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.

Egalitarianism
Egalitarianism

Author: Nils Holtug

Publisher: Clarendon Press

Published: 2006-11-30

Total Pages: 352

ISBN-13: 019160884X

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Egalitarianism, the view that equality matters, attracts a great deal of attention amongst contemporary political theorists. And yet it has turned out to be surprisingly difficult to provide a fully satisfactory egalitarian theory. The cutting-edge articles in Egalitarianism move the debate forward. They are written by some of the leading political philosophers in the field. Recent issues in the debate over equality are given careful consideration: the distinction between 'telic' and 'deontic' egalitarianism; prioritarianism and the so-called 'levelling down objection' to egalitarianism; whether egalitarian justice should have 'whole lives' or some subset thereof as its temporal focus; the implications of Scanlon's contractualist account of the value of choice for egalitarian justice; and the question of whether non-human animals fall within the scope of egalitarianism and if so, what the implications are. Numerous 'classic' issues receive a new treatment too: how egalitarianism can be justified and how, if at all, this value should be combined with other values such as desert, liberty and sufficiency; how to define the 'worst off' for the purposes of Rawls' difference principle; Elizabeth Anderson's feminist account of 'equality of relations'; how equality applies to risky choices and, in particular, whether it is justifiable to restrict the freedom of suppliers who wish to release goods that confer different levels of risk on consumers, depending on their ability to pay. Finally, the implications of egalitarianism and prioritarianism for health care are scrutinized. The contributors to the volume are: Richard Arneson, Linda Barclay, Thomas Christiano, Nils Holtug, Susan Hurley, Kasper Lippert-Rasmussen, Dennis McKerlie, Ingmar Persson, Bertil Tungodden, Peter Vallentyne, Andrew Williams, and Jonathan Wolff.

The Effects of Social Health Insurance Reform on People’s Out-of-Pocket Health Expenditure in China
The Effects of Social Health Insurance Reform on People’s Out-of-Pocket Health Expenditure in China

Author: Kai Liu

Publisher: Springer

Published: 2016-09-21

Total Pages: 199

ISBN-13: 9811017778

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This study examines and explains the relationship between social health insurance (SHI) participation and out-of-pocket expenditures (OOP) as well as the mediating role the institutional arrangement of SHI plays in this relationship in China. Embracing a new institutionalist approach, it develops two analytical perspectives: determination, which identifies the mechanisms of social health insurance, and strategic interaction, which explores the interaction among social health insurance agencies, healthcare providers, patients, and institutions. It reveals the poor performance of social health insurance in decreasing out-of-pocket health expenditures caused by a trade-off between the reimbursement, behavior management, and purchasing mechanisms of social health insurance programs. Further, it finds that the inequitable allocation of healthcare resources and patients’ concerns regarding the benefits offset the strategies used by social health insurance agencies to manage care-seeking behavior. It also discovers that the complex interactions between insurance agencies, doctors, patients and a larger disenabling institutional surrounding restricts the purchasing efficiency of social health insurance. This book is characterized by its unique synthesis of the role of the institutional arrangement of social health insurance in China, the interaction between the stakeholders in health sectors, and of the relationship between healthcare institutions, actors, and policy outcomes. Providing a comprehensive overview, it enables scholars and graduate students to understand the ongoing process of social health insurance reform as well as the dynamics of health cost inflation in China. It also benefits policymakers by recommending a single-payer model based on an evidence-based investigation.

The Public-private Health Care State
The Public-private Health Care State

Author: Rosemary A. Stevens

Publisher: Routledge

Published: 2017-07-28

Total Pages: 368

ISBN-13: 1351475800

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The distinctive mixing and continuous remixing of public and private roles is a defining feature of health care in the United States. The Public-Private Health Care State explores the interweaving of public and private enterprise in health care in the United States as a basis for thinking about health care in terms of its history and its continuing evolution today. Historian and policy analyst Rosemary Stevens has selected and edited seventeen essays from both her published and unpublished work to illustrate continuing themes, such as: the flexible meanings of the terms public and private, and how useful their ambiguity has been and is; the role of ideology as ratifying rather than preordaining change; and the common behavior of public leaders and corporate entities in the face of fiscal opportunity. The topics--covering the period of 1870 through the twenty-first century--represent Stevens' research interests in hospital history and policy, the medical profession, government policy, and paying for health care. The volume also considers her involvement with policy questions, which include health services research, health maintenance organizations, and physician workforce policy. Section I demonstrates the long history of state government involvement with private not-for-profit hospitals from the 1870s through the 1930s. Section II examines the federal role in health care from the 1920s through the 1970s, including the establishment of veterans' hospitals and the implementation of Medicaid. Section III shows how shifting governmental roles require constantly changing organizing rhetoric, whether for inventing a federal role for health services research and HMOs, regionalization in the 1970s, or defining civil rights and equity as mobilizing vehicles in the 1980s. Section IV examines growing concerns from the 1970s through the present about the traditional public role of the largely private medical profession. Section V returns to the ambiguous public-priv