How Medicaid Fails the Poor

How Medicaid Fails the Poor PDF

Author: Avik Roy

Publisher: Encounter Books

Published: 2013-11-12

Total Pages: 44

ISBN-13: 1594037523

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Medicaid, America’s government-run health insurance program for the poor, should be a lifeline that provides needed health care to Americans with no other options. Surprisingly, however, it doesn’t. The medical literature reveals a $450 billion-a-year scandal: that people on Medicaid have far worse health outcomes than those with private insurance, and no better outcomes than those with no insurance at all. Why is this so? In How Medicaid Fails the Poor, Avik Roy explains how Medicaid’s clumsy design and perverse incentives make it hard for people on Medicaid to get the medical care they need. Medicaid doesn’t reimburse doctors or hospitals for the cost of caring for Medicaid enrollees, forcing many doctors to opt out of the program. The Affordable Care Act, otherwise known as Obamacare, doubles down on this broken system. Roy shows us that there are better ways, using private insurance, to provide needed care to our poorest citizens.

Mama Might Be Better Off Dead

Mama Might Be Better Off Dead PDF

Author: Laurie Kaye Abraham

Publisher: University of Chicago Press

Published: 2019-05-10

Total Pages: 308

ISBN-13: 022662384X

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“A provocative examination of our health care delivery for the poor. . . . Such an honest and candid account is essential.” —Alex Kotlowitz, national bestselling author of There Are No Children Here Mama Might Be Better Off Dead immerses readers in the lives of four generations of a poor, African-American family from North Lawndale, Chicago, who are beset with the devastating illnesses that are all too common in America’s inner-cities. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Laurie Kaye Abraham chronicles their access—or lack thereof—to medical care. Their story reveals an inadequate health care system that is further undermined by the effects of poverty. Mama Might Be Better Off Dead is an unsettling, profound look at the human face of health care in America. This new edition includes an incisive foreword by David Ansell, a physician who worked at Mt. Sinai Hospital, where much of the Banes family’s narrative unfolds. “Goes to the heart of today’s problem. Powerful . . . deeply searching.” —Washington Post “A powerful indictment of the big business of medicine.” —Los Angeles Times “Abraham . . . illuminates the problems with passion and skill.” —Kirkus Reviews “This personally observed, lucid chronicle and call for reform of our ailing health system covers all levels of responsibility in the medical establishment.” —Publishers Weekly “Clearly identifies in human and policy terms how [healthcare] programs have failed a population desperately in need of help.” —Library Journal

False Premise, False Promise

False Premise, False Promise PDF

Author: Sally C. Pipes

Publisher: Encounter Books

Published: 2020-01-07

Total Pages: 115

ISBN-13: 1641770732

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American health care is at a crossroads. Health spending reached $3.5 trillion in 2017. Yet more than 27 million people remain uninsured. And it's unclear if all that spending is buying higher-quality care. Patients, doctors, insurers, and the government acknowledge that the healthcare status quo is unsustainable. America's last attempt at health reform -- Obamacare -- didn't work. Nearly a decade after its passage in 2010, Democrats are calling for a government takeover of the nation's healthcare system -- Medicare for All. The idea's supporters assert that health care is a right. They promise generous, universal, high-quality care to all Americans, with no referrals, copays, deductibles, or coinsurance. With a sales pitch like that, it's no wonder that seven in ten people now support Medicare for All. Doctors, especially young ones, are coming around to the idea of single-payer, too. Democrats, led by the progressive wing of the party, hope to capitalize on this enthusiasm. In 2017, they introduced companion legislation in the House and Senate that would establish Medicare for All. They have already promised to do the same when the next Congress convenes in 2019. More than 70 House Democrats have joined a new Medicare for All Caucus. Senator Bernie Sanders is effectively already on the presidential campaign trail, making his case for single-payer. If Democrats take the White House and Senate in 2020, and hold onto the House, a Medicare for All bill could be among the first pieces of legislation presented to the new president for a signature. In this book, Sally C. Pipes, a Canadian native, will make the case against Medicare for All. She'll explain why health care is not a right -- and how progressives pressing for single-payer are making a litany of promises they can't possibly keep. Evidence from government-run systems in Canada, the United Kingdom, and other developed countries proves that single-payer forces patients to withstand long waits for poor care at high cost. First, she'll unpack the Medicare for All plans under consideration in Congress. She'll explain how radical they truly are. Medicare for All will not save $5 trillion, as some of its proponents claim. It will cost about $32 trillion over 10 years, according to analyses from the Urban Institute and the Mercatus Center. It will outlaw private health insurance. It will raise taxes by trillions of dollars. It will cut pay for doctors to the rates paid by Medicare and thereby exacerbate our nation's shortage of physicians. And it will ration care. Then, Sally will detail the horrors of single-payer. She'll start in Canada, whose single-payer system most closely resembles the one progressives have in mind for the United States. Analyses of the government-run systems in the United Kingdom and a few other developed countries will follow, with particular focus on the problems that these systems pose for patients and doctors. To substantiate her indictment of single-payer, Sally will marshal both quantitative and qualitative evidence. She'll highlight how Americans fare better than their peers in Canada and the United Kingdom on the health outcomes that are directly linked to the quality of a healthcare system, including survival rates for patients with cancer and cardiovascular issues. She'll also explain why the health outcomes where the United States performs poorly relative to other nations, like infant mortality and life expectancy, tell us little about our healthcare system. Sally will pepper her text with heart-wrenching stories of the human costs of single-payer -- of people who were injured, were forced to remain in pain, or even died because their government-run healthcare system delayed or denied care. Too often, evangelists for free markets limit their arguments to facts and statistics -- and fail to appeal to the public's emotions. Sally will feature the stories of individuals and families who have been victims of single-payer systems. These vignettes will help drive home the truth about single-payer -- and why it must not come to the United States. She'll conclude with her vision for delivering the affordable, accessible, quality care the American people are looking for.

Poor People's Medicine

Poor People's Medicine PDF

Author: Jonathan Engel

Publisher: Duke University Press

Published: 2006-02-22

Total Pages: 350

ISBN-13: 9780822336952

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DIVA national and state-by-state history of public health options for the American poor./div

The Economics of Medicaid

The Economics of Medicaid PDF

Author: Jason J. Fichtner

Publisher: Mercatus Center at George Mason University

Published: 2014-03-24

Total Pages: 208

ISBN-13: 0989219364

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Medicaid, originally considered an afterthought to Medicare, is today the largest health insurance provider in the United States. Under the Affordable Care Act, the Congressional Budget Office projects Medicaid enrollment to increase nearly 30 percent by 2024 and federal spending on the program to double over the next decade. For the states, Medicaid is already the largest single budget item, and its rapid growth threatens to further crowd out other spending priorities. In this collection of essays published by the Mercatus Center at George Mason University, nine experts discuss the escalating costs and consequences of a program that provides second-class health care at first-class costs. The authors begin with an explanation of Medicaid’s complex state-federal funding structure. Next, they examine how the system’s conflicting incentives discourage both cost savings and efficient care. The final chapters address the pros and cons of the most mainstream Medicaid reform proposals and offer alternative solutions. This book offers a timely assessment of how Medicaid works, its most problematic components, and how—or if—its current structure can be adequately reformed to provide quality care for those in need at sustainable costs. Contributors include: Joseph Antos, American Enterprise Institute Charles Blahous, Mercatus Center at George Mason University Darcy Nikol Bryan, MD, practicing physician James C. Capretta, Ethics and Public Policy Center Robert F. Graboyes, Mercatus Center at George Mason University June O’Neill, Baruch College, CUNY Nina Owcharenko, Heritage Foundation Thomas Miller, American Enterprise Institute

Automating Inequality

Automating Inequality PDF

Author: Virginia Eubanks

Publisher: St. Martin's Press

Published: 2018-01-23

Total Pages: 288

ISBN-13: 1466885963

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WINNER: The 2018 McGannon Center Book Prize and shortlisted for the Goddard Riverside Stephan Russo Book Prize for Social Justice The New York Times Book Review: "Riveting." Naomi Klein: "This book is downright scary." Ethan Zuckerman, MIT: "Should be required reading." Dorothy Roberts, author of Killing the Black Body: "A must-read." Astra Taylor, author of The People's Platform: "The single most important book about technology you will read this year." Cory Doctorow: "Indispensable." A powerful investigative look at data-based discrimination—and how technology affects civil and human rights and economic equity The State of Indiana denies one million applications for healthcare, foodstamps and cash benefits in three years—because a new computer system interprets any mistake as “failure to cooperate.” In Los Angeles, an algorithm calculates the comparative vulnerability of tens of thousands of homeless people in order to prioritize them for an inadequate pool of housing resources. In Pittsburgh, a child welfare agency uses a statistical model to try to predict which children might be future victims of abuse or neglect. Since the dawn of the digital age, decision-making in finance, employment, politics, health and human services has undergone revolutionary change. Today, automated systems—rather than humans—control which neighborhoods get policed, which families attain needed resources, and who is investigated for fraud. While we all live under this new regime of data, the most invasive and punitive systems are aimed at the poor. In Automating Inequality, Virginia Eubanks systematically investigates the impacts of data mining, policy algorithms, and predictive risk models on poor and working-class people in America. The book is full of heart-wrenching and eye-opening stories, from a woman in Indiana whose benefits are literally cut off as she lays dying to a family in Pennsylvania in daily fear of losing their daughter because they fit a certain statistical profile. The U.S. has always used its most cutting-edge science and technology to contain, investigate, discipline and punish the destitute. Like the county poorhouse and scientific charity before them, digital tracking and automated decision-making hide poverty from the middle-class public and give the nation the ethical distance it needs to make inhumane choices: which families get food and which starve, who has housing and who remains homeless, and which families are broken up by the state. In the process, they weaken democracy and betray our most cherished national values. This deeply researched and passionate book could not be more timely.

Care Without Coverage

Care Without Coverage PDF

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2002-06-20

Total Pages: 213

ISBN-13: 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.

An American Sickness

An American Sickness PDF

Author: Elisabeth Rosenthal

Publisher: Penguin

Published: 2017-04-11

Total Pages: 434

ISBN-13: 0698407180

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A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.