bills before he is leaving office and has done them secretly. According to "Leadership = Controversy With Civility" (2011), "Involve everyone in planning and problem solving. Avoid making decisions behind closed doors” (para. 10). This states that to avoid controversy that all decisions should avoid secrecy and allot everyone in the decision. This shows bad leadership by the governor. It also shows how the governor had made the decisions hastily because of the rush out of office and the want to passing...
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...you read regarding healthcare reform. Evaluate each source's CURRENCY, AUTHORITY, PURPOSE, OBJECTIVITY and WRITING STYLE on a 10-point scale (10 is the best score). You should write notes to yourself about why you scored each source as you did. If you don’t write notes, you will have a much harder time explaining your rationale for your scores. Bring this ranking sheet with you when you come to class. When you are done scoring, rank the five sources from 1-5 (#1 should be the best source; 5 should be the worst). You can discuss your rankings with your group and explain why you ranked the sources the way you did. Example: Z. Why I Hate Health Care Reform C:_9__ A:_6___ P: _5__ O: _1__ W: _9__ Total Score: _30_/50 Rating the Articles A. One Month Later: Making Healthcare Reform a Reality C:_7___ A:_5___ P: __5__ O: __5__ W: __4__ Total Score: __26__/50 Notes: B. The Five Biggest Lies in the Healthcare Debate C:__3__ A:___5 P: _6___ O: ___2_ W: ___6_ Total Score: ___22_/50 Notes: C. The Moral Case Against Healthcare Reform C:__2__ A:__6__ P: _2___ O: __6__ W: _3___ Total Score: _19___/50 Notes: D. What Happened to Healthcare Reform? C:__5__ A:__1__ P: ___7_ O: __2__ W: __9__ Total Score: __24__/50 Notes: E. Andrew Rubin on Healthcare Reform C:__4__ A:_5___...
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...For US citizens covered by private health insurance, receiving treatment is not necessarily easy with many insurance contracts containing terms and conditions excluding treatments which would be covered under the NHS. This has led to scandals where individuals have died as a result of not reading the fine print on their insurance contracts a massive 21% of claims in California are rejected by private insurers. (Reuters 2011) The profit-driven running of companies that are essentially meant to provide coverage guaranteeing the maintenance of health has seen managers receiving salaries exceeding 13 million dollars compared with the NHS’s top salary of less than half a million US. Not covering an individual for expensive treatment thus saves the company money and provides stockholders with dividends or capital gain a very dangerous approach to the provision of healthcare coverage. An estimated 62% of individuals’ bankruptcies are related to healthcare bills, and of these,80% had health insurance numbers which would cause widespread revolt among Europeans. The private nature of US healthcare has resulted in pharmaceutical companies directly advertising to consumers the infamously endemic “ask your doctor if MagicMarioMix is suitable for you” tagline. Consumers thus ask their doctors about the advertised drug, and every 1 US dollar spent on advertising by pharmaceutical companies’ results in $4.20 of sales. The quick-fix or one-pill solution approach, rife among Americans, is reflected...
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...The article that I am reviewing is called “Healthcare Reform: The Importance of a Public Option” by Stephen Gorin. The article discusses the issues that we are now currently dealing with well the House and the Senate debate and try to create the healthcare reform that would make sure that everyone has healthcare coverage. The big issue within this article is creating a level playing field for all the parties: the non covered public, the already covered public, the healthcare companies and the government. As if you didn’t already know this is not the easiest task as everyone wants to have a say on how it is going to be accomplished. One of the big things discussed in this article is the public plan option that is currently being debated in the legislation. Many people don’t feel that it would create a “level playing field”. One person described the public option as "a Trojan horse for government control and the progressive destruction of Americans' private health insurance coverage.” They are stating that there would be no way that with a public option would insurance companies is able to compete with a government public option. They cover what would have to happen to make this plan also work. They stated that to make the public option work that they would have to reduce rates to providers who could in turn refuse to see these patients with this coverage. They then go to discuss that they would have to create a payment system to providers that is equal and they close the gap...
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...doubt that the American health care system has a history of being in disarray. Despite the introduction of the managed care, which was intended to help bring costs down, the cost of health care continues to rise. In addition to the spiraling costs of the health care system, millions of Americans still could not afford any form of health care insurance. The question is what can be done about it? The answer is neither easy nor clear cut. In 2010, the Patient Protection and Affordable Care Act (PPACA) of 2010—commonly called the Affordable Care Act (ACA) or Obamacare, after its major backer, US president Barack Obama—sought to reform a number of aspects of the US health insurance industry, as well as improve the access to and quality of health care services. Keywords Americans with Disabilities Act; Best Practice Protocols; Fee for Service System; Grassroots Activism; Gross Domestic Product; Industrial Democracy; Managed Care; Medicaid; Medicare; Single-payer System; The Pepper Commission; The Rehabilitation Act - Bill 504 Health Care Reform in the U.S. Overview Health care is very much on the minds of Americans. Former presidential candidate Hillary Rodham Clinton made health care her platform and insisted that universal health care is achievable. Although affordable health care for everyone sounds like a positive step forward, the American public was not sure enough of that statement to support her election as president. The American health care system is bound to the insurance...
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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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...for and against tort reform in U.S. health care? In America today, medical professionals are facing more dramatic liability claims than at any point in history from patients and tort lawyers. From increased demands by malpractice insurance carriers to higher standards and quality of care criteria, medical professionals are under extreme scrutiny which makes the art of practicing medicine very difficult. As pressure continues to mount in America both by politicians and social groups how are demanding a restructuring and overhaul of the current system, medical professionals will have to be very diligent about meeting the new standards expected in healthcare of they will face lawsuits and tort actions that could destroy their careers (Qazi, 2012). The healthcare debate in the United States has been dominating the industry since President Obama passed key legislation that will forever change the American medical system. Arguments against healthcare reform stem largely from the provisions and laws that are being proposed by Obamacare. The restructured proposals have drawn many opponents, especially in the healthcare and insurance industry. Primarily, the argumentative claim is that the costs to practice medicine and insure all patients will not be sustainable. Additionally, the increase in the amount of patients that will flood the system will demand an increase in medical insurance premium costs, drive down competition, and lower the overall quality of care that Americans are used...
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...Health Care Reform Managed Care has been around since the 19th century. Managed care is to help assistant patients funds and try to lower his or her health expensive. Henry Kaiser provides prepaid health insurance to plenty of Americans. In 1970 the health system was reform and the health maintenances organization, preferred provider organization (PPO), and Point of Service (POS) introduced to managed care. Health maintenance organization (HMO) is used to pay for care within the network. Preferred provider organization usually pays more if he or she gets care within the network. POS plans to let patients choose between HMO and PPO. Managed care has its good and bad features, but the services are to reduce cost if possible. Managed care has faced problems with physician initiate care, and the solution is utilization review, which includes pre-admission, certificates, second opinions, and salaried payment. The solutions are based on the doctor. Managed care have strong opinions is reflected on the media. Managed care has improved patient by lower there cost of care. Managed care appears across the country in the 19th century. Managed care is to meet the needs of people health care. Managed care is for health care such as health maintenance and insurance company. Managed care acts as the intermediate between the patient and the doctor. Managed care is supposed to help reduce the cost of health benefits and better services. Managed care tries to assistant the patients...
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...Control of Health Care in Puerto Rico Josie Valentín Walden University Overview of the health care system The Puerto Rico Department of Health (PRDH), the State Health Agency (SHA), is a free-standing, independent agency. Under its jurisdiction are all the health-related affairs of Puerto Rico. The PRDH performs the following functions: Planning, evaluating, and regulating as well as auditing the programmatic, administrative, and fiscal aspects of health facilities and services. The PRDH performs these duties in the public and private health sectors of the commonwealth. The system is driven by health needs or problems to produce health results or outcomes. The government’s role in health, once limited primarily to protecting the public from epidemics of infectious diseases. This information are Retrieved from http://www.cdc.gov /phppo/inpho/profile/pr Who controls health care in Puerto Rico today? Why? Several affiliated organizations function under the SHA. Included in this group are the General Health Council, Administration of Health Facilities and Services, Administration of Medical Services of Puerto Rico, and Central Areawide Comprehensive Health Services Corporation (CACHSC). The CACHSC is a private non-profit organization which serves as fiscal agent to the SHA for Federal grants earmarked to provide high-quality primary and migrant health care to medically underserved and low income residents of the mountainous municipalities. The General Council of...
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...Evolving Practice of Nursing and Patient Care Delivery Models The Speech Hello, my fello nurses. Thank you for being here at the Summit of Nursing Evolution. My name is Chhay Yann-Ly and I am a nurse. We are living in an era where the United States (US) health care system is going through tremendous changes and challenges, with sky-rocketing health care costs, fragmented and poor quality of care, high volume of aging population, and passage of the Patient Protection and Affordable Care Act (PPACA) in 2010. A summary of the PPACA is basically to improve the health care delivery system, expand coverage, and control cost (Democratics Senate Gov/Reform, n. d.). With these changes, comes the evolutionary nursing professional transformation process. This speech is a crash course on the evolving practice of nursing and patient care delivery models. The goal of this speech is to discuss the continuity or continuum of care in relation to accountable care organizations, medical homes, and nurse-managed clinics health care models. Since nursing is the backbone of health care, all of these care delivery models require a robust nursing contribution for success (American Nurses Association (ANA), 2010). The first model is the accountable care organizations (ACO). ACOs is a “shared savings” with Medicare (part A & B). The ACO, according to the ANA (2010), is “a collaboration among primary care clinicians, a hospital, specialists and other health professionals who accept joint responsibility...
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...Managed Care Staci Berry MHA614 Policy Formation & Leadership In Health Organizations Instructor: Judy Roberts April 2, 2013 Managed Care In this paper we will discuss managed care. We will find and discuss the definition of managed care. This paper will also explain the different types of managed care plans that are available to Americans. This paper will provide examples of the different types of managed care plans available. It will also explain how each plan works. We will also talk about why rising exposure to health care costs are threatening the well-being of American families. According to Harrington and Estes, managed care is a term that has been overused and really does not have a specific meaning. “Originally, it referred to health care delivered with a capitated financing mechanism. Then it included health care delivered through contracting networks. Currently it refers to most any health are delivery that is different from fee-for-service health care delivery” (Harrington & Estes, 2008 pg.42). When dealing with managed care usually there is a panel of providers that the individual can use. If they go outside of this panel they will be more likely to have to pay a higher copayment or deductible. Some characteristics of a managed care health plan delivery system include: “explicit standards for the selected health car providers, it also puts emphasis on preventive care, as well as provides financial incentives to ensure the use of the...
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...the society today is health care reform and government plays a large role in regulating managed health care systems. A vast difference between movement along and shift in the demand curve for the different health care systems. For instance, the government funds Medicaid and Medicare to provide services to the indigent and disabled population. However, many factors exist that influence the control of health care spending from an economic standpoint. The objective of this paper is to discuss the role of government and the supply and demand curves concept to show the difference between movement along and shift of the curves in the managed care system. The concept of medical price elasticity to evaluate the manage health care industry is also discussed. Resource Allocation Law makers presented several proposals for health care reform and the final bill passed with the intention of providing health care to all Americans. One important issue concerning many consumers about health care reform is the selection of an appropriate managed health care program because one must choose a managed care provider by December 31, 2010. The application of principles to understand the health care systems is challenging because of the complexity of health care as a product or service; however, the fundamental problem addressed by economics is allocation of limited resources among unlimited demand (Scott, Solomon, & McGowan, 2001). Such is the case in the health care industry. According...
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...Timeline: History of Health Reform in the U.S. VIEW: Early 1900's 1930 – 1934 1935 – 1939 1940 - 1945 1945 - 1949 1950 - 1954 1955 - 1959 1960 – 1964 1965 – 1969 1970 - 1974 1975 – 1979 1980 - 1984 1985 - 1989 1990 – 1994 1995 - 1999 2000 – 2004 2005 – 2009 2010 1912 Teddy Roosevelt and his Progressive party endorse social insurance as part of their platform, including health insurance. 1912 National Convention of Insurance Commissioners develops first model of state law for regulating health insurance. 1915 The American Association for Labor Legislation 1912 Teddy Roosevelt and his Progressive party endorse social insurance as part of their platform, including health insurance. 1912 National Convention of Insurance Commissioners develops first model of state law for regulating health insurance. 1915 The American Association for Labor Legislation Early 1900's 1921 Women reformers persuade Congress to pass the Sheppard-Towner Act, which provided matching funds to states for prenatal and child health centers. Act expires in 1929 and is not reauthorized. (AALL) publishes a draft bill for compulsory health insurance and promotes campaigns in several states. A few states show interest, but fail to enact as U.S. enters into World War I. The idea draws initial support from the AMA, but by 1920 AMA reverses their position. 1927 Committee on the Costs of Medical Care forms to study the economic organization of medical care. Group is comprised of economists...
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