...[pic] Title: Total and State Medicaid Spending Growth FY 2000 - FY 2012 Description: With the expiration of federal stimulus funding in 2011, state spending on Medicaid is projected to rise 28.7% in 2012, while overall Medicaid spending will increase 2.2%. Source: Historic Medicaid Growth Rates, KCMU Analysis of CMS Form 64 Data; FY 2008, 2009 and 2010, KCMU survey of Medicaid officials in 50 states and DC conducted by Health Management Associates, 2011. Topics: Medicaid / CHIP Included in these Slideshows: KFF.org Data Spotlight Slide Date: October 28, 2011 Introduce the issue. Describe the problems in the U.S. healthcare system and how we might use another nation's healthcare system for reform. Evaluate how a new system would improve access to care, quality of care, and the efficient utilization of resources. Define the problem. a. High insurance premiums and out of reach for many American who remain uninsured. b. Drug companies are widely perceived as greedy and insensitive. c. Differences in prescription patterns related to insurance coverage. d. Medicaid patients are more likely to be prescribed generic drugs than patients who have commercial health insurance. e. Unethical behavior by the insurers that shows many institutions have violate fundamental values. f. Negative relationship between the insurers and physicians, personal-satisfaction ratings for health insurance plans, public concern about HMOs in particular and the health care...
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...disparities in the healthcare system. With the new Patient Protection & Affordable Care Act, the insurance companies can no longer drop the coverage if one becomes sick, bill individual into bankruptcy because of an annual or lifetime limit, and they will not be able to discriminate against anyone with a pre existing condition. Most of the Medicare and Medicaid community suffers do to the imbalance in our healthcare system this situation affects the quality of care and places a financial strain on the government, individuals and families, employers and employees, and public and private providers. Most of the Medicare beneficiaries have to enroll in the MA program to help them to succeed and receive the adequate treatments without MA to help the disadvantaged seniors on the island, Puerto Rico's elderly citizens will be forced to turn to Mi Salud in larger numbers. Although Mi Salud is scheduled to receive an average of $690 million annually during the next five years, the widening deficit in MA funding is likely to create a net negative impact on federal funding for healthcare in Puerto Rico. The Health care Policies and Issues Ethical concerns and issues The Affordable Care Act (ACA) policies are intended to give patients more access to health care without any restrictions as in the past that were imposed by the Health Care Industry and at a reasonable cost capping the administrative costs to the industry to no more than 20% of what the insurance costs. These restrictions...
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...to helping health care but no one actually can explain how it was going to become resolved. America was to the final point, where we as people, thought that the biggest controversy would become resolved and a new era of transparency would be developing. In these years that have come many of the changes that has been promised to America, has yet to occur and is still the same as before. The most recent health care reform is The Affordable Care Act which has expanded access to health care which was created and signed to make sure that all Americans in the United States have affordable health care available to them and to monitor the rising of the health care costs. The Affordable Care Act (ACA) is the most comprehensive reform of the United States medical system in at least 45 years. The ACA transforms the non-group insurance market in the United States and mandates that most residents have health insurance, significantly expands public insurance and subsidizes private insurance coverage, raises revenues from a variety of new taxes, and reduces and reorganizes spending under the nation’s largest health insurance plan, Medicare. Projecting the impacts of such fundamental reform to the health care system is fraught with difficulty. But such projections were required for the legislative process, and were delivered by the Congressional Budget Office (CBO). This Act has become implemented and the one major concern is the impact of the costs that employers will have to cover. Many of...
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...well under $1,000, but in the United States a bill for this procedure would likely be closer to the $7,000 to $9,000 range (Rosenthal, 2013). In the midst of the debate, and while Republicans and Democrats alike may claim that they want the best health care available for all American people, in the media more often than not this argument comes down to dollars and cents. However, it is of course too simplistic to say that only the power of money and no other forces are at play here. In this paper I will present the case of the Affordable Care Act (ACA), more commonly referred to as Obamacare, as it relates to a number of different political and economic ideologies presented in readings and in lecture. The goal of the ACA is to increase the quality and affordability of medical care and health insurance options in the United States through a dramatic overhaul of the current system. The Affordable Care Act was signed into law by President Obama on March 23, 2010, however the law and its many parts have been debated by both major U.S. political parties and the debate continued to rage even after the Supreme Court’s 2012 ruling that most provisions in the ACA were constitutional (The...
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...debate the advantages and disadvantages of ObamaCare, aka Affordable Care Act (ACA), for the American people. While many are elated and view the government as taking responsibility for those who in the past have not seen a doctor on a regular basis due to having no insurance, there are still others who believe that the passage of the law will be detrimental to the country’s economy. Many are concerned that individuals will no longer have the choice of what type of medical attention they receive because the government will make those decisions for them. The truth is the Affordable Care Act requires certain types of coverage and ends discrimination that has led to higher costs and cancellations for women and people with pre-existing medical conditions. “The new ACA is a law aimed at reforming the American healthcare system. Its main focus is on providing more Americans with access to affordable health insurance, improving the quality of healthcare, regulating the health insurance industry, and reducing health care spending in the US.” In spite of the many attempts by the GOP to overthrow the ACA, the fact is that it is not Government provided healthcare, but an approach by the government to subsidize and regulate private health insurance and expand Government healthcare programs like Medicare and Medicaid. There are ongoing arguments between Democrats, Republicans, and the American people over the ACA offering contraception with no charge to the patients, particularly for companies...
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...Immediately after the passage of the health care bill, it has faced a great deal of opposition and became one of the most disputed topics around the nation it went under fire questioning the Constitutionality, the quality of care under the bill, and the retention of pre- existing health care converge. Implementing a new system of healthcare means rising government spending which will inevitably cause taxes to soar on the already struggling middle class as well as the upper class. This policy raises issues of “federalism” because some find the fact that mandated health care can be considered unconstitutional. Some view the fact of the government telling the citizens they have to have healthcare goes against the constitution. In this act the government would require us, as US citizens, to buy healthcare from private companies and keep it for the rest of our lives or we would be mandated to pay annual penalties. Some see this as unconstitutional because it is forcing Americans to “buy” insurance so their health needs can be covered. While Mr. Obama’s healthcare plan focuses on the future, it fails to help struggling American citizens presently. The healthcare reform act will increase taxes, lower salaries of doctors and other medical professions, and will cost more in government expenditures on healthcare, not save. Obamacare is aimed at helping the underinsured to gain insurance. With this plan everyone would have health insurance regardless of income, or anything...
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...------------------------------------------------- The Impact on Low Income Individual Medicaid is the U.S.’s primary public health insurance program designed to provide health coverage for low-income children and families who lack access to private health insurance because of their limited finances, health status, or severe physical, mental health, intellectual, or developmental disabilities1. Currently, 1 in every 5 Americans uses Medicaid as their primary form of insurance. This means that as of 2015 over 65 million Americans, by guidelines of the department of health and human service, live on or below the federal poverty line 2. Although those numbers may seem large, former guidelines for Medicaid have left a large portion of the low-income population excluded from coverage and uninsured. Currently, adults under age 65, in nearly 25 states, no matter how low their income, are ineligible for Medicaid unless they are disabled or pregnant. As a solution to this problem the Supreme Court passed The Affordable Care Act (ACA), which would provide an expansion of Medicaid to millions of low-income, uninsured adults who were previously excluded. However the choice to expand remains a state option. While many states have chosen to move forward with the expansion, many have either opted out or lie in debate. One of the major arguments against the expansion of Medicaid lies in the debate of whether “Medicaid is worse than no coverage at all 3.” My paper will examine the affects of public...
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...infrastructure, to name a few. In the United States alone, the percentage of the GDP spent on health care over a three year period, from 2011-2013, averaged 17.066% (17.1%, 17.0%, 17.1%, each respective year) (The World Bank Group, Inc, 2015). In retrospect, despite the passing and subsequent implementation of the Affordable Care Act in 2010, with the final aspects of the bill effective January 1, 2015, the ever-rising cost of health care may never truly subside, as the nation’s baby boomers continue to age and subsequent chronic conditions often associated with aging such as coronary artery disease, diabetes, and certain cancers increase with the aging population. In fact, according to Centers for Medicare and Medicaid Services (2015), Medicare accounted for 20% of total US health care expenditure in 2014, growing 5.5% and expected to “accelerate after 2015” in direct correlation to the expected increases in use of medical goods and services utilized by the aging, as well as the continued enrollment of baby-boomers into the Medicare program. With such a looming high-cost of national resources, the concept of health care rationing must come into play, as the demand will certainly outweigh the supply. In fact, some argue that age-based rationing or “ageism” is the moral and ethically best choice in rationing...
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...violating the Federal Coasting Act of 1793. 2. The Court ruled in favour of Gibbons, arguing that commerce is the trade of commodities, which includes navigation, and, under the power of Congress. The Court also ruled that goods made, moved and sold intrastate were out of federal commerce power. 3. Dissent – there was no dissent. Swift and Co. v United States 1. The six biggest meatpacking companies in the US conspired to fix prices. When they were hit with federal injunctions, they agreed to merge into one company to continue the trade internally. 2. The Commerce Clause allows the government to regulate monopolies if it has a direct effect on commerce. The meaning of interstate commerce was broadened by including actions that were part of the chain where the chain was interstate in character. 3. Dissent – there was no dissent. United States v E.C. Knight Co. 1. The Sherman Antitrust Act outlawed attempts to monopolise trade in the United States. The American Sugar Refining Company had acquired E.C. Knight and other sugar companies and had monopolised the sugar industry in the US. 2. Manufacturing, in this case refining, is a local activity not subject to congressional regulation of interstate commerce. 3. Dissent – To be done A.L.A. Schecter Poultry Corp v United States 1. The National Industrial Recovery Act (NIRA) which regulated issues on prices, labour and sales. The NIRA allowed local codes for trade to be written by private trade and industrial groups and the President...
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...Another argument that people against Universal Healthcare often like to talk about is that if more people started going to the hospital more frequently because of healthcare, then the wait time would increase with the people. This has been shown to happen in both Canada and the UK, countries known to have universal health care (ProCon.org). Wait time is nothing new in America, whether that be for a line to an amusement park ride or for a transplant. If this was really a reason not to have health care, then the US would currently be working on reforming other medical branches that have those wait times, such as waitlists for organ transplants, but even that has shown that Americans are willing to wait if it will help them. Another qualm that people often worry about when talking about Universal Healthcare is where the money for funding such a thing would come from, and many others worry if it will come out of their tax dollars. Gabriel Zieff introduces one such idea, "One proposal for universal healthcare...
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...1. Point-Counterpoint State Medicaid Policy and Health Reform Harold A. Pollack University of Chicago Authors: Pollack, Harold A.1 Source: Journal of Health Politics, Policy & Law; Feb2013, Vol. 38 Issue 1, p161-163, 3p The article discusses the positive and negative implications of the new ruling that the federal government could not require states that receive federal funds under the Medicaid program to participate in the Patient Protection and Affordable Care Act's (PPACA's) Medicaid expansion. Several shortcomings like limited provider payment and associated patient access barriers have been observed in Medicaid that make its adoption not a good idea. However, families below the poverty line can benefit. In July 2012, the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). The Court thus ended one phase in the political and legal battle over health reform. Yet in doing so, it opened a new front. In a notable departure from post–New Deal commerce clause jurisprudence, the Court ruled that the federal government could not require states that receive federal funds under the Medicaid program to participate in the PPACA’s Medicaid expansion. In effect, the Court made states’ participation in the PPACA’s Medicaid expansion voluntary — a possibility that neither the act’s supporters nor its opponents seriously entertained during the long legislative battle of 2009 and 2010. The full implications of these...
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...Research Paper: Healthcare Services and The Affordable Care Act (ACA). Table of Contents: Abstract……………………………………………………………………………………...3 Introduction………………………………………………………………………………….3 Background of the Affordable Care Act …………………………………………………4 The Affordable Care Act………………………………………………………………….. 5 Methodology………………………………………………………………………………...8 Collection of Data…………………………………………………………………………..9 Primary………………………………………………………………………………10 Secondary…………………………………………………………………………..11 The Environmental Working Group………………………………………………………12 Primary Survey…………………………………………………………………….13 Questions and Answers…………………………………………………………...14 Findings from the collection of information and data…………………………………..15 Conclusion and recommendations……………………………………………………….17 Appendix A: SWOT Analysis……………………………………………………………..19 Appendix B: EWG’s Business Strategy …………………………………………………26 Appendix C: EWG’s Business Analyses………………………………………………...32 Appendix D: References…………………………………………………………………..37 Abstract Healthcare has been a topic of debate since a long period of time. The recent changes in the government legislation have specified some employer-based requirements for the healthcare provision to employees. Many organizations have also been impacted by the legislative amendments. The following section will cover the introductory knowledge of the Affordable Care Act along with its objectives. Furthermore, we will discuss the impact of this act has on the American society...
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...Industry Report for United Health Group Executive Summary Our mission is to perform extensive research and recommend the best alternatives. Our vision is to strive for excellence as being a respectful firm. Our values are integrity, responsibility, collaboration, respect and excellence. Health insurance companies should consider updating their business models to conduct business in accordance with the Affordable Care Act. Healthcare reform allows for consumers to have more control over their medical care and coverage. United Health Group has the majority of Medicare and Medicaid enrollees. The Affordable Care Act allows for no discrimination against consumers with pre-existing conditions. United Health Group has multicultural websites that allow for consumers to understand what effects their specific culture. Healthcare and knowledge of the field can be given. Consumers are not given the proper tools that they need to understand their healthcare. Insurance brokerage firms are disappearing despite the helpful role that they play. Illnesses need to be curved from management to prevention. Healthcare companies need to remove themselves from negative behavior. A vast amount of money is used in the fast food business from health insurance companies. Innovation is key for United Health Group to continue with development. Government is not evolving with the times. United Health Group is in relatively good shape that needs some minor adjustments...
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...Introduction: The U.S. spends more per capita, and the highest percentage of GDP, on healthcare than any other Organisation for Economic Co-operation and Development (OECD) country as reported in the March 2009, “Trends in Healthcare Costs and Spending” by Kaiser Family Foundation. Given the unusual relationships in healthcare between consumers, payers, and providers, the ethical implications involved in healthcare decisions, it is nearly impossible to define the “right” amount to be spend in healthcare. As our nation is debating what the appropriate amount to be spend on healthcare is, this project aims on understanding the drivers for this high cost and possible ways to control them. One of the important drivers for this high healthcare cost that we identified and will discuss in this paper is unnecessary care. Although there are number of factors contributing to unnecessary care, this paper focuses on four key issues mainly sterilization, hospital acquired infections, medical errors and hospital readmissions. Sterilization: Background of the issue Hospitals are hygienic paradoxes. It is where patients are cured from diseases and acquire a new one. Hospital hygiene is difficult to achieve. According to the World Health Organization estimates, “more than 1.4 million people worldwide are affected by infections acquired in hospitals” (Cleanhospitals.net). Why are there so many unclean hospitals and what body of people holds them accountable for medical negligence...
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...U.S. Health Care Quality Analysis: Legislative History Following up to the 1999 release of the Institute of Medicine (IOM) report, To Err Is Human, in 2002 a Kaiser Family Foundation survey found that only about 5% of physicians considered medical errors as a primary healthcare concern.[1] Congress, however, did not share the physicians’ nonchalant attitude and gave the Agency for Healthcare Research and Quality (AHRQ) an estimated $50 million towards minimizing medical errors.[2] Senator James Jeffords (R-VT) of the 107th Congress introduced the Patient Safety and Quality Improvement Act (S.2590) to the Senate on June 4, 2002[3] attempting to improve the safety of patients and “…reduce the incidence of events that adversely effect patient safety.”[4] In 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act (P.L 108-173).[5] A section of this law authorized AHRQ to research effectiveness in treatments in order to set a guideline to improve the quality of care.[6] John Eisenberg helped build this program that generates summaries that can help provide health care providers with evidence-based practices that help improve quality of care delivered.[7] Realizing the importance of this research to quality of care, the president signed the Under the American Recovery and Reinvestment Act of 2009 (H.R. 1) into law on February 17, 2009, providing additional funding to continue effective research.[8] This helps to demonstrate the...
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