Public support for policies that would help people with chronic conditions.
(9/39)
According to a national public opinion survey, Americans strongly support government solutions to help people with chronic conditions and their caregivers. Such solutions include a Medicare prescription drug benefit, a tax credit for caregivers, a tax break for people who purchase private long-term care insurance, and public long-term care insurance. A majority is willing to support several of these initiatives by paying higher taxes, but our survey suggests that other initiatives may not have sufficient support to offset their incremental costs. In addition, support for these proposals varies systematically by individual characteristics, which suggests that there are different constituencies for each proposal. (+info)
Hospital charge exemptions for the poor in Shandong, China.
(10/39)
Rapid economic changes in China have produced soaring hospital charges, a breakdown of the old social health insurance system, a resulting crisis in hospital affordability and renewed interest in mechanisms for discounts or exemptions from hospital charges for the poor. Little is known, however, about how effective such systems are in practice. We studied nine public hospitals in Shandong Province that offer discount or exemption mechanisms for the poor. Methods included document review, key informant interviews, detailed review of financial records and focus group discussions. These hospitals receive little government subsidy and must support themselves almost entirely through user fees. Hospital managers saw discount mechanisms primarily as marketing tools and designed them to limit their cost. Only a small fraction of hospital services were eligible for discount, and these were usually low cost or low utilization items. Discounts were generally 10-50% for selected items with very few services exempted from charge. The total value of discounts granted was 1% or less of total hospital operating budgets. Correct identification of indigents was a major difficulty for hospitals. Only a minority of indigents received discounts, the process was sometimes arbitrary and some who received discounts were not really poor. Government policies requiring discounts for the poor were vague and not enforced. The exemption programmes studied do not provide effective protection from hospital charges for the poor. To be effective, exemption mechanisms would likely require both financing and regulation by the government as well as an accurate way to identify the poor. (+info)
Individual insurance: how much financial protection does it provide?
(11/39)
This paper examines the comparative financial protection provided by individual and group health insurance. Data sources include two national surveys of employer-based health plans and e-health insurance listings for individual coverage on the World Wide Web. Data on the use and cost of services are from the National Medical Expenditure Survey (NMES), a national household survey of Americans. We estimate that individual insurance pays on average 63 percent of the health care bill, whereas group health insurance pays 75 percent. Deductibles are much higher in individual insurance, and covered benefits are more meager. At 200 percent of poverty, the top 25 percent of health care users with individual coverage would spend 11 percent of their income for out-of-pocket health care expenses, as opposed to 6 percent for persons with group coverage. (+info)
Joint custody: bipartisan interest expands scope of tax-credit proposals.
(12/39)
The Bush administration's proposal to use tax credits to cover the uninsured has not attracted enough bipartisan support to make headway in a divided Congress. Democratic objections have centered on the administration's insistence that the credits be used primarily in the individual market. But bipartisan exploration of alternative credit designs has continued on Capitol Hill. Democratic proposals to include health coverage for laid-off workers in debate over the post-September 11 economic stimulus package and more recently in the Trade Adjustment Assistance Act have resulted in increased awareness that tax credits might be used for employer groups as well as in the nongroup market. (+info)
Using tax credits and state high-risk pools to expand health insurance coverage.
(13/39)
There are practical proposals now on the public policy table to reduce the number of Americans without health coverage. While they won't make health care free or eliminate the forty million uninsured persons, they would help millions of Americans acquire or improve their health insurance. Practical strategies can also be taken to address access issues for unhealthy persons in the nongroup market through federal assistance to states to establish and improve state high-risk health insurance pools, as well as to make health insurance more affordable for low-income Americans. (+info)
Competitive markets for individual health insurance.
(14/39)
A more dynamic individual insurance market could match benefits with individual preferences, provide more portable and permanent coverage, and stimulate consumer-focused service. Necessary reforms, such as tax parity and targeted assistance to high-risk pools, would enable individual coverage to expand efficiently. In contrast, requirements for guaranteed issue and community rating drive low-risk persons out of voluntary individual markets and raise overall premiums. Guaranteed renewability and switching costs would stabilize individual-market risk pools. As the individual market becomes more representative of the overall population, insurers' perceived needs to underwrite and market selectively will lessen, making administrative loading factors less significant. (+info)
Reducing uninsurance through the nongroup market: health insurance credits and purchasing groups.
(15/39)
The president's proposal to introduce tax credits for the purchase of health insurance will enable millions of Americans to purchase private health insurance, improving the functioning of private markets, empowering patients to make informed decisions, and increasing the use of high-value health care. Evidence points to the availability of comprehensive individual insurance for the young and the old, the sick and the healthy. There are a number of policies that would increase access to the nongroup market, none of which would adversely affect group markets. These policies together will ensure that all Americans have good, affordable health insurance choices available to them. (+info)
Ensuring health security: is the individual market ready for prime time?
(16/39)
Proposals to expand coverage of the uninsured through federal tax credits rely heavily on the individual insurance market. Yet the current market makes coverage less accessible, less affordable, and inadequate to meet the needs of many people without insurance, especially those who have modest incomes or are in less-than-perfect health. States' efforts to regulate the individual market can improve access for the vulnerable but, absent subsidies, may place coverage out of reach for the young and healthy. A combination of subsidies and market reforms could make insurance available to millions of Americans. (+info)