HSM 544 Health Policy Economics Discussions Week 1-7

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HSM 544 Health Policy Economics Discussions Week 1-7
Identify the three major tasks of economics and discuss why they are important. What are their…

 

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HSM 544 Health Policy Economics Discussions Week 1-7

HSM 544 Health Policy Economics Discussions Week 1-7

Three Major Tasks of Economics|Factors Influencing Healthcare Demand|Financing Healthcare|Production Function Analysis|Managed Care Concept|Redistribution and Social Insurance|The Role of Nonprofits in Healthcare|Public Health Insurance|Human Capital and Policy|Impact of Health Policy…

Set 1

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HSM 544 Three Major Tasks of Economics and Factors Influencing Healthcare Demand Discussions Week 1

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HSM 544 Three Major Tasks of Economics Week 1 Discussions 1

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Identify the three major tasks of economics and discuss why they are important. What are their roles in organization management?  Are there any additional or different questions that need to be asked when it comes to healthcare?  Can you think of other tasks or roles economics plays in our healthcare system?

Healthcare economics can defy traditional predictive models.  Consumer behavior and reimbursement schemes and amounts are quite volatile in the healthcare context.  How healthcare is delivered can vary depend on who is control of state and federal government.  For the class, does this undermine the effectiveness of healthcare economics?

Unlike a lot of consumers, healthcare consumers often hold the key themselves as to how much demand for care they are going to need, based on their ability to comply with a health regimen.  For the class, how does this affect the validity of economic predictors?…

HSM 544 Factors Influencing Healthcare Demand Week 1 Discussions 2

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Identify and discuss the factors that influence the demand for healthcare and, in turn, healthcare economics. What factor do you believe has the greatest impact on healthcare economics and why?

Healthcare economics differs from other types of economics, mainly due to the presence of third party payers, such as the government or insurance companies.

For the class, how do such third party players influence supply and demand?  Are there any obvious ways that healthcare costs can be reduced?  How do providers profit from such arrangements, where their actual collection may barely cover their costs?  Do people demand health coverage merely because they have the ability to pay for it?

Many diseases are preventable and to some extent, healthcare consumers can control their own demand for healthcare services.

For the class, do you think there are sufficient incentives in our healthcare system for healthcare consumers to control their own need for healthcare services?…

HSM 544 Financing Healthcare and Production Function Analysis Discussions Week 2

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HSM 544 Financing Healthcare Week 2 Discussions 1

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Discuss the role of all parties (patient, providers, and payers) to contain costs. What is the impact of cost-containment efforts on the rising cost of healthcare?

Coding is an important and complex process. Government audits (RAC) can reveal a certain upcoding (overcharging) that might take place, which would unnecessarily increase the cost of healthcare.

For the class, what can cause this to occur? How can it prevented?  There are some approaches and models that have proven to be successful in containing costs.

For the class, what are examples of such models and what has made them successful?

There is concern that despite the high percentage of healthcare costs in the US, there is not enough of a national will to control these costs.

For the class, do you think this is the case? Are healthcare costs a high enough priority in this country?  How has managed care changed the dynamic? How has it shifted risks of losses among the major players in healthcare?…

HSM 544 Production Function Analysis Week 2 Discussions 2

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What are the primary steps in a production function analysis? How would you apply these steps in a healthcare organization?  What areas of healthcare economics do you think the production function has the production function been most applicable to and most successful in improving?

Marginal costs do look at costs on an additional unit basis.  For the class, how do marginal costs apply to healthcare?  There are also categories of costs which are indirect and direct costs.  Is there any connection between indirect and direct costs and variable or fixed costs?

There are many variables that go into these calculations.  Is there always a direct connection between inputs and outcomes, i.e., can managers always control outcomes?  There are relationships between inputs and outputs, but they are not always linear.  Why won’t there always be a clear line between healthcare inputs-physician time/technology and good healthcare outcomes?

HSM 544 Managed Care Concept and Redistribution and Social Insurance Discussions Week 3

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HSM 544 Managed Care Concept Week 3 Discussions 1

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Discuss the concept of managed care. Why was it created? What were its goals? Have these goals changed? Has it worked? How it can be improved?

Managed care, in theory, should address quality, cost and access concerns.  In practice, what are the limitations of managed care in achieving these goals?  What are the major obstacles to an MCO’s ability to control costs and provide access?

Managed care, in theory, should help control costs, but not all of healthcare has adopted this model.  Why is this the case?  Which managed care programs have been the most successful and why?

Managed care was created for a few reasons. First, the obvious it was a response to rising costs. This was partially due to the payment structure they had at the time (fee-for-service), in which providers were the major benefactors as they had every incentive to provide more care than what was needed increasing their profits. The second was to…

HSM 544 Redistribution and Social Insurance Week 3 Discussions 2

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Discuss the connection between redistribution and social insurance. How was the Affordable Care Act designed to save money and curb rising healthcare costs, and why was it successful (or not)?  What steps are taken to ensure that social insurance is available to those who actually need it?

There are members of both political parties who see the ACA as a starting point, i.e., that its problems should be changed and its strengths be maintained.  What are the primary criticisms of this program?  Redistribution of wealth does have a negative connection to it; however, there can be distinct benefits from redistribution.  How can society best balance the costs and benefits from this process?  Does the healthcare system overall benefit from this process?…

HSM 544 The Role of Nonprofits in Healthcare and Public Health Insurance Discussions Week 4

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HSM 544 The Role of Nonprofits in Healthcare Week 4 Discussions 1

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How does the role of nonprofit healthcare organizations differ from that of for-profit healthcare organizations? Which entity is better suited to meet the growing demand for health services by the aging population, and why?

Do you think one type of entity is more effective in delivering healthcare than the other? Why do you think this might be the case?  What might the differences between a county entity and a non-profit one? Neither will pay taxes, but what might be the operational differences?

If there are for-profit organizations, with potential for greater resources and profits in healthcare, why would any healthcare organization be non-profit?

There are healthcare organizations in many areas of healthcare that are organized as for-profits or non-profits.

The type of service provided does not dictate which status an entity will choose.

For the class, what do you think is the most important factor in this decision?

HSM 544 Public Health Insurance Week 4 Discussions 2

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Health policy is moving closer (in distinct increments) to a broader role in healthcare, and public health insurance can take many forms. What do you envision the government’s role to be (e.g., a continued regulation on specific aspects or a more sweeping policy that leads to public health insurance)?  In your comments distinguish between state and federal policy.

Healthcare is such a large public good with substantial governmental and societal investment.

There is disagreement about what direction healthcare policy should go but the basic objectives have been consistent-contain costs, improve quality and access.

For the class, why do you think there is such a lack of consensus in how to achieve those objectives?  Is there any way that healthcare and healthcare policy can be stabilized, notwithstanding the political climate?

HSM 544 Human Capital and Policy and Impact of Health Policy Week 5 Discussions

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HSM 544 Human Capital and Policy Week 5 Discussions 1

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What steps can Congress and state legislatures take to alleviate a serious national shortage of skilled providers? Research suggests medical errors have been linked to inadequate staffing (i.e., quantity and quality of skilled personnel). What steps would you take to mitigate shortages?

What factors have contributed to this change in supply and demand?  What are the disadvantages of using “agency” nurses?  Why might more healthcare organizations more likely to hire mid-levels in the future?  What incentives can be offered to med students/residents to undertake this burden?  What do you think has contributed to reducing the incentive to becoming an incentive?

HSM 544 Impact of Health Policy Week 5 Discussions 2

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What is the impact of health policy on resourcing (i.e., funding, technology, capital assets, and other key, nonhuman means of healthcare delivery)?

The EHR has been cited as a means of promoting the accuracy and timeliness of medical information, which has the ultimate aim of improving the quality of healthcare.

For the class, is there evidence that this, in fact, has been the case?  What is the rationale for the growth of this industry? Is profitable? Is it competitive?  What are the risks associated with telemedicine that are not associated with in-person medical care?

Healthcare policy is really something of a misnomer in a society where policy goals are ever-changing. There are many policy objectives and policies.

For the class, how does society select its healthcare policy and goals? Clearly quality, access and cost are factors in developing policy but policy tries to help us reach these goals.

HSM 544 Healthcare Coverage Overview and Health Coverage Discussions Week 6

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HSM 544 Healthcare Coverage Overview Discussions 1 Week 6

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Respond to a proposal of how to optimize healthcare coverage for as many U.S. citizens as possible. Post a 1- to 2-minute VoiceThread recapping a news article or proposal and provide your opinion of how this proposal would impact the ability to balance costs, quality, and access to healthcare for all stakeholders involved (e.g., patients, providers, third-party payers, legislators, etc.). Identify whether this coverage should be voluntary or mandatory, with rationale.

Making healthcare more affordable does make healthcare more accessible.  Are there any negative consequences associated with reducing insurance premiums on the access or quality of healthcare?  Is universal healthcare that much different an idea, just with tax dollars rather than insurance premiums?

There has also been a departure.by physicians from the healthcare system because of the emphasis on capitation and risk bearing by providers there.  Do you think a similar trend could occur in the US?  Do you think socialist governments tend to have socialist health plans. Is there any element of socialism in the US healthcare system that might be at odds with a normally capitalistic/democratic system like the US?…

HSM 544 Health Coverage Discussions 2 Week 6

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Respond to a proposal of how to optimize healthcare coverage for as many U.S. citizens as possible. Post a 1- to 2-minute VoiceThread recapping a news article or proposal and provide your opinion of how this proposal would impact the ability to balance costs, quality, and access to healthcare for all stakeholders involved (e.g., patients, providers, third-party payers, legislators, etc.). Identify whether this coverage should be voluntary or mandatory, with rationale.

Most insurance plans are based on the idea that there is pooled risk. We may never or rarely use as much healthcare as the others in the pool.  Is universal healthcare that much different an idea, just with tax dollars rather than insurance premiums?  Large pieces of legislation that impact something as important as people’s health tend to be difficult to dismantle completely.  What do you think the future of this legislation is?

HSM 544 National Systems of Healthcare and Notional Healthcare in the United States Discussions Week 7

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HSM 544 National Systems of Healthcare Discussions 1 Week 7

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How do you describe a developed nation’s system of healthcare?  Your description should provide (only) one positive and one negative quality about that system.  Connect both of these qualities to either cost, quality, or access.

What are the risks associated with repealing the ACA? What are the risks to patients who have enrolled in this program, if any?  What is a fundamental difference between the Japanese system and the US and European systems?  Why isn’t the US considered one of the higher quality healthcare countries? Don’t we have the most advanced healthcare technology?

HSM 544 Notional Healthcare in the United States Discussions 2 Week 7

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Provide an example of at least one obstacle to implementing national healthcare in the United States and how you would overcome it. In your response, explain if your suggestion is part of the “repeal and replace” promise by President Trump in reference to the Affordable Care Act.

Do you think the ACA is in the tradition of such healthcare programs and how is it a departure from them?  Do you think this is inherently fair, or inherently unfair? Is there any other way that the poor can obtain healthcare?  Is there a Constitutional provision which allows the national government to pass legislation on healthcare?  What is the primary objection to such a system?

Set 2

HSM 544 Health Policy and Economics Discussions Week 1-7 All Posts 393 Pages Keller

HSM 544 Three Major Tasks of Economics and Factors Influencing Healthcare Demand Discussions Week 1 All Posts 49 Pages Keller

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HSM 544 Three Major Tasks of Economics Discussions 1 Week 1 All Posts 24 Pages Keller

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Identify the three major tasks of economics and discuss why they are important. What are their roles in organization management?

With each year that passes there are new issues within the health industry, as one is solved another one surfaces, we are always going to have issues with the health care industry. One of the issues we’ve been facing recently is the quality of healthcare as it appears that the focus has shifted to making money rather than providing quality care. Because of the focused placed on fee-for service, where providers are paid for their services provided, providers focus on providing quantity of care with the interest in generating profits and neglecting the quality of care provided. This resulted in the over use of resources and providers billing for unnecessary procedures and services. Programs such as the Center for Medicare and Medicaid Services have since created value-based programs that are directed at changing this concepts by connecting the providers payments to the quality of service they provide, thus reducing unnecessary charges and cost…

HSM 544 Factors Influencing Healthcare Demand Discussions 2 Week 1 All Posts 25 Pages Keller

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Identify and discuss the factors that influence the demand, in turn healthcare economics. What factor do you believe has the greatest impact on healthcare economics and why?

Availability is a factor that influences health care services. Your access to transportation may limit the availability you have to some better health care services or treatments at locations not close to your home. Availability of more skilled nurses or doctors may be limited if you live in a rural geographical location or one with challenging economic conditions. Likewise, specialized equipment may be in short supply, too, reducing immediate availability. If you have a unique health condition, the availability of a professional who can meet your health care need may not even reside in the same country, further influencing whether you can meet a health care need.

Cost – Personal financial situations are a factor that influences health care services, even if you have some form of insurance. Some medical doctor’s offices and hospitals may refuse to treat you for certain conditions without adequate…

HSM 544 Financing Healthcare and Production Function Analysis Discussions Week 2 All Posts 57 Pages Keller

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HSM 544 Financing Healthcare Discussions 1 Week 2 All Posts 31 Pages Keller

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Discuss the role of all parties (patient, providers, and payers) to contain costs. Analyze the impact of cost-containment efforts on the rising cost of healthcare.

In 2000, health care spending rose to $1.3 trillion dollars, or an average of $4,637 per person. As a percentage of the Gross Domestic Product (GDP), it grew from 13.1 percent in 1999 to 13.2 percent in 2000. National health expenditures are expected to reach $2.8 trillion in 2011, with an average annual growth rate of 7.3 percent from 2001 to 2011. By growing 2.5 percent faster than the GDP, expenditures will consume approximately 17 percent of the GDP in 2011.

In 2000, spending for health services increased at virtually identical rates in the public (6.9 percent) and private (7.0 percent) sectors. Spending on Medicare, the largest single public health care program rose 5.6 percent in 2000, following much lower growth rates of 0.6 percent in 1998 and 1.5 percent in 1999. For the private sector, the year 2000 marked the third straight year of significantly high growth. During 2000, hospital spending growth was 5.1 percent, the first time since 1993 that hospital spending increased more than 4.0 percent…

HSM 544 Production Function Analysis Discussions 2 Week 2 All Posts 26 Pages Keller

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What are the primary steps in a production function analysis? How would you apply these steps in a healthcare organization?

Medicare is in over its head and if it remains along that path it will go under. The federal government needs to figure out what to do contain cost and keep the program afloat, if not it could be detrimental. Private facilities may not want to provide services for Medicare members for fear of not getting paid. As the population ages the number of Medicare members increases as well as the cost, this is why it is important to promote preventative care so that the population would be healthier and would not be reliant on medical care. Though Medicare have good intention, it is quickly becoming problematic and  in jeopardy of increased debt if there isn’t a reform soon.

HSM 544 Managed Care Concept and Redistribution and Social Insurance Discussions Week 3 All Posts 61 Pages Keller

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HSM 544 Managed Care Concept Discussions 1 Week 3 All Posts 31 Pages Keller

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Discuss the concept of managed care. Why was it created? What were its goals? Have these goals changed? Has it worked? How it can be improved?

Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services….

HSM 544 Redistribution and Social Insurance Discussions 2 Week 3 All Posts 30 Pages Keller

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Discuss the connection between redistribution and social insurance.  Pros and cons of key financing mechanisms for social health protection.

Redistribution from an economic stand point means the theory, policy, or practice of lessening or reducing inequalities in income through such measures as progressive income taxation and antipoverty programs.  Whereas Social Insurance is protection of the individual against economic hazards (such as unemployment, old age, or disability) in which the government participates or enforces the participation of employers and affected individuals.

or reducing inequalities in income through such measures as progressive income taxation and antipoverty programs. Whereas Social Insurance is protection of the individual against economic hazards (such as unemployment, old age, or disability) in which the government participates or enforces the participation of employers and affected individuals…

HSM 544 The Role of Nonprofits in Healthcare and Public Health Insurance Discussions Week 4 All Posts 55 Pages Keller

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HSM 544 The Role of Nonprofits in Healthcare Discussions 1 Week 4 All Posts 28 Pages Keller

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How does the role of nonprofit healthcare organizations differ from profit healthcare organizations?

At the most basic level, healthcare organizations of all sizes and types are either nonprofit (NP) or for profit (FP). Similarities between both types of organizations include but are not limited to:

  1. Both have universal goals to provide the highest quality healthcare services needed by patients served.
  2. Both have universal goals to balance costs, quality, and access among all stakeholder groups (e.g., patients, providers, administrators, third-party payers, etc.).
  3. Both MUST make a profit to stay in business and continue providing healthcare services to patients who need them.
  4. Both have to comply with legal policies and regulations at local, county, state, and federal levels.
  5. Both experience similar challenges such as healthcare professional shortages/turnover/burnout, high rates of malpractice lawsuits/litigation, highly complex reimbursement for services and products provided.

Differences between NPs and FPs included but are not limited to:

  1. NPs do not pay income taxes, whereas FPs do pay income taxes (mostly at corporate rates). In return for the benefit of NPs not paying income taxes, legally these organizations are required to treat a reasonable volume of patients for free (i.e., without the ability to pay for services through insurance or personal funds). Conversely, FPs are not legally required to treat patients without an ability to pay for services received.
  2. NPs must put profits into an “excess account” earmarked for a capital improvement projects such as a new piece of technology or structure remodel/addition, etc. FPs pay taxes on profits and distribute the remaining amount to owners/shareholders.
  3. NPs are eligible to apply for and receive numerous federal grants to supplement income and pay for services that may lose money (aka lost leader programs) whereas FPs are typically not eligible to receive grant monies.
  4. NPs typically have a much larger source of gifts and donations by patrons through foundations than FPs.
  5. NPs typically have a much larger volunteer staff than FPs.

HSM 544 Public Health Insurance Discussions 2 Week 4 All Posts 27 Pages Keller

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Health policy is moving closer (in distinct increments) to a broader role in healthcare. Public health insurance can take many forms. Discuss what you envision the government’s role to be (e.g., a continued regulation on specific aspects or a more sweeping policy that leads to public health insurance). In your comments distinguish between state- and federal-government policy.  Also, we need health policies and initiatives that are affordable and sustainable. Thoughts?

Based on the article titled Why Public Health Insurance Could Help, Even if You Don’t Want It, Jayachandran illustrates how the federal government of Mexico provided essential foods such as beans and rice to the poor.  India provided its poorer citizens with welfare for work.  In both instances, these governments took responsibility because they were able.  I believe the same is true for health insurance, specifically public health insurance in the United States…

HSM 544 Human Capital and Policy and Impact of Health Policy Discussions Week 5 All Posts 57 Pages Keller

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HSM 544 Human Capital and Policy Discussions 1 Week 5 All Posts 29 Pages Keller

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What steps can Congress and state legislatures take to alleviate a serious national shortage of skilled providers. Research suggests medical errors have been linked to inadequate staffing (i.e., quantity and quality of skilled personnel). What steps would you take to mitigate shortages?

Access to primary health care services in a timely manner is a significant factor for optimal public health outcomes. However, there is currently a notable shortage of primary health care workers, which may compromise the quality of patient care. It has been established that practices with more than 2,000 patients per practitioner working full-time are not able to provide the level of care and access to their patients as required. At this ratio, each primary care physician is estimated to spend more than 17 hours each day in the provision of acute, chronic, and preventative health care. This is clearly not feasible and does not include other responsibilities and paperwork associated with the position.

Attracting a greater number of medical students into the provision of primary health care, rather than specialization, would help increase the number of primary care practitioners. There are several ways of doing this, including:…

HSM 544 Impact of Health Policy Discussions 2 Week 5 All Posts 28 Pages Keller

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What is the impact of health policy on resourcing (i.e., funding, technology, capital assets, and other key, nonhuman means of healthcare delivery)?  How do we increase awareness about health policies among the targeted population?

Healthcare Reform Act—officially called the Patient Protection and Affordable Care Act (PPACA)—institutes sweeping changes across all healthcare stakeholders, including payers, providers, and plan members. In fact, the amount of change required by the PPACA is so extensive, distilling all the changes down and accounting for their impact is a serious challenge for the industry as a whole. However, if we focus on the apparent macro changes that affect payers—an increase in competition for the group market, an increase in overall access, and new regulations on expense caps for medical costs—a rational set of assumptions becomes apparent for predicting the direct impact on stakeholders. The implementation of these changes will cause payers to:…

HSM 544 Healthcare Coverage and Political Issues to National Health Discussions Week 6 All Posts 60 Pages Keller

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HSM 544 Healthcare Coverage Discussions 1 Week 6 All 32 Posts Pages Keller

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What means exist for U.S citizens to obtain healthcare coverage? Should coverage be voluntary or mandatory?

The Affordable Care Act provided Americans with better health security by putting in place comprehensive health insurance reforms that: expanded coverage, holds insurance companies accountable, lower health care costs, guarantee more choice, and enhance the quality of care for all Americans (Medicaid).

Prior to the passage of the Affordable Care Act, the individual insurance market was a notoriously difficult place for consumers without employer-based health benefits to purchase insurance. It also was challenging for insurers to sell insurance without incurring large losses. As a result, insurers went to great lengths to exclude people with even mild health problems. In 2010, the Commonwealth Fund Biennial Health Insurance Survey found that more than one-third of people who tried to purchase health insurance in the individual market in the previous three years—an estimated 9 million people—had been turned down, charged a higher price, or had a condition excluded from their health plan….

HSM 544 Political Issues to National Health Discussions 2 Week 6 All Posts 28 Pages Keller

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What are the most important political issues that challenge the creation of a national system of healthcare? What should we do differently to control healthcare costs? Are we doing enough or should we look at other countries that have been able to control and manage their healthcare expenditures?

Worldwide there is a growing awareness of the need to adapt health care systems to meet the challenges of the twenty-first century.  The reasons for this need are many but include shifting trends in demographics and illness, epidemiological knowledge of the social determinants of health, the radical possibilities of new technologies, and rapidly increasing health care costs as well as relatively long-standing concerns about the need to respect and support the autonomy of patients…

HSM 544 National Systems of Healthcare and National Healthcare in the United States Discussions Week 7 All Posts 54 Pages Keller

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HSM 544 National Systems of Healthcare Discussions 1 Week 7 All Posts 28 Pages Keller

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Describe a developed nations system of healthcare. Your description should provide (only) one positive and one negative quality about that system. Connect both of these qualities to either cost, quality, or access.

The United States has a mix of clashing ideas  private insurance through employment; single-payer Medicare mainly for those 65 and older; state-managed Medicaid for many low-income people; private insurance through exchanges set up by the Affordable Care Act; as well as about 28 million people without any insurance at all. Hospitals are private, except for those run by the Veterans Health Administration…

HSM 544 National Healthcare in the United States Discussions 2 Week 7 All Posts 26 Pages Keller

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Provide an example of a national-level policy directed at health. Explain the policy.

Health care spending in the U.S. far exceeds that of other high-income countries; though spending growth has slowed in the U.S. and in most other countries in recent years. Even though the U.S. is the only country without a publicly financed universal health system, it still spends more public dollars on health care than all but two of the other countries. Americans have relatively few hospital admissions and physician visits, but are greater users of expensive technologies like magnetic resonance imaging (MRI) machines. Available cross-national pricing data suggest that prices for health care are notably higher in the U.S., potentially explaining a large part of the higher health spending. In contrast, the U.S. devotes a…