Access to Health Care in America


Book Description

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.




Pursuing Quality, Access, and Affordability


Book Description

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.




The Affordable City


Book Description

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.




Making Medicines Affordable


Book Description

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.







Improving Access to Affordable University Education in Saskatchewan


Book Description

In fact, Saskatchewan students now pay significantly higher tuition and fees than do most students in the U. S. The average tuition and other fees at public four-year universities in the United States this year are shown in Table 2. The average tuition and additional compulsory fees at Saskatchewan's three universities, $5,526, are higher than tuition and fees in three of the six regions in the U. [...] Tuition and fees in each of the various colleges/faculties at U of S and U of R are shown in Table 3. Tuition fees in Dentistry at the U of S are the highest in Canada. [...] Revenue for capital projects at the U of S has increased at an average rate of 60% in each of the years from 1999-00 to 2003-04, amounting to a total of $45.8 million in 2003-04, according to the annual U of S financial statements. [...] The majority of this funding comes from the province, though the construction of the CLS synchrotron at the U of S has resulted in large increases in federal contributions. [...] Thus, while total provincial funding for universities has increased over the past decade more in Saskatchewan than in other provinces, a significant portion of the increase in the past five years has been for research and capital expenses, and not for the operation of educational programs at the universities.




Health-Care Utilization as a Proxy in Disability Determination


Book Description

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 States and Public Higher Education Policy


Book Description

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.







Communities in Action


Book Description

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.