One of the biggest ironies in healthcare is
the fact that everyone pushes preventative care so that the
insurer will know his/her health status and be able to
prevent some chronic health problem in the future-but with
higher co-payees, denial of coverage-these preventative
steps are not done. So that in the future, when the
major health concerns become apparent, the illness will be
more costly and the outcome may be the death of the insured.
Very cost-effective-but only if you are not this person.
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Document Name & Link to Document
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Description
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File Size /Type
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Before and After Welfare Reform: The Uncertain Progress
for Poor Families and Children
|
The
sweeping reforms of the ‘Personal Responsibility and
Work Opportunity Reconciliation Act of 1996,’ which
ended the federal entitlement to cash assistance under
the Aid to Families with Dependent Children program and
created the Temporary Assistance for Needy Families
program, brought about dramatic decreases in welfare
caseloads at a time when the economy was booming…The
long-term impact of welfare reforms on the health and
well-being of poor children and their families is far
from clear |
165
kb pdf |
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Census
Bureau-Health Insurance Coverage-2001
|
Reversing two years of falling uninsured
rates, the share of the population without health insurance
rose in 2001. An estimated14.6 percent of the population
or 41.2 million people were without health insurance
coverage during the entire year in 2001,up from 14.2
percent in 2000, an increase of 1.4 million people
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Closing
the inequality gap in access to primary healthcare for
women living with Hepatitis C
|
One of the major
challenges facing women diagnosed with hepatitis C is
overcoming the stigma attached to this illness which
frequently acts as a barrier to appropriate and timely
primary health care.
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Containing
Cost while Maintaining Quality
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Articles about how insurance companies
are trying to reduce costs and maintain profitability
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Data
to Analyze Children’s Health Insurance Coverage: An
Assessment of Issues
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Survey data will play an important role
in the evaluations of the Children’s Health Insurance
Program (CHIP) because program administrative data cannot
tell us what is happening to the number of uninsured
children. This report discusses key analytic issues
in the use of national survey data to estimate and analyze
children’s health insurance coverage.
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disease
management
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Report from the health insurance industry-"Financial
and risk considerations for successful Disease Management
Programs"
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PDF / 211 kb
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Est.
future Hepatitis C morbidity, mortality, and costs in the US
|
This study estimated future morbidity,
morality, and cost resulting from hepatitis C virus
(Hepatitis C Virus).
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PDF / 133 KB
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Eugenics—Sacred and Profane
|
Government regulation in the field of “reprogenetics,”
as it is now called, is virtually nonexistent. “I’m a
hematologist/internist,” Dr Rosner told me, “and I could
hang up a sign that says ‘IVF Clinic’ and go to work.”
Last year, the President’s Council on Bioethics began a
major inquiry into the state of public policy in areas
of biotechnology that touch the beginnings of human
life, noting that “there is presently no governmental
body (state or federal) exercising monitoring or
regulatory authority over the use of PGD,” nor is there
regulation or oversight of the long-term health effects
of PGD on children born using the procedure. Worse, the
Council observed, “there are also no governmental or
nongovernmental guidelines regarding the boundary
between using PGD for producing a disease-free child and
using it for so-called enhancement purposes or to
produce siblings for children needing transplant
donors.” |
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health
care exposure
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Exposure to toxins and infectious diseases
in the work area
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PDF / 471 KB
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health
care fraud
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mid-way thru article-Corporate Healthcare
Fraud-costs and risks
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PDF / 346 KB
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health
care workers with AIDS
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Surveillance of Health Care Workers with
AIDS and the positions that they hold
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PDF / 42 KB
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Health Insurance Coverage of the Near Elderly |
On
the whole, the near elderly actually have higher rates
of health insurance coverage than other age groups…Many
are decreasing the level of their workforce
participation and their incomes in turn are declining.
For many others, health status begins to decline in
their mid-fifties. |
1484
kb pdf |
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Health
Insurer Benefits
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Oxford Health Plans reports improved first-quarter
earnings and raises its profits forecast for year, becoming
latest health insurer to benefit from nationwide trend
of moderating hospital and drug costs; says net income
rose 2.1 percent
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Health insurance for medically
uninsurable individuals
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According to a new 2006 report by United Health
Foundation, 15.9 percent (46.6 million people) of all
Americans are uninsured. State-sponsored risk pools are
aimed at a small slice of those Americans : those who
can afford to buy health insurance, but are
denied
affordable health insurance coverage by
private companies because of a pre-existing medical
condition. |
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Health Insurance, Treatment and
Outcomes: Using Auto Accidents as Health Shocks |
Previous studies find that the uninsured receive less
health care than the insured, yet differences in health
outcomes have rarely been studied. In addition,
selection bias may partly explain the difference in care
received. To examine health outcomes and deal with
selection problems, this paper focuses on an unexpected
health shock—severe automobile accidents where victims
have little choice but to receive treatment. Another
innovation is the use of a comparison group that is
similar to the uninsured: those who have private health
insurance but do not have automobile insurance. The
medically uninsured are found to receive twenty percent
less care and have a higher mortality rate compared to
patients with health insurance. It appears that the
ability-topay of patients has a significant effect on
treatment decisions and the additional treatment yields
large improvements in health outcomes. |
Pdf 296 kb |
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HIPPA-portability
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Insurance report on HIPPA regulations
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PDF / 50 KB
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HIV
Exposure Report Form
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Report Form for the potential HIV exposure
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PDF / 80 KB
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How Private Insurance Works-A Primer |
This primer provides a basic overview of private
coverage for health care. It begins by describing what
we mean by private health coverage, and continues with
discussions of the types of organizations that provide
it, its key attributes, and how it is regulated. |
1044
kb pdf |
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Insurance
claims
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1998 legislative outlook for the insurance
industry
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PDF / 151 KB
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Insurance
Personnel |
Within the private
sector, the insurance industry has been at the forefront
of the societal response to HIV/AIDS, often in the
‘firing-line’ from AIDS activists resulting from the
industry’s HIV testing policies.
|
Pdf 372 kb
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Insurance
privacy issues
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Insurance report on the current issues
in Employee Benefits
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PDF / 336 KB
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Insurance
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Insurance report on the capitation arrangements
to protect against losses
|
PDF / 462 KB
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Insurance-Actuarial
aspects of Dread Disease
|
Actuarial aspects of dread Disease Products
concerning infectious diseases
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PDF / 526 KB
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Insurance-Hepatitis C-health,
law protection
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Insurance report on Hepatitis C and the
potential cost hospitals may face
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PDF / 417 KB
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It Can Happen Here |
American doctors once conducted an
experiment that proved you can kill the disabled babies
of poor families and get away with it. Their research
was funded by the Federal Government. Twenty-four babies
with spina bifida lost their lives. The experiment was
declared a success. Yes, it can happen here. |
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Los Angeles hospital van
spotted dumping paraplegic man on street |
A hospital van dropped off a homeless paraplegic man on
Skid Row and left him crawling in the street with
nothing more than a soiled gown and a broken colostomy
bag, police said. |
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MEDICINE IN A STRAITJACKET |
The art and science of medicine, through a collaborative
effort by the AMA and HCFA, is to be reduced to the
production of voluminous documents by the new "E&M"
"guidelines." Meanwhile, the business of insurance,
which now funds most of American medicine, is targeted
for obliteration by so-called conservatives in Congress
in the Patient Access to Responsible Care Act (PARCA),
H.R. 1415. ..The two actions are not unrelated. Both
medicine and insurance were compromised long ago by the
practice of assigning benefits to "providers" and by
broad expansions of coverage to routine, low-cost goods
and services. Thus, doctors became the servants of third
parties rather than patients, and insurance was
transformed into third-party prepayment for consumption
rather than a voluntary mechanism for sharing
catastrophic risk and protecting financial assets |
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Mentally Retarded Women and
Forced Contraceptives |
This presentation was based on whether or not mentally
retarded girls and women should be forced to use
contraceptives (for example subdermal implants or
IUDs). Debates have gone on for years over certain
cases concerning the rights and abilities of mentally
retarded persons. Are they capable of properly caring
for an infant? Is this fair to the child? Or should
forced contraceptives be used to at least "buy them
time"? One main cause of controversy is where to draw
the line. Are some mentally retarded persons more
capable than others and should this give them more
rights? Both doctors and families have disagreed on when
a person becomes incapable of caring for a child, let
alone themselves. Many also disagree on the definition
of a mentally retarded person. |
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Mix-up breaches confidentiality
of dozens in state AIDS program |
The state Department of Health Services inadvertently
revealed the names and addresses of up to 53
Californians enrolled in an AIDS drug assistance program
to other enrollees by putting benefit notification
letters in the wrong envelopes, officials said Friday. |
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Near-Elderly Americans Talk about Health Insurance-At
the Edge |
While some are retiring early because they can afford to
do so (19%), others are out of the workforce because of
illness or disability (14%). But the majority are still
working and despite their years, many are not
financially stable. More than a fifth of the near
elderly are in low-income families, with incomes less
that 200% of the federal poverty level |
583
kb pdf |
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New Lawsuit Alleges Pacificare Set
Course Of Deception To Avoid Claims and Cancel Policy of
34 Year Old Kidney Cancer Patient To Increase Company
Profits. |
Pacificare allegedly withheld the coverage decision for
the second surgery until the patient flew across the
country for the procedure. Submitted documents indicate
Pacificare informed the patient the day before the
surgery that they were denying coverage which forced the
patient to ask his parents to loan him $25,000 for a
down payment on the surgery. When the patient returned
home, instead of offering to pay for the surgery,
Pacificare allegedly sent a letter that purported to
cancel the policy. |
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One in Three: Non-Elderly Americans Without Health
Insurance 2002-03 |
This
report examines how many people under the age of 65 were
without health insurance for all or part of 2002 and
2003. The findings are based exclusively on data
projections drawn from the most recent CPS as well as
the Census Bureau’s Survey of Income and Program
Participation. |
213 kb pdf |
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Outcomes
and Costs of Care in Hepatitis C.
|
Prospective, multicenter, pharmaceutical
company-sponsored randomized clinical trials in the
treatment of chronic hepatitis C have shown that clearance
of hepatitis C virus (Hepatitis C Virus) is more likely in those treated
with -interferons than in untreated patients
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Patients
Paying Larger Percentage for Insurance |
Faced with "rapidly rising" prescription
drug spending, which is climbing at about 15% per year,
employers and insurers have increasingly shifted the
costs to patients, who "may soon pay even more,"
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Probability Tables for disability |
Mathematical descriptions and methods used for
determining the probability of disability used by the
Rand corporation
|
230 kb pdf |
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Problems
of Lost Health Benefits
|
Census Bureau figures, 1.4 million Americans
lost their health insurance last year, an increase largely
attributed to the economic slowdown and resulting rise
in unemployment. The largest group of the newly uninsured
— some 800,000 people — had incomes in excess of $75,000.
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Preventive Services: Helping Employers Expand Coverage
|
By
purchasing health insurance for their employees,
employers influence access to health care for more than
168 million insured Americans…Two out of every three
Americans were covered by private health insurance
sponsored by employers in 2001
|
348 kb pdf
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Preventive Services: Helping States Improve Mandates
(Large file-please allow extra time for download) |
Mandating coverage of a range of recommended preventive
services can improve health, prevent disease and
disability, and potentially lower some health costs |
1487 kb pdf |
|
Privacy and the Health Industry |
This article examines confidentiality and freedom of
information in the health industry and access to medical
records in both the public and private sector. In
particular, it considers changes to the access of
medical records in the private health sector after the
amendments to the Privacy Act 1988 (Cth) in 2003. |
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Re
unaffordable meds
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Winning affordable medications for ALL
Americans-a report to subcommittee on Health
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PDF / 27 KB
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Risk
& Management for Healthcare workers-bloodborne
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Risk and Management of Blood-Borne Infections
in Health Care Workers-an insurance report
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PDF / 354 KB
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Sicker and Poorer: The Consequences of Being Uninsured |
If being uninsured leads to poorer health, inefficient
use of medical care resources, fewer hours worked and
lower earnings, and lower educational attainment, then a
large uninsured population creates costs in the form of
foregone opportunities, which do not appear as explicit
government payments or budgetary line items. |
1602
kb pdf |
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State Medicaid Eligibility Cutbacks &
Exclusions-Proposed & Recently-Enacted, 2001-04 |
Nonetheless, many states dropped coverage of legal
aliens; cut eligibility and benefits for, or even
dropped, state-only medical assistance for the
federally-unmatchable poor; added or raised premiums and
copays and cut "optional" services in S-CHIP and
Medicaid; raised Medicaid drug copays; added preferred
formularies, generics requirements and monthly number
limits for Medicaid drugs; stopped “presumptive”
eligibility for pregnant women (a clever back-door way
to bar otherwise-federally-mandated coverage of
citizen-to-be fetuses of poor illegal alien mothers) and
curtailed services and enrollment in expensive home and
community-based (HCB) waivers. |
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Survey of People with Disabilities |
Report offers many graphs and charts concerning this
study |
216 kb pdf |
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The Battle to Make Health Care
Work |
Will a system set up to maximize profit ever truly care
for patients? One indication comes from looking at how
HMOs organize their lists of approved drugs, or
formularies, for their doctors to use. As one might
expect, the drugs are often the cheapest and typically
not the best. For instance, PacifiCare, now the nation's
largest HMO for Medicare recipients, replaced an
effective, high-cost schizophrenia drug called Risperdal
with the low-cost, 36 year-old drug, Haldol. A
thirty-day supply of Risperdal costs $240 compared to
$2.50 for a similar supply of Haldol — nearly a 1,000%
savings for PacifiCare. But the side effects of the
inferior Haldol include severe, uncontrollable shaking |
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The
Business of Medicine
|
A kind of "generational switch,"
which Dr. Trujillo believes has ushered out the golden
epoch of medicine – characterized by professional autonomy
and high reimbursement. "Now, we are in an era
where increasing financial control is exerted upon us.
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The
high cost of Health goes Higher
|
Kaiser Family Foundation and the Health
Research and Educational Trust finds that premiums for
employer-sponsored health insurance, which covers two
of three Americans, increased an average of 11 percent
in 2001, the largest increase since 1992
|
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The
Other Drug War-Public citizen
|
How the pharmaceutical industry fights
to protect its interests
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PDF / 318 KB
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The Right to Equal Treatment: Student Toolkit to address
Racial and Ethnic Disparities in US Health Care |
The problem of racial and ethnic disparities in health
is one of the most serious human rights issues facing
Americans today. People in racial and ethnic minority
groups in this country tend to live shorter lives and
suffer higher rates of diseases than do whites. |
263
kb pdf |
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The Social Impact of AIDS in the United States |
The
U.S. health care system stands alone among advanced
industrial countries in lacking a national program to
ensure universal or nearly universal health insurance
coverage. The various public and private insurance plans
and delivery systems (such as the Veterans
Administration health system) reflect what John Iglehart
characterizes as ''society's profound ambivalence about
whether medical care for all is a social good, of which
the costs should be borne by society, or a benefit that
employers should purchase for employees and their
dependents, with government insurance for people outside
the work force." This ambivalence, and the resulting
lack of any political consensus on how to finance and
deliver health services, has resulted in an odd
assortment of programs that does provide health
insurance to about 85 percent of the population, but
leaves some 36 million people uninsured. The uninsured
are primarily full-time workers and their dependents who
are employed in small firms at a low or the minimum
wage. |
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Tip
of iceberg
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Insurance report on occupational exposure
to an infectious disease and how companies can protect
themselves
|
PDF / 445 KB
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Tourist Rx: Traveling overseas
for inexpensive, quality care: For surgeons in India,
dentists in the Philippines, medical tourism is taking
off -- and U.S. medical insurers are taking notice
|
Added bonus: Medical tourists get to see another part of
the world. But the risks can be significant. Imagine
everything that can go wrong after surgery -- then
imagine it going wrong in a strange city, 10,000 miles
from home, in a country whose legal system may make it
difficult or impossible to sue. |
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Tuskegee Syphilis Experiment |
In 1932 the United States Public Health Service (PHASE),
in cooperation with the Tuskegee Institute, initiated a
study in Macon County, Alabama to determine the effects
of untreated syphilis. The study would last until 1970
and follow 399 black men diagnosed with syphilis. In
order to ensure that they would not be treated, which
became increasingly difficult with the discovery and
widespread use of penicillin after 1943, local
physicians, draft boards and PHS venereal disease
eradication programs were given a list of the
"subjects." The men, the most educated of whom
completed 7th grade, were told they were being treated
for "bad blood," a term the white doctors claimed was a
synonym for syphilis in the black community. One
participant responded, "That could be true. But I have
never heard no such thing." |
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US Government's Plutonium
Experiments on Citizens |
"The government should not be able to buy its way out of
responsibility by paying off victims with taxpayers'
money," said Steve Dasbach, chairman of America's
third-largest political party. "Instead, attempted
murder charges should be filed against the politicians
who approved secret radioactivity, chemical, and
biological experiments on innocent Americans." |
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What
Happens When COBRA Ends
|
There are two federal laws that can be
used to continue health insurance once your COBRA Continuation
Coverage ends. Both provide access to health insurance
without having to prove that you are "insurable."
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Why do Americans have such poor Health?
|
In order to understand
the current status of medical care in the U.S., Canada
and Europe it is vital to understand that health care in
these 3 regions is nearly completely under the control
of the pharmaceutical industry. All major pharmaceutical
firms have interlocking boards of directors so there is
no real competition among these companies.
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Why Pediatricians Need Lawyers
to Keep Children Healthy
|
Pediatricians recognize that social and nonmedical
factors influence child health and that there are many
government programs and laws designed to provide for
children’s basic needs. However, gaps in implementation
result in denials of services, leading to preventable
poor health outcomes. Physician advocacy in these arenas
is often limited by lack of knowledge, experience, and
resources to intervene. The incorporation of on-site
lawyers into the health care team facilitates the
provision of crucial legal services to vulnerable
families. Although social workers and case managers play
a critical role in assessing family stability and
finding appropriate resources for families, lawyers are
trained to identify violations of rights and to take the
appropriate legal steps to hold agencies, landlords,
schools, and others accountable on behalf of families.
The incorporation of lawyers in the clinical setting
originated at an urban academic medical center and is
being replicated at >30 sites across the country.
Lawyers can help enhance a culture of advocacy in
pediatrics by providing direct legal assistance and case
consultation for providers, as well as jointly
addressing systemic issues affecting children and
families. Until laws to promote health and safety are
consistently applied and enforced, pediatricians will
need lawyers to effectively care for vulnerable
children. Pediatrics 2004;114:224 –228;
advocacy, health disparities, prevention. |
Pdf 334 kb |
