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Health-Care Utilization as a Proxy in Disability Determination

Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
Page : 161 pages
File Size : 34,77 MB
Release : 2018-04-02
Category : Medical
ISBN : 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.

The End of Employer-Provided Health Insurance

Author : Paul Zane Pilzer
Publisher : John Wiley & Sons
Page : 288 pages
File Size : 19,42 MB
Release : 2014-11-17
Category : Business & Economics
ISBN : 1119012112

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How to save 20 to 60 percent on health insurance! The End of Employer-Provided Health Insurance is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. This book is written to ensure that you, your family, and your company get your fair share of the trillions of dollars the U.S. government will spend subsidizing individual health insurance plans between now and 2025. You will learn how to navigate the Affordable Care Act to save money without sacrificing coverage, and how to choose the plan that offers exactly what you, your family and your company need. Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. The purpose of The End of Employer-Provided Health Insurance is to show you how to profit from this paradigm shift while helping you, your family, and your employees get better and safer health insurance at lower cost. It will help you save thousands of dollars per person each year and protect you from the greatest threat to your financial future—our nation's broken employer-provided health insurance system. We are at the beginning of a paradigm shift in the way businesses offer employee health benefits and the way Americans get health insurance—a shift from an employer-driven defined benefit model to an individual-driven defined contribution model. This parallels a similar shift in employer-provided retirement benefits that took place two to three decades ago from defined benefit to defined contribution retirement plans. Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans. Using the techniques outlined in this book, you and your employer will save money on health insurance by migrating from employer-provided health insurance coverage to employer-funded individual plans at a total cost that is 20 percent to 60 percent lower for the same coverage. That's $4,000 to $12,000 in savings per year for a family of four for the same hospitals, same doctors, and same prescriptions.

Expanding access to quality health care

Author : United States. Congress. House. Committee on Education and the Workforce. Subcommittee on Employer-Employee Relations
Publisher :
Page : 136 pages
File Size : 26,6 MB
Release : 2002
Category : Business & Economics
ISBN :

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Coverage Matters

Author : Institute of Medicine
Publisher : National Academies Press
Page : 204 pages
File Size : 45,21 MB
Release : 2001-10-27
Category : Medical
ISBN : 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.

Employment and Health Benefits

Author : Institute of Medicine
Publisher : National Academies Press
Page : 381 pages
File Size : 40,65 MB
Release : 1993-02-01
Category : Medical
ISBN : 0309048273

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The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.

Care Without Coverage

Author : Institute of Medicine
Publisher : National Academies Press
Page : 213 pages
File Size : 13,98 MB
Release : 2002-06-20
Category : Medical
ISBN : 0309083435

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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.

Reinsuring Health

Author : Katherine Swartz
Publisher : Russell Sage Foundation
Page : 220 pages
File Size : 19,38 MB
Release : 2006-05-11
Category : Medical
ISBN : 1610445201

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America's current system of health insurance, which relies almost exclusively on employer-sponsored coverage, is in danger of collapse, and this problem is not limited to the poor and working class. An increasing number of middle class Americans do not have employer-provided insurance and—due to skyrocketing premiums—cannot afford to purchase coverage for themselves. Reinsuring Health, by economist Katherine Swartz, examines this growing national crisis and outlines a concrete plan to make health insurance accessible and affordable for all Americans. Reinsuring Health documents why the number of uninsured Americans—now 45.5 million people—has grown in the last twenty-five years. Swartz focuses on how labor market changes—such as the decline of domestic manufacturing, decreased unionization, and the growth of non-standard work arrangements—have led U.S. employers to retreat from providing health insurance for their workers. These trends, combined with the increasing costs of medical care, have led to an explosion in health insurance premiums and a decline in coverage, particularly among the middle-class. Since those who seek insurance as individuals are generally most likely to need health care, private insurers charge higher premiums in the individual (non-group) markets than to people who obtain group insurance. This makes individual health insurance less attractive to the young and increasingly unaffordable for middle-class Americans. Similarly, insurers charge higher per person (or per family) premiums to small firms than to large companies, so many small firms do not sponsor coverage for their employees. Reinsuring Health shows how these problems can be overcome if the federal government provides a new reinsurance program which would protect insurance companies that provide small group and individual health insurance against the possibility that their policy-holders will incur very high medical expenses. By assuming some of the risk that people will face extremely costly medical bills, the government will make insurers less hesitant to offer coverage to high-risk individuals, and will help drive down premiums for others. Reinsuring Health demonstrates that this form of government reinsurance has worked in the past, helping to establish smooth running private markets for catastrophe insurance and secondary mortgages. Today, growing numbers of middle class Americans lack health insurance. Protection against the possibility of falling ill or getting hurt and having to pay extraordinary health care bills should not be a luxury available only to the very rich and the very poor. Reinsuring Health proposes a straightforward solution that would bring health insurance back within the reach of the increasing ranks of the uninsured, particularly those who are in the middle class.

Health Insurance Options

Author : United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher :
Page : 162 pages
File Size : 47,63 MB
Release : 1990
Category : Compulsory health insurance
ISBN :

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