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Statistics published by the U. S. Department of Commerce (1980) indicate that in 1977 we spent 8. 1% of our gross national product (GNP) on life, health, property-casualty, and other forms of insurance. An additional 5. 7% was used to pay the Social Security tax, which is another form of insurance premium, for a total of 14. 8% of the GNP. \ Although insurance had its historical origin in marine insurance, it has now developed into one of the major industries of the American economy and extends into many areas of economic activity. One area where growth has been particularly strong is the medical sector. Health insurance is a major institution in all industrialized countries. It became a government responsibility in 1883 when Bismarck intro duced a compulsory program of health insurance for industrial workers in Germany. Programs for workers in various industrial and income categories soon followed in other European countries-Austria (1888), Hungary (1891), Norway (1909), Servia (1910), Great Britain (1911), and Russia and Romania (1912) (Rubinow, 1913:250). Programs in these countries were extended in subsequent years, and other countries in Europe followed with their own programs. Consequently, today most industrial countries have universal or near-universal health insurance coverage. In the United States the issue of national health insurance has been seriously debated since just prior to World War I, and polling data since the 1930s show that a substantial majority of the public has been supportive of such a program (Erskine, 1975).
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
The Theory of Social Health Insurance develops the theory of social health insurance also known as public health insurance. While a good deal is known about the demand and supply of private insurance, the theoretical basis of social health insurance is much more fragile. The Theory of Social Health Insurance examines questions including why does social health insurance exist and even dominate private health insurance in most developed countries? What are the objectives and constraints of social health insurance managers? What is the likely outcome or "performance" of social health insurance? The Theory of Social Health Insurance reviews the conventional theory of demand for insurance and health insurance, the supply of health insurance in general and social health insurance in particular, the properties of the optimal health insurance contract, and whether there are factors limiting the growth of social health insurance.
Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.
Folland, Goodman, and Stano’s bestselling The Economics of Health and Health Care text offers the market-leading overview of all aspects of Health Economics, teaching through core economic themes, rather than concepts unique to the health care economy. The Eighth Edition of this key textbook has been revised and updated throughout, and reflects changes since the implementation of the Affordable Care Act (ACA). In addition to its revised treatment of health insurance, the text also introduces the key literature on social capital as it applies to individual and public health, as well as looking at public health initiatives relating to population health and economic equity, and comparing numerous policies across Western countries, China, and the developing world. It provides up-to-date discussions on current issues, as well as a comprehensive bibliography with over 1,100 references. Extra material and teaching resources are now also available through the brand new companion website, which provides full sets of discussion questions, exercises, presentation slides, and a test bank. This book demonstrates the multiplicity of ways in which economists analyze the health care system, and is suitable for courses in Health Economics, Health Policy/Systems, or Public Health, taken by health services students or practitioners.
A Shared Destiny is the fourth in a series of six reports on the problems of uninsurance in the United States. This report examines how the quality, quantity, and scope of community health services can be adversely affected by having a large or growing uninsured population. It explores the overlapping financial and organizational basis of health services delivery to uninsured and insured populations, the effects of community uninsurance on access to health care locally, and the potential spillover effects on a community's economy and the health of its citizens. The committee believes it is both mistaken and dangerous to assume that the persistence of a sizable uninsured population in the United States harms only those who are uninsured.
This book discusses the following: Microeconomic tools for health economics; Statistical tools for health economics; The production of health; Demand for health capital; Consumer choice and demand; Asymmetric information and agency; Imperfect agency and supplier-induced demand; Health, health care, and advertising; Physician uncertainty and small area variations; Insurance; Managed care and Health Maintenance Organizations (HMOs); The production and cost of health care; Technology; Labor markets and professional training; The training and practice of physicians; Hospitals and long-term care; The role of nonprofit firms; Government interventions in health care markets and an introduction to regulation; Equity, efficiency, and need; Social insurance; Comparative health care systems; Health system reform; Cost-benefit analysis and applications to health care; Economics of mental health and substance abuse.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.