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Whether they recognize it or not, virtually all colleges and universities face three GrandChallenges:·Improve the learning outcomes of a higher education: A large majority of college graduates are weak in capabilities that faculty and employers both see as crucial.·Extend more equitable access to degrees: Too often, students from underserved groups and poor households either don’t enter college or else drop out without a degree. The latter group may be worse off economically than if they’d never attempted college.·Make academic programs more affordable (in money and time) for students and other important stakeholder groups: Many potential students believe they lack the money or time needed for academic success. Many faculty believe they don’t have time to make their courses and degree programs more effective. Many institutions believe they can’t afford to improve outcomes.These challenges are global. But, in a higher education system such as that in the United States, the primary response must be institutional. This book analyzes how, over the years, six pioneering colleges and universities have begun to make visible, cumulative progress on all three fronts.
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Affordability, access, and accountability have long been among the central challenges facing higher education—and they remain so today. Here, Donald E. Heller and other higher education scholars and practitioners explore the current debates surrounding these key issues. As students and their families struggle to meet rising tuition prices, and as state funding for higher education dwindles, policymakers confront issues of affordability within state and institutional budgets. Changing demographics and challenges to affirmative action complicate the admissions process even as colleges and universities seek to diversify enrollments. And issues of institutional accountability have forced the restructuring of higher education governing boards and a reexamination of the role of public trustees in governance. This collection analyzes how issues of affordability, access, and accountability influence the way in which state governments approach, monitor, and set public higher education policy. The contributors examine the latest research on pressing challenges, explore how states are coping with these challenges, and consider what the future holds for public postsecondary education in the United States.
Equitable Access to High-Cost Pharmaceuticals seeks to aid the development and implementation of equitable public health policies by pharmaco-economics professionals, health economists, and policymakers. With detailed country-by country analysis of policy and regulation, the Work compares and contrasts national healthcare systems to support researchers and practitioners identify optimal healthcare policy solutions. The Work incorporates chapters on global regulatory changes, health technology assessment guidelines, and competitive effectiveness research recommendations from international bodies such as the OECD or the EU. Novel policies such as horizon scanning, managed-entry agreement and post-launch monitoring are considered in detail. The Work also thoroughly reviews novel pharmaceuticals with particular research interest, including cancer drugs, orphan medicines, Hep C, and personalized medicines. - Evaluates impact and efficacy of current access policies and pricing regulation of high-cost drugs - Incorporates existing guidelines and recommendations by international organizations - Compares and contrasts how different countries fund and police high-cost drug access - Explores novel and emergent policies, including managed entry agreement, analysis of real world data and differential pricing - Reviews novel pharmaceuticals of current research interest
The loss of hearing - be it gradual or acute, mild or severe, present since birth or acquired in older age - can have significant effects on one's communication abilities, quality of life, social participation, and health. Despite this, many people with hearing loss do not seek or receive hearing health care. The reasons are numerous, complex, and often interconnected. For some, hearing health care is not affordable. For others, the appropriate services are difficult to access, or individuals do not know how or where to access them. Others may not want to deal with the stigma that they and society may associate with needing hearing health care and obtaining that care. Still others do not recognize they need hearing health care, as hearing loss is an invisible health condition that often worsens gradually over time. In the United States, an estimated 30 million individuals (12.7 percent of Americans ages 12 years or older) have hearing loss. Globally, hearing loss has been identified as the fifth leading cause of years lived with disability. Successful hearing health care enables individuals with hearing loss to have the freedom to communicate in their environments in ways that are culturally appropriate and that preserve their dignity and function. Hearing Health Care for Adults focuses on improving the accessibility and affordability of hearing health care for adults of all ages. This study examines the hearing health care system, with a focus on non-surgical technologies and services, and offers recommendations for improving access to, the affordability of, and the quality of hearing health care for adults of all ages.
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.
For many years the integration of the location of land use and activities in spatial systems, as well as the provision of transport in movement of goods, services and people, has been recognized as a challenge amongst various specialists, including: engineers, transportation planners, economists, environmentalists, urban and regional planners and developers. The purpose of this book is to address transportation modelling in terms of technology, techniques and methodology application in context to the interface between transportation systems, land use planning, and environmental challenges and application. The methodology of transportation modelling is applied to international practices and application based on specific case studies, inclusive of public transportation projects; transportation modelling techniques in practice; international research agenda; network design and channel strategies; strategic planning; application of technology in traffic surveys and interpretation; emissions from transportation systems; application of mathematical models and the interface between environment, land use and development in terms of location in space and the resulting activities. Of value to both theorists and practitioners, this book references the integration of transportation modelling techniques within an interdisciplinary environment inside all spatial systems.
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.
For many younger and lower-income people, housing affordability continues to worsen. Based on the academic research of two distinguished housing economists – and stimulated by working with governments across the world - this wide-ranging book sets out clear theoretical and empirical frameworks to tackle one of today’s most important socio-economic issues. Housing unaffordability arises from complex forces and a prerequisite to effective policy is understanding the causes of rising house prices and rents and the interactions between housing, housing finance and the macroeconomy. The authors challenge many of the conventional wisdoms in housing policy and offer innovative recommendations to improve affordability.
From Los Angeles to Boston and Chicago to Miami, US cities are struggling to address the twin crises of high housing costs and household instability. Debates over the appropriate course of action have been defined by two poles: building more housing or enacting stronger tenant protections. These options are often treated as mutually exclusive, with support for one implying opposition to the other. Shane Phillips believes that effectively tackling the housing crisis requires that cities support both tenant protections and housing abundance. He offers readers more than 50 policy recommendations, beginning with a set of principles and general recommendations that should apply to all housing policy. The remaining recommendations are organized by what he calls the Three S’s of Supply, Stability, and Subsidy. Phillips makes a moral and economic case for why each is essential and recommendations for making them work together. There is no single solution to the housing crisis—it will require a comprehensive approach backed by strong, diverse coalitions. The Affordable City is an essential tool for professionals and advocates working to improve affordability and increase community resilience through local action.