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Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
This book offers a novel study on the impact of the Covid-19 pandemic on insurance from an international and comparative perspective. It assesses how insurance has to adapt to a new landscape, the effects of which will last over time and cut across all areas of the field. To avoid physical contact, digitalisation has accelerated dramatically, affecting insurance in all its phases: risk selection, underwriting, pricing and claims settlement. However, the effects of the Covid-19 pandemic go far beyond that. The extent to which a claim caused directly or indirectly by the virus is or is not covered by a given policy has been the subject of debate in many insurance branches. The most litigated cases worldwide are those that concern damages resulting from business interruption due to restrictions enforced by the authorities in virtually every country. This book analyses the rulings (for and against the insured) that have already been handed down by courts in various jurisdictions (for example in the US, Latin America, Spain and Germany), in order to provide guidance to the parties in future lawsuits and also to guide the courts’ own responses. This analysis extends to the measures that governments have taken in relation to insurance during the pandemic, as well as the changes that insurers have introduced in their general conditions to exclude coverage for the pandemic. This response is unsatisfactory, as the big question is how pandemic-related risks can be covered if private insurers simply refuse to do so. Solutions based on risk sharing with public entities or the use of contractual modalities such as parametric insurance are among those outlined by the authors. The book was written by experts from academia and lawyers specialising in this field, and written for all those interested in the field of insurance: lawyers, judges, academics and legal professionals.
When policy makers and researchers consider potential solutions to the crisis of uninsurance in the United States, the question of whether health insurance matters to health is often an issue. This question is far more than an academic concern. It is crucial that U.S. health care policy be informed with current and valid evidence on the consequences of uninsurance for health care and health outcomes, especially for the 45.7 million individuals without health insurance. From 2001 to 2004, the Institute of Medicine (IOM) issued six reports, which concluded that being uninsured was hazardous to people's health and recommended that the nation move quickly to implement a strategy to achieve health insurance coverage for all. The goal of this book is to inform the health reform policy debateâ€"in 2009â€"with an up-to-date assessment of the research evidence. This report addresses three key questions: What are the dynamics driving downward trends in health insurance coverage? Is being uninsured harmful to the health of children and adults? Are insured people affected by high rates of uninsurance in their communities?
Offering an innovative and experience-based perspective, Richard G. Liskov’s erudite treatise provides a comprehensive overview of the basic principles and procedures for how state insurance regulators in the US supervise a crucial sector of the economy. The book not only explores the theoretical dimensions of insurance regulation, but also presents practical insights and guidance for dealing with the main US insurance regulatory issues.
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Health insurance companies claim to act in their customers' best interests, but quite often fail to deliver on that promise. In this step-by-step guide, health insurance attorney Scott Glovsky examines the lawyer's role in helping a client navigate a health insurance denial, from understanding consumer rights, the appeals process, independent medical review, through the intricacies of an insurance bad faith lawsuit, and how the Affordable Care Act has impacted health care law. Drawing from decades of experience from large firms and from his own private practice, Scott uses his unique client-centered approach to shed light on this important and often misunderstood practice area.
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This Primer is about the 'how' of primary health care (PHC) and brings together best practices and knowledge that countries have generated through 'natural experiments' in strengthening PHC with the best available research evidence. Despite the progress made towards PHC globally, the concept is still often misunderstood, even within the public health community. The Primer offers a contemporary understanding of PHC and more conceptual clarity for strengthening PHC-oriented health systems. It does so by consolidating both scientific evidence and an extensive sample of practical experiences across countries for the needed evidence to address practical implementation issues. The Primer is organized in three parts. Part I explains the PHC approach, its history, core concepts and rationale, and draws out lessons for transformation. Part II addresses operational and strategic levers that make PHC work. It covers governance, financing and human resources for health, medicines, health technology, infrastructure and digital health, and their role in implementing change. Part III concludes with a cross-cutting view of the impacts of PHC on the health system, efficiency, quality of care, equity, access, financial protection and health systems resilience, including in the face of climate change.