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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.
A sharp exposé of the roots of the cost-exposure consensus in American health care that shows how the next wave of reform can secure real access and efficiency. The toxic battle over how to reshape American health care has overshadowed the underlying bipartisan agreement that health insurance coverage should be incomplete. Both Democrats and Republicans expect patients to bear a substantial portion of health care costs through deductibles, copayments, and coinsurance. In theory this strategy empowers patients to make cost-benefit tradeoffs, encourages thrift and efficiency in a system rife with waste, and defends against the moral hazard that can arise from insurance. But in fact, as Christopher T. Robertson reveals, this cost-exposure consensus keeps people from valuable care, causes widespread anxiety, and drives many patients and their families into bankruptcy and foreclosure. Marshalling a decade of research, Exposed offers an alternative framework that takes us back to the core purpose of insurance: pooling resources to provide individuals access to care that would otherwise be unaffordable. Robertson shows how the cost-exposure consensus has changed the meaning and experience of health care and exchanged one form of moral hazard for another. He also provides avenues of reform. If cost exposure remains a primary strategy, physicians, hospitals, and other providers must be held legally responsible for communicating those costs to patients, and insurance companies should scale cost exposure to individuals’ ability to pay. New and more promising models are on the horizon, if only we would let go our misguided embrace of incomplete insurance.
Hidden Cost, Value Lost, the fifth of a series of six books on the consequences of uninsurance in the United States, illustrates some of the economic and social losses to the country of maintaining so many people without health insurance. The book explores the potential economic and societal benefits that could be realized if everyone had health insurance on a continuous basis, as people over age 65 currently do with Medicare. Hidden Costs, Value Lost concludes that the estimated benefits across society in health years of life gained by providing the uninsured with the kind and amount of health services that the insured use, are likely greater than the additional social costs of doing so. The potential economic value to be gained in better health outcomes from uninterrupted coverage for all Americans is estimated to be between $65 and $130 billion each year.
This paper provides comparative analysis on private sector engagement for COVID-19 response in the Eastern Mediterranean region (EMR) with a specific focus on private sector health service delivery. The intention of this paper is to distil behaviours and derive lessons to strengthen governance of health systems, inclusive of the private sector in health. The study methodology included a literature review of articles published between January 2020 and March 2022 supplemented by key informant interviews with government, academic, development partner and private sector representatives. The comparative analysis highlights a range of practice in response to COVID-19. Practice built upon available institutional arrangements, organisational structures, mechanisms for coordination and information exchange. The degree to which this was effective varied and is reflective of the attributes of EMR contexts to manage change and secure essential public health functions. WHO seeks to support Member States with a practice-based and action-oriented approach to governance of the private sector in health, one that is grounded in context.
The Covid-19 pandemic underscored the essential nature of public health to a high-functioning society across all realms: personal, governmental, and corporate. Corporations, specifically, experienced the significant business impact that a major public health event can have, having to manage workplaces from a health and safety perspective, address workforce disruption, deal with vacillating demand for goods and services, and manage the disruption of supply chains. Entire industries were disrupted disproportionately like the service and travel industries. In addition, corporations saw the disparate impact on their minority workers, bringing health inequities into sharp focus. These and other consequences demonstrated the drastic economic impact that public health occurrences can have on businesses and the communities in which they operate.