e Affordable Care Act (ACA) will significantly expand access to affordable
health coverage in California starting in 2014. Californians with the lowest
incomes will have access to coverage under the expansion of Medi-Cal, while
millions of low- and middle-income families will be eligible for subsidies
through the California Health Benefit Exchange (the Exchange). Demand for
health insurance in the state will also increase as a result of the minimum
After reading this chapter, you should be able to: Convey important facts about rising health care costs in the United States, relate the economic implications of rising health care costs, discuss the problem of limited access to health care for those without insurance, list the demand and supply factors explaining rising health care costs, summarize the goals of the Patient Protection and Affordable Care Act and the major changes that it institutes.
The United States has seen major advances in medical care over the past decades, but
access to care at an affordable cost is not universal. Many Americans lack health care insurance
of any kind, and many others with insurance are nonetheless exposed to financial risk because of
high premiums, deductibles, co-pays, limits on insurance payments, and uncovered services. One
might expect that the U.S. poverty measure would capture these financial effects and trends in
them over time.
In 1978 the Conference of Alma Ata stated in Section VI: “Primary health care is essential
health care based on practical, scientifically sound and socially acceptable methods and
technology made universally accessible to individuals and families in the community through
their full participation and at a cost that the community and country can afford to maintain at
every stage of their development in the spirit of self-reliance and self-determination.
The Affordable Care Act establishes Affordable Insurance Exchanges (Exchanges) to provide
individuals and small business employees with access to health insurance coverage beginning January
An Exchange is an entity that both facilitates the purchase of Qualified Health Plans (QHP)
by qualified individuals and provides for the establishment of a Small Business Health Options Program
(SHOP), consistent with Affordable Care Act 1311(b) and 45 CFR 155.20.
Research conducted for Missing the Target 7 by civil society activists on-the-
ground in six countries (Argentina, Cambodia, Moldova, Morocco, Uganda,
and Zimbabwe) shows that efforts to prevent vertical transmission are
failing to reach the very group it was designed for—HIV-positive
We come across an era of strong and even more unusual individual claims, while the solution to often conflicting demands becomes increasingly elusive and parochial. One of the most intriguing philosophical questions is how to link human responsibility to those consequences of action which no one can fully foresee but, nevertheless, which no one can afford to neglect. Many biotechnological challenges are of this nature.
Today, tens of millions of Americans – including those with and without health insurance – struggle to
pay their health care bills. A study released last year by CredAbility, a nonprofit credit counseling agency,
estimated that 20% of their clients listed medical debt as the primary reason for seeking bankruptcy
protection. The burden of being unable to afford care often has a greater impact on women than men.
In one study, more than 50% of women delayed seeking medical care because they couldn't afford it,
compared to 39% of men. Women are also less likely to...
An Affordable Insurance Exchange is a new, competitive marketplace
where families and small business owners will be able to shop for private
health insurance. Starting in 2014, the Exchanges will allow you to
compare qualified health plans, get answers to questions, find out if you
are eligible for tax credits for private insurance or health programs such
as Medicaid, and enroll in a health plan that meets your needs.
Members of Congress and their staff will be required to get their
insurance from the Exchanges, too.
For too long, we had a health insurance
market that worked very well for big
insurance companies, but not so well for
American families and small businesses.
For many years, Americans watched
their health insurance costs rise more
rapidly than their wages. From 1999-2009,
health insurance costs and premiums
skyrocketed, leaving employers in the
difficult position of deciding whether they
could continue to maintain coverage for
their workers. And small businesses paid
an average of 18 percent more for the
same health coverage as large businesses.
We’re excited to continue implementing the new Medicare benefits provided to you under the 2010 Affordable Care Act. There’s a lot of information about this law in the news including many new opportunities for all Americans to compare plans and get affordable health care coverage.
This chapter addresses the rising cost of health care in the United States. We will discuss both the economic and noneconomic costs associated with providing health care to the American public. We will end by summarizing the goals of the legislation passed in 2010, the Patient and Affordable Care Act (PPACA).
Chapter 21 - Health care. After reading this chapter, you should be able to: Convey important facts about rising health care costs in the United States, relate the economic implications of rising health care costs, discuss the problem of limited access to health care for those without insurance, list the demand and supply factors explaining rising health care costs, summarize the goals of the Patient Protection and Affordable Care Act and the major changes that it institutes.
About a dozen mothers sit on gurneys and nurse newborns in a ward that is
nothing more than a long, open room. Two nurses in starched, white uniforms
walk the hallway wearily. They work thirteen-hour shifts, four days a week,
and earn the equivalent of $25 a week. The hospital lacks oxygen equipment,
thermometers, blood pressure machines, and basic pharmaceuticals
antibiotics. Patients are asked to bring their own drugs if they can afford them.
Equipment in surgical suites is old and worn, with rubber cracked and
The Affordable Care Act provides States with significant flexibility in the design and operation of their
Exchange to best meet the unique needs of their citizens and their marketplace. States can choose to
operate as a State-based Exchange, or the Secretary of the Department of Health & Human Services
(HHS) will establish and operate a Federally-facilitated Exchange in any State that does not elect to
operate a State-based Exchange.
In many parts of the world, where medicines are not readily available
or affordable, the public continue to rely on medicines used traditionally
in their cultures. At the same time, affluent consumers in the industrialized
world are spending their own money on healthcare approaches
that fall outside what has been considered mainstream medicine. A growing
body of national and international studies highlight the reality that
there is exponential growth of global interest in and use of traditional (i.e.
indigenous), complementary and alternative medicine (TCAM).
THE ESSENCE OF THE GUIDELINES presented here—start with your reports,
enter the data directly into the computer, validate on entry, and
monitor your results continuously—first appeared in a newsletter I
edited in the mid-1980s.The reactions of readers then ranged from
tepid to outwardly hostile:“We can’t afford to give every physician a
computer,” raged one data manager, ignoring the $10,000 per patient
that is the normal minimal expense for clinical data.
Concerns about rising health care costs and affordability of health care for families
persist despite the enactment of comprehensive health reform legislation in March
2010 (the Affordable Care Act, or ACA).
The ACA changed the health care landscape
considerably by providing significant financial assistance to help people with low and
moderate incomes afford coverage and associated cost sharing.
Earlier in the year, when the affiliate rule was first implemented, the state expected that
the planned expansion of Medicaid to non-elderly adults with incomes under 133% of poverty
under the Affordable Care Act in 2014 would ensure that most of the low-income WHP clients
would become eligible for Medicaid and that additional support might only be needed for those
women with incomes between 138% and 185% of poverty.
Although cataract surgery has been performed
for many centuries, technological advances now
provide us with the opportunity to afford our
patients vision more similar to the pre-cataract
state than ever before. Advanced instrumentation
and surgical techniques allow our patients to
expect excellent uncorrected vision within 24 h
of surgery. In addition, newer multifocal and
accommodating intraocular lens (IOLs) offer the possibility of distance, near, and intermediate
vision without glasses [2, 23, 32]....