Federalism and Health Policy

Federalism and Health Policy

Author: Alan Weil

Publisher: The Urban Insitute

Published: 2003

Total Pages: 448

ISBN-13: 9780877667162

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The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.


Administrative Burden

Administrative Burden

Author: Pamela Herd

Publisher: Russell Sage Foundation

Published: 2019-01-09

Total Pages: 361

ISBN-13: 1610448782

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Winner of the 2020 Outstanding Book Award Presented by the Public and Nonprofit Section of the National Academy of Management Winner of the 2019 Louis Brownlow Book Award from the National Academy of Public Administration Bureaucracy, confusing paperwork, and complex regulations—or what public policy scholars Pamela Herd and Donald Moynihan call administrative burdens—often introduce delay and frustration into our experiences with government agencies. Administrative burdens diminish the effectiveness of public programs and can even block individuals from fundamental rights like voting. In AdministrativeBurden, Herd and Moynihan document that the administrative burdens citizens regularly encounter in their interactions with the state are not simply unintended byproducts of governance, but the result of deliberate policy choices. Because burdens affect people’s perceptions of government and often perpetuate long-standing inequalities, understanding why administrative burdens exist and how they can be reduced is essential for maintaining a healthy public sector. Through in-depth case studies of federal programs and controversial legislation, the authors show that administrative burdens are the nuts-and-bolts of policy design. Regarding controversial issues such as voter enfranchisement or abortion rights, lawmakers often use administrative burdens to limit access to rights or services they oppose. For instance, legislators have implemented administrative burdens such as complicated registration requirements and strict voter-identification laws to suppress turnout of African American voters. Similarly, the right to an abortion is legally protected, but many states require women seeking abortions to comply with burdens such as mandatory waiting periods, ultrasounds, and scripted counseling. As Herd and Moynihan demonstrate, administrative burdens often disproportionately affect the disadvantaged who lack the resources to deal with the financial and psychological costs of navigating these obstacles. However, policymakers have sometimes reduced administrative burdens or shifted them away from citizens and onto the government. One example is Social Security, which early administrators of the program implemented in the 1930s with the goal of minimizing burdens for beneficiaries. As a result, the take-up rate is about 100 percent because the Social Security Administration keeps track of peoples’ earnings for them, automatically calculates benefits and eligibility, and simply requires an easy online enrollment or visiting one of 1,200 field offices. Making more programs and public services operate this efficiently, the authors argue, requires adoption of a nonpartisan, evidence-based metric for determining when and how to institute administrative burdens, with a bias toward reducing them. By ensuring that the public’s interaction with government is no more onerous than it need be, policymakers and administrators can reduce inequality, boost civic engagement, and build an efficient state that works for all citizens.


Leadership by Example

Leadership by Example

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2003-05-21

Total Pages: 206

ISBN-13: 0309168880

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The federal government operates six major health care programs that serve nearly 100 million Americans. Collectively, these programs significantly influence how health care is provided by the private sector. Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care - not only in these six programs but also throughout the nation's health care system. The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE (individuals in the military and their dependents), and IHS (native Americans). It then examines the steps each program takes to assure and improve safety and quality of care. The Institute of Medicine proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion on which this book focuses includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and more. Leadership by Example also includes a proposed research agenda to support quality enhancement. The third in the series of books from the Quality of Health Care in America project, this well-targeted volume will be important to all readers of To Err Is Human and Crossing the Quality Chasm - as well as new readers interested in the federal government's role in health care.


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.


Federal Paperwork Burdens

Federal Paperwork Burdens

Author: United States. Congress. Senate. Committee on Governmental Affairs. Subcommittee on Federal Spending Practices and Open Government

Publisher:

Published: 1979

Total Pages: 396

ISBN-13:

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Sludge

Sludge

Author: Cass R. Sunstein

Publisher: MIT Press

Published: 2021-09-07

Total Pages: 168

ISBN-13: 0262365332

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How we became so burdened by red tape and unnecessary paperwork, and why we must do better. We've all had to fight our way through administrative sludge--filling out complicated online forms, mailing in paperwork, standing in line at the motor vehicle registry. This kind of red tape is a nuisance, but, as Cass Sunstein shows in Sludge, it can also also impair health, reduce growth, entrench poverty, and exacerbate inequality. Confronted by sludge, people just give up--and lose a promised outcome: a visa, a job, a permit, an educational opportunity, necessary medical help. In this lively and entertaining look at the terribleness of sludge, Sunstein explains what we can do to reduce it. Because of sludge, Sunstein, explains, too many people don't receive benefits to which they are entitled. Sludge even prevents many people from exercising their constitutional rights--when, for example, barriers to voting in an election are too high. (A Sludge Reduction Act would be a Voting Rights Act.) Sunstein takes readers on a tour of the not-so-wonderful world of sludge, describes justifications for certain kinds of sludge, and proposes "Sludge Audits" as a way to measure the effects of sludge. On balance, Sunstein argues, sludge infringes on human dignity, making people feel that their time and even their lives don't matter. We must do better.


Health and the War on Poverty

Health and the War on Poverty

Author: Karen Davis

Publisher: Brookings Institution Press

Published: 1978

Total Pages: 264

ISBN-13:

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Monograph on health policy towards low income groups in the USA, with particular reference to the achievements of the federal health service programmes between 1965 and 1975 - describes conditions for eligibility to medical care programmes, examines public expenditure on health, medical care of the aged and of the handicapped (disabled person), etc. In poverty areas, and includes a methodology for measuring the contribution of medical care to health. References and statistical tables.