Universal Coverage of Long-Term Care in the United States
Universal Coverage of Long-Term Care in the United States

Author: Douglas A. Wolfe

Publisher: Russell Sage Foundation

Published: 2012-09-01

Total Pages: 244

ISBN-13: 1610447999

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As millions of baby boomers retire and age in the coming years, more American families will confront difficult choices about the long-term care of their loved ones. The swelling ranks of the disabled and elderly who need such care—including home care, adult day care, or a nursing home stay—are faced with a strained, inequitable and expensive system. How will American society and policy adapt to this demographic transition? In Universal Coverage of Long-Term Care in the United States, editors Nancy Folbre and Douglas Wolf and an expert group of care researchers assess the current U.S. long-term care policies and exercise what can be learned from other countries facing similar care demands. After the high-profile suspension of the Obama Administration’s public long-term insurance program in 2011, Robert Hudson and Howard Gleckman provide concrete suggestions for lowering the cost and improving the quality of long-term care coverage in America. In a deeply personal and empirically rigorous analysis, family care expert Carol Levine draws crucial lessons from her experience as a caregiver for her ailing husband. She sheds light on the often fraught interactions that occur between the formal care system and family caregivers and analyzes how public policy can best support long-term family care. The volume next examines recent reforms in other developed countries and finds valuable lessons for American policy-makers. Contributors David Bell and Alison Bowes discuss the provision of personal care services in Scotland, which have been publicly financed since 2002. Their analysis shows that the new program reduced costs improved efficiency and allowed more recipients to receive care. The volume assesses the political and institutional prospects for moving towards a truly universal long-term care system in the United States. Robyn Stone provides a sobering overview of the formal, paid long-term care workforce in America, which is in crisis due to increasing demand and a shortage of qualified workers. Economist Leonard Burman focuses on public finances of the long-term care system, which will come under increasing strain as more Americans rely on Medicaid to pay for their long-term care. In the volume’s concluding chapter, Folbre and Wolf summarize criticisms of existing long-term care policies and outline particular reforms that can move the United States toward a universal system of long-term care insurance. Universal Coverage of Long-Term Care in the United States provides an essential resource on how to improve the long-term care sector in America and helps advance the national debate on this pressing topic. This volume is available for free download on the Foundation’s website, as are the volume’s individual chapters.

Improving the Quality of Long-Term Care
Improving the Quality of Long-Term Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2001-02-27

Total Pages: 344

ISBN-13: 0309132746

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Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

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.

Explaining Divergent Levels of Longevity in High-Income Countries
Explaining Divergent Levels of Longevity in High-Income Countries

Author: National Research Council

Publisher: National Academies Press

Published: 2011-06-27

Total Pages: 200

ISBN-13: 0309217105

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During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages-cancer and cardiovascular disease-available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which-unlike randomized controlled trials-are subject to many biases.

Crossing the Global Quality Chasm
Crossing the Global Quality Chasm

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2019-01-27

Total Pages: 399

ISBN-13: 0309477891

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In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.

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.

Caring for Our Own
Caring for Our Own

Author: Sandra R. Levitsky

Publisher: Oxford University Press

Published: 2014-04-17

Total Pages: 225

ISBN-13: 0199993149

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Caring for Our Own inverts an enduring question of social welfare politics. Rather than ask why the American state hasn't responded to unmet social welfare needs by expanding social entitlements, this book asks: Why don't American families view unmet social welfare needs as the basis for demands for new state entitlements? The answer, Sandra Levitsky argues, lies in a better understanding of how individuals imagine solutions to the social welfare problems they confront and what prevents new understandings of social welfare provision from developing into political demand for alternative social arrangements. Caring for Our Own considers the powerful ways in which existing social policies shape the political imagination, reinforcing longstanding values about family responsibility, subverting grievances grounded in notions of social responsibility, and in some rare cases, constructing new models of social provision that transcend existing ideological divisions in American social politics.

Introduction to U.S. Health Policy
Introduction to U.S. Health Policy

Author: Donald A. Barr

Publisher: JHU Press

Published: 2011-12-01

Total Pages: 659

ISBN-13: 1421402971

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Health care reform has dominated public discourse over the past several years, and the recent passage of the Affordable Care Act, rather than quell the rhetoric, has sparked even more debate. Donald A. Barr reviews the current structure of the American health care system, describing the historical and political contexts in which it developed and the core policy issues that continue to confront us today. This comprehensive analysis introduces the various organizations and institutions that make the U.S. health care system work—or fail to work, as the case may be. A principal message of the book is the seeming paradox of the quality of health care in this country—on the one hand it is the best medical care system in the world, on the other it is one of the worst among developed countries because of how it is organized. Barr introduces readers to broad cultural issues surrounding health care policy, such as access, affordability, and quality. He discusses specific elements of U.S. health care, including insurance, especially Medicare and Medicaid, the shift to for-profit managed care, the pharmaceutical industry, issues of long-term care, the plight of the uninsured, medical errors, and nursing shortages. The latest edition of this widely adopted text updates the description and discussion of key sectors of America’s health care system in light of the Affordable Care Act.