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Let’s say you’re the devil, and you want to corrupt the American republic. How would you go about it? According to David Hyman, you might create something like Medicare, the federal health care program for the elderly. Hyman submits that Medicare may be the greatest trick the devil ever played. Medicare feeds on the avarice of doctors and other providers, turns seniors into health care gluttons, and makes regions of the United States green with envy over the dollars showered on other regions. The program exploits the sloth of government officials to increase the tax burden on workers and drag down the quality of care for seniors. Medicare makes Democrats lust for socialized medicine, while its imperviousness to reform makes Republicans angrier and angrier. Most of all, Medicare allows its ideological supporters to bleat and preen their way to the heights of moral vanity. In the style of C.S. Lewis’ The Screwtape Letters, Hyman writes that Medicare has “freed the self-interest of these mortals from its natural restraints. As a result, the seven deadly sins have blossomed.” With epic political battles over Medicare and the future of limited government looming just over the horizon, Hyman uses satire to cast a critical eye on this mediocre government program.
Why health care reform must tackle the escalating cost of medical technology Technological innovation is deeply woven into the fabric of American culture, and is no less a basic feature of American health care. Medical technology saves lives and relieves suffering, and is enormously popular with the public, profitable for doctors, and a source of great wealth for industry. Yet its costs are rising at a dangerously unsustainable rate. The control of technology costs poses a terrible ethical and policy dilemma. How can we deny people what they may need to live and flourish? Yet is it not also harmful to let rising costs strangle our health care system, eventually harming everyone? In Taming the Beloved Beast, esteemed medical ethicist Daniel Callahan confronts this dilemma head-on. He argues that we can't escape it by organizational changes alone. Nothing less than a fundamental transformation of our thinking about health care is needed to achieve lasting and economically sustainable reform. The technology bubble, he contends, is beginning to burst. Callahan weighs the ethical arguments for and against limiting the use of medical technologies, and he argues that reining in health care costs requires us to change entrenched values about progress and technological innovation. Taming the Beloved Beast shows that the cost crisis is as great as that of the uninsured. Only a government-regulated universal health care system can offer the hope of managing technology and making it affordable for all.
This book provides a comprehensive and approachable overview of Medicare under the Affordable Care Act. The author illustrates how the ACA addresses the long-term fiscal and demographic challenges facing Medicare, as well as the potential for Medicare to become a single-payer system.
Everyone agrees on the need to reform Medicare but not on how to do it. Some argue the program is too comprehensive, others that it is not comprehensive enough. Some suggest it pays too much for health care, others, too little. Meanwhile, the financial stakes continue to mount. Medicare spending exceeded $400 billion in 2007, making it more expensive than the entire health systems of most other nations, as well as the largest national public program other than Social Security and national defense. In R eforming Medicare, Henry J. Aaron and Jeanne M. Lambrew deftly guide readers through this complex debate. They identify and analyze the three leading approaches to reform. Updated social insurance would retain the current system while rationalizing coverage and reducing bureaucracy. Premium support would replace the current system with a capped, per-person payment that beneficiaries could use to buy health insurance. Consumer-directed Medicare would have beneficiaries pay for care up to a high deductible from government- supported savings accounts and offer premium-support coverage above the deductible. In addition to rating each option on its ability to promote access to health care, improve the quality of care, and control costs, the authors evaluate each reform's political strengths and weaknesses. Given the heat generated by the Medicare debate, it is unlikely that any single approach will be implemented in full. Consequently, Aaron and Lambrew describe incremental strategies that blend elements of each plan. Their analysis provides essential insight into the types of hybrid policies that Congress will consider in coming years.
After the Constitutional Convention, Benjamin Franklin was asked, “Well, Doctor, what have we got—a Republic or a Monarchy?” Franklin’s response: “A Republic—if you can keep it.” This book argues: we couldn’t keep it. A true republic privileges the common interest above the special interests. To do this, our Constitution established an elaborate system of checks and balances that disperses power among the branches of government, which it places in conflict with one another. The Framers believed that this would keep grasping, covetous factions from acquiring enough power to dominate government. Instead, only the people would rule. Proper institutional design is essential to this system. Each branch must manage responsibly the powers it is granted, as well as rebuke the other branches when they go astray. This is where subsequent generations have run into trouble: we have overloaded our government with more power than it can handle. The Constitution’s checks and balances have broken down because the institutions created in 1787 cannot exercise responsibly the powers of our sprawling, immense twenty-first-century government. The result is the triumph of special interests over the common interest. James Madison called this factionalism. We know it as political corruption. Corruption today is so widespread that our government is not really a republic, but rather a special interest democracy. Everybody may participate, yes, but the contours of public policy depend not so much on the common good, as on the push-and-pull of the various interest groups encamped in Washington, DC.
Today, as never before, healthcare has the ability to enhance the quality and duration of life. At the same time, healthcare has become so costly that it can easily bankrupt governments and impoverish individuals and families. Health services research is a highly multidisciplinary field, including such areas as health administration, health economics, medical sociology, medicine, , political science, public health, and public policy. The Encyclopedia of Health Services Research is the first single reference source to capture the diversity and complexity of the field. With more than 400 entries, these two volumes investigate the relationship between the factors of cost, quality, and access to healthcare and their impact upon medical outcomes such as death, disability, disease, discomfort, and dissatisfaction with care. Key Features Examines the growing healthcare crisis facing the United States Encompasses the structure, process, and outcomes of healthcare Aims to improve the equity, efficiency, effectiveness, and safety of healthcare by influencing and developing public policies Describes healthcare systems and issues from around the globe Key Themes Access to Care Accreditation, Associations, Foundations, and Research Organizations Biographies of Current and Past Leaders Cost of Care, Economics, Finance, and Payment Mechanisms Disease, Disability, Health, and Health Behavior Government and International Healthcare Organizations Health Insurance Health Professionals and Healthcare Organizations Health Services Research Laws, Regulations, and Ethics Measurement; Data Sources and Coding; and Research Methods Outcomes of Care Policy Issues, Healthcare Reform, and International Comparisons Public Health Quality and Safety of Care Special and Vulnerable Groups The Encyclopedia is designed to be an introduction to the various topics of health services research for an audience including undergraduate students, graduate students, andgeneral readers seeking non-technical descriptions of the field and its practices. It is also useful for healthcare practitioners wishing to stay abreast of the changes and updates in the field.
The Law of Health Care Finance and Regulation is based on Part III, “Institutions, Providers, and the State,” of parent book Health Care Law and Ethics and adds additional coverage of a variety of issues that have shaped health care finance law. Integrating public health, financial and ethical issues, this casebook uses compelling case law, clear notes and comprehensive background information to illuminate the complex and dynamic field of health care law. Key Features: Based on material in Part III of the popular parent book, “Institutions, Providers, and the State,” along with coverage of duty to treat, hospital liability, managed care liability, and regulating access to drugs. Includes cases and material not found in the parent book on: • Judicial and administrative review of Medicare decisions. Certificate of need laws. Review immunity. Integrates public health and ethics issues and features clear notes that provide context, smooth transitions between cases, and background information. Website provides background materials, updates of important events, additional relevant topics and links to other resources on the Internet.
Health Care Law and Ethics, Ninth Edition offers a relationship-oriented approach to health law—covering the essentials, as well as topical and controversial subjects. The book provides thoughtful and teachable coverage of every aspect of health care law. Current and classic cases build logically from the fundamentals of the patient/provider relationship to the role of government and institutions in health care. The book is adaptable to both survey courses and courses covering portions of the field. Key Features: New authors Nick Bagley and Glenn Cohen Incorporated anticipated changes to the Affordable Care Act More current cases and more streamlined notes, including ones on medical malpractice, bioethics, and on finance and regulation More coverage of “conscientious objection” and “big data” - Discussion of new “value based” methods of physician payment - Expanded coverage of “fraud and abuse” Current issues in public health (e.g., Ebola, Zika) and controversies in reproductive choice (e.g., Hobby Lobby) Coverage of cutting-edge genetic technologies (e.g., gene editing and mitochondrial replacement)
Downsizing Federal Government Spending is a clear and essential guide for policymakers and voters alike on reducing federal spending and on preventing a massive budget crisis that could crush the generations ahead. It provides a detailed series of comprehensive and concise policy strategies to reduce rampant government spending and the national deficit. Sectioned by topic – including Agriculture, Defense, Education (both K-12 and Higher Education), Healthcare, Foreign Policy, and Fiscal Policy - each chapter has been meticulously researched by Cato scholars. Consistent and informed critiques of federally-funded programs come with solid alternatives – identifying areas for needed spending cuts, state-based funding, privatization, termination, and more. Edited by Chris Edwards, this collection moves forward with the crucial task of evaluating federal spending, and reveals how spending changes and cuts would not only eliminate the deficit, but also strengthen the economy, enlarge personal freedom, and leave a positive fiscal legacy for the next generation.