Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-04-02

Total Pages: 161

ISBN-13: 030946921X

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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.


The Uninsured in the United States

The Uninsured in the United States

Author: David Mikkelsen

Publisher: Nova Biomedical Books

Published: 2011

Total Pages: 0

ISBN-13: 9781614701750

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The total U.S. civilian non-institutionalized population in 2009 was estimated to be slightly more than 301 million, of whom 15.1 per cent or 45.5 million, were estimated by the American Community Survey to be without health insurance or uninsured. The uninsured are far more likely than those with health insurance to report problems getting needed medical care, less likely to follow recommended treatments because of costs, have less access to care, receive less preventive care, and are more likely to be hospitalized for avoidable health problems. Moreover, it is widely believed that the uninsured, when they need care, are less able to pay for their care since they do not have health insurance. Therefore, it also can be further assumed that other payers take on the financial burden of their care through higher prices. This book examines the plight of the uninsured in the United States today, by State and Congressional District.


The Affordable Care Act

The Affordable Care Act

Author: Tamara Thompson

Publisher: Greenhaven Publishing LLC

Published: 2014-12-02

Total Pages: 130

ISBN-13: 0737771496

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The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.


Coverage Matters

Coverage Matters

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2001-10-27

Total Pages: 204

ISBN-13: 0309076099

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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.


Your Best Health Care Now

Your Best Health Care Now

Author: Frank Lalli

Publisher: Simon and Schuster

Published: 2016-09-20

Total Pages: 352

ISBN-13: 1501132903

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Inspired by his viral New York Times article, prize-winning investigative journalist Frank Lalli details how he mastered the ins and outs of health care—and how you, too, can get the best care for your money. Frank Lalli, the former editor of Money and George magazines, has devoted his career to getting to the bottom of a good story. When he was diagnosed with Multiple Myeloma, a rare but potentially deadly blood cancer, he put his reporter’s instincts to work and got the wonder drug he needed at an affordable price—thousands of dollars less than he was told he would have to spend. Amazed by the complex and arbitrary nature of the health care system, he decided to share what he has learned as his own Health Care Detective so that others can find their best care and save money, too. Based on three years of research and more than 300 first-hand interviews with experts, Your Best Health Care Now is your easy-to-follow, real-world guide to making today’s health system work for you. You’ll learn all the smart moves and timely tips to get better care and save hundreds, if not thousands, of dollars—no matter what your concerns may be. Whether you’re trying to book a free check-up or negotiate with a surgeon, looking for an effective generic drug or the best price for a brand-name, or worrying about high insurance deductibles and rising premiums or a stack of surprise bills, Your Best Health Care Now has the answers you need to take charge of your wellbeing.


Moral Hazard in Health Insurance

Moral Hazard in Health Insurance

Author: Amy Finkelstein

Publisher: Columbia University Press

Published: 2014-12-02

Total Pages: 161

ISBN-13: 0231538685

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Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice


What's In, What's Out

What's In, What's Out

Author: Amanda Glassman

Publisher: Brookings Institution Press

Published: 2017-10-10

Total Pages: 449

ISBN-13: 1944691057

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Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty. Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly. What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.