America's Health Care Safety Net


Book Description

America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.




Transforming Food Systems for a Rising India


Book Description

This open access book examines the interactions between India’s economic development, agricultural production, and nutrition through the lens of a “Food Systems Approach (FSA).” The Indian growth story is a paradoxical one. Despite economic progress over the past two decades, regional inequality, food insecurity and malnutrition problems persist. Simultaneously, recent trends in obesity along with micro-nutrient deficiency portend to a future public health crisis. This book explores various challenges and opportunities to achieve a nutrition-secure future through diversified production systems, improved health and hygiene environment and greater individual capability to access a balanced diet contributing to an increase in overall productivity. The authors bring together the latest data and scientific evidence from the country to map out the current state of food systems and nutrition outcomes. They place India within the context of other developing country experiences and highlight India’s status as an outlier in terms of the persistence of high levels of stunting while following global trends in obesity. This book discusses the policy and institutional interventions needed for promoting a nutrition-sensitive food system and the multi-sectoral strategies needed for simultaneously addressing the triple burden of malnutrition in India.




Strengthening the Safety Net


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Strengthening the Safety Net


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Realizing the Full Potential of Social Safety Nets in Africa


Book Description

Poverty remains a pervasive and complex phenomenon in Sub-Saharan Africa. Part of the agenda in recent years to tackle poverty in Africa has been the launching of social safety nets programs. All countries have now deployed safety net interventions as part of their core development programs. The number of programs has skyrocketed since the mid-2000s though many programs remain limited in size. This shift in social policy reflects the progressive evolution in the understanding of the role that social safety nets can play in the fight against poverty and vulnerability, and more generally in the human capital and growth agenda. Evidence on their impacts on equity, resilience, and opportunity is growing, and makes a foundational case for investments in safety nets as a major component of national development plans. For this potential to be realized, however, safety net programs need to be significantly scaled-up. Such scaling up will involve a series of technical considerations to identify the parameters, tools, and processes that can deliver maximum benefits to the poor and vulnerable. However, in addition to technical considerations, and at least as importantly, this report argues that a series of decisive shifts need to occur in three other critical spheres: political, institutional, and fiscal. First, the political processes that shape the extent and nature of social policy need to be recognized, by stimulating political appetite for safety nets, choosing politically smart parameters, and harnessing the political impacts of safety nets to promote their sustainability. Second, the anchoring of safety net programs in institutional arrangements †“ related to the overarching policy framework for safety nets, the functions of policy and coordination, as well as program management and implementation †“ is particularly important as programs expand and are increasingly implemented through national channels. And third, in most countries, the level and predictability of resources devoted to the sector needs to increase for safety nets to reach the desired scale, through increased efficiency, increased volumes and new sources of financing, and greater ability to effectively respond to shocks. This report highlights the implications which political, institutional, and fiscal aspects have for the choice and design of programs. Fundamentally, it argues that these considerations are critical to ensure the successful scaling-up of social safety nets in Africa, and that ignoring them could lead to technically-sound, but practically impossible, choices and designs.




새로운 위험에 대응한 사회안전망 구축 (Redesigning Safety Nets as a Response to New Challenges).


Book Description

English Abstract: The safety net faces new challenges. Non-regular workers are increasing with diversifying forms of employment, but the current safety net does not protect these new types of workers. The COVID-19 crisis highlights the lack of protection for these workers in our existing safety net. Also, the transition to a digital and eco-friendly economy is expected to trigger drastic changes in jobs and put burdens on the most vulnerable workers, which requires strengthening the safety net.This study examines the limitations of the current safety net in rapidly changing economic and social conditions and provides ways to restructure it in response to new challenges. This study consists of four chapters: income support system, employment safety net, adult education and training, and safety net for sick workers. These four fields have revealed major problems in the COVID-19 crisis and need to be addressed and strengthened to build a comprehensive safety net.Chapter 1 examines the effectiveness of the income support system during the COVID-19 period and provides an overall evaluation of the system in terms of inclusiveness, poverty reduction, economic responsiveness, and consistency. Chapter 2 analyzes what causes blind spots in the employment safety net and estimates a structural model, including unemployment insurance for the self-employed and unemployment assistance, to suggest policies for a comprehensive employment safety net. Chapter 3 investigates the characteristics of users and non-users of adult education and training voucher programs and examines why the most vulnerable groups in need of the programs do not use vouchers. Chapter 4 analyzes the state of the safety net supporting sick workers and examines the impact of health shock on employment and income to provide implications for the design of sickness benefits.These four chapters share a common concern about the safety net's wide blind spots, especially for vulnerable workers, and discuss policy tasks. First, the employment safety net does not provide protection for temporary, non-regular workers and the self-employed due to limited unemployment insurance coverage. Also, income support programs for the working-age group are not responsive to economic needs, and support against economic difficulties is insufficient. This study suggests strengthening unemployment assistance for the low-income and vulnerable workers to enhance the inclusiveness and economic responsiveness of the safety net. Second, although anyone can participate in adult education and training institutionally, the actual participation rate of the vulnerable is low. This study points out that it is important to induce their actual participation, not simply an external expansion. Third, insecure workers are less likely to access sick leaves than secure workers. Due to the disparity across workers, sickness benefits under discussion for adoption may also have practical blind spots for vulnerable workers. This study discusses policies that need consideration when designing sickness benefits to provide a secure safety net for sick workers.




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.




Forum Session Announcement - Examining the Condition of the Health Care Safety Net


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Forum Session Announcement - Examining the Condition of the Health Care Safety Net: Time to Re-Cast? F O R U M S E S S I O N Examining the Condition of the Health Care Safety Net: Time to Re-Cast?MAY 18, 2012 OVERVIEW This Forum session explored the current status of the health care safety net. [...] The IOM report defines safety net providers as "those providers that organize and deliver a significant level of health care and other related services to uninsured, Medicaid, and other vulnerable patients."1 These in- clude federally qualified health centers (FQHCs), free clinics, public hospital systems, and local health departments. [...] Like all health care providers, safety net organizations anxiously await the outcome of the Supreme Court's decision on the health re- form law. [...] In addition to coverage changes that impact safety net providers, the Patient Protection and Affordable Care Act (PPACA) features a number of efforts to improve health care delivery by strengthening the coordination and integration of care. [...] Safety net providers' mission to serve the community and coordinate care also aligns well with the goals for ACOs, but some have expressed concerns about the readi- ness of safety net systems to join such organizations or create their own.5 Although CMS's ACOs target Medicare patients and safety net providers do not typically serve large numbers of them, some states are adapting the concept of the.




Strengthening the Safety Net


Book Description