Health Care Reform and Disparities


Book Description

This book exposes and examines how Medicare, Medicaid, and private health insurance plans combined with widespread business practices and fraud create inequity—the root cause of our dysfunctional health care system, and the reason for the rising cost of health care for all Americans. In Health Care Reform and Disparities: History, Hype, and Hope, prolific author Toni P. Miles, MD, PhD, uniquely expands the usual discussion of health disparities by including and emphasizing the voice and perspective of the consumer, and by featuring policy, media, and financing data. Highlighting the subjective experience humanizes the effects of bureaucratic inequity and inefficiency, while examining the facts and figures spotlights real-world opportunities for moving away from operating on a discrimination basis and refocusing on quality of care. The first chapter outlines the larger historical context of the health care crisis before subsequent sections describe individual aspects of the health care system—and each one's role in creating or exacerbating disparities. Health care issues specific to demographic groups such as young adults are addressed. This work is an accessible, eye-opening resource for educators, students, and policy makers, as well as anyone wanting to find up-to-date details on the policies and regulations evolving from the Affordable Care Act.




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.




The Affordable Care Act


Book Description

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.




Just Medicine


Book Description

Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system—and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.




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.




Health Care Politics, Policy, and Services


Book Description

Designated a Doody's Core Title! Winner of an AJN Book of the Year Award! Who Has a Right to Health Care? What Is the Government's Role in Providing Accessible Health Care? How Are Corporations, Insurance Companies, and Health Care Providers Affecting the Quality of Health Care? And, Most Importantly, Can We Reform the U.S. Health Care System? We often debate these issues in health care policy or public health courses, yet we do so without the proper knowledge of the underlying structure of the U.S. health care system--or a framework by which it can be judged. Many health care workers entering the system are ill-equipped to address the issues faced in direct health care practice, in part because they have no ability to evaluate it. In this innovative text, Gunnar Almgren provides all the tools necessary to understand and critique a health care policy in dire need of change. First, he describes the historical evolution of U.S. health care, explaining how the early roles of hospitals, doctors, and nurses still influence today's system. He explains the complex financial aspects of health care, including the concerns of all its major stakeholders. He looks at the government's role in regulating and funding health care, and how that role has expanded and contracted through various political administrations. An entire chapter describes the facilities and services available for the elderly--an issue that will continue to rise in importance as America ages. Finally, he examines the many causes of disparities in the U.S. health care system. In addition, Almgren offers a unique social justice analysis as a framework by which the current system--and proposed reforms--can be judged. By analyzing the health care system through various models of social justice, we can begin to understand and address the urgent issues of economic, racial, and geographic disparities that plague our current system. With its clear, thorough, and comprehensive coverage of U.S. health care, this unique text is accessible to all those in public health, nursing, social work, public policy, or public administration. No other book addresses the underlying issues of the U.S. health care system alongside a variety of social justice models that we can use to evaluate, and perhaps eventually, change it.




Health Professions Education


Book Description

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.




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.




Care Without Coverage


Book Description

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.




Health Care Disparities and the LGBT Population


Book Description

This co-edited volume addresses a population of people whose lack of health care access, mistreatment in health care settings, and refusal of health care services are often omitted from discussions about health care disparities and insurance reform. The perspectives and needs of LGBT people should be routinely considered in public health efforts to improve the overall health of every person and eliminate health disparities. Previous research suggests that LGBT people experience worse health outcomes than their heterosexual counterparts. Differences in sexual behavior account for some of these disparities, but others are associated with social and structural inequities. Low rates of health insurance coverage, high rates of stress due to systematic harassment, stigma, and discrimination, and a lack of cultural competency in the health care system frequently manifest in negative health-related behaviors. The lack of data collection on sexual orientation and identity in state and federal health care surveys leads to inadequate information about LGBT populations and impedes the establishment of health programs and public policies that benefit them. This volume’s research will increase people’s understanding of the social and structural inequalities that LGBT populations experience. With its diverse perspectives, this book will not only benefit LGBT people, but will also more broadly improve the lives of entire communities, medical care, and prevention programs and services. Improvements to our country’s health care system should go beyond providing universal insurance and should ensure equitable health care for all.