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From a MacArthur Genius ​MIT economist and pre-eminent Stanford economist comes a lively and provocative proposal for American health insurance reform Few of us need convincing that the American health insurance system needs reform. But many of the existing proposals focus on expanding one relatively successful piece of the system or building in piecemeal additions. These proposals miss the point. As the Stanford health economist Liran Einav and the MIT economist and MacArthur Genius Amy Finkelstein argue, our health care system was never deliberately designed, but rather pieced together to deal with issues as they became politically relevant. The result is a sprawling yet arbitrary and inadequate mess. It has left 30 million Americans without formal insurance. Many of the rest live in constant danger of losing their coverage if they lose their job, give birth, get older, get healthier, get richer, or move. It's time to tear it all down and rebuild, sensibly and deliberately. Marshaling original research, striking insights from American history, and comparative analysis of what works and what doesn’t from systems around the world, Einav and Finkelstein argue for automatic, basic, and free universal coverage for everyone, along with the option to buy additional, supplemental coverage. Their wholly original argument and comprehensive blueprint for an American universal health insurance system will surprise and provoke. We’ve Got You Covered is an erudite yet lively and accessible prescription we cannot afford to ignore.
Religion and politics appear together in newspaper headlines more today than ever before. Questions about the relationship between religion and politics--on theoretical, historical, and behavioral levels--are likewise heavily debated behind the front pages, by scholars in political science who demonstrate the 'new Christian thinking.' The Re-Enchantment of Political Science engages these scholars in an interdisciplinary conversation concerning the identity and ends of Christian political science. It considers whether and to what extent the community of Christian scholarship, within its own narrative religious traditions, can add a distinctive and significant dimension to the discipline of political science. Contributors also explore how the new Christian thinking informs political theory and its subfields, including liberalism, communitarianism, and critical theory. Finally, the book describes how policy studies are possible within a Christian framework using standard scholarly tools of analysis. The Re-Enchantment of Political Science, in revealing the growing theoretical and methodological sophistication of faith-informed political science, charts the terrain of political science today.
America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.
The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.
Based on the current climate of our nation’s finances and healthcare spending, it is clear that young doctors and medical students are likely to see a dramatic transformation of the manner in which America offers medical care to its citizens over the course of their careers. As such, it is pivotal that the next generation of America’s leaders on the front lines of medicine develop a sense of where healthcare has evolved from and future potential directions of change. An Introduction to Health Policy: A Primer for Physicians and Medical Students is the first of its kind: a book written by doctors for doctors in order to allow busy physicians and medical students to quickly develop an understanding of the key issues facing American healthcare. This book seeks to efficiently and effectively educate physicians and medical students in a clinical context that they can understand on the past, present, and potential future issues in healthcare policy and the evolution of American healthcare. The reader will walk away from the book with the ability to discuss the fundamental issues in American healthcare with ease.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
A Brookings Institution Press and the National Academy of Public Administration publication America's complex system of multi-layered government faces new challenges as a result of rapidly changing economic, technological, and demographic trends. An aging population, economic globalization, and homeland security concerns are among the powerful factors testing the system's capacity and flexibility. Major policy challenges and responses are now overwhelmingly intergovernmental in nature, and as a result, the fortunes of all levels of government are more intertwined and interdependent than ever before. This volume, cosponsored by the National Academy of Public Administration (NAPA), defines an agenda for improving the performance of America's intergovernmental system. The early chapters present the current state of practice in intergovernmental relations, including discussion of trends toward centralization, devolution, and other power-sharing arrangements. The fiscal underpinnings of the system are analyzed, along with the long-term implications of current trends in financing at all levels. The authors identify the principal tools used to define intergovernmental management–grants, mandates, preemptions—in discussing emerging models and best practices in the design and management of those tools. In tergovernmental Management for the 21st Century applies these crosscutting themes to critical policy areas where intergovernmental management and cooperation are essential, such as homeland security, education, welfare, health care, and the environment. It concludes with an authoritative assessment of the system's capacity to govern, oversee, and improve. Contributors include Jocelyn Johnston (American University), Shelley Metzenbaum (University of Maryland), Richard Nathan (SUNY at Albany), Barry Rabe (University of Michigan), Beryl Radin (American University), Alice Rivlin (Brookings Institution), Ray Sheppach (National Governors Association), Frank Shafroth (George Mason University), Troy Smith (BYU–Hawaii), Carl Stenberg (University of Nor
The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.