The Health and Wealth of a Nation: Employer-Based Health Insurance and the Affordable Care Act

Employer-Based Health Care – All Cons, No Pros
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Overview This research examines the behaviors of firms with respect to their provision of health care prior to the Affordable Care Act ACA deliberations and uses those behaviors to assess changes in employer-sponsored health insurance that might occur once the ACA is fully implemented. Product Details About the Author.

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The Health and Wealth of a Nation: Employer-Based Health Insurance and the Affordable Care Act [Nan L. Maxwell] on *FREE* shipping on. Editorial Reviews. About the Author. Nan L. Maxwell is a senior researcher in the Oakland, The Health and Wealth of a Nation: Employer-Based Health Insurance and the Affordable Care Act - Kindle edition by Nan L. Maxwell. Download it.

About the Author Nan L. Maxwell is a senior researcher for Mathematica Policy Research. Average Review. Write a Review.

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Therefore, ACA reform should consider health insurance premium price control methods to reduce the financial burden of federal subsidies, and to increase health care affordability for Americans who do not receive either government or employer subsidies. Additionally, it remains to be seen whether inflation of health insurance premiums will also cause more health plans to get hit with the excise tax over time. However, critics of this approach argue that it will lead to lower-quality care by reducing employees' access to certain types of previously available health services. Urban Institute, Washington, DC: 9. McArdle, Frank et al.

The clinic holds a monthly lottery to decide which locals will be added to its rolls. Out of an estimated number of those without insurance of 20,, the charity can offer free specialist care to only 1, Despite the passage of the Affordable Care Act in , America remains an outlier in health-care provision. It has some of the best hospitals in the world, but it is also the only large rich country without universal health coverage. And health-care costs can be financially ruinous.

America made a good start. At the time this was one of the largest government-backed health-care plans in the world. But America never followed rich European and later East Asian countries in introducing universal coverage.

Ethical Issues in the Provision of Health Care

Many Republicans believe that health care is not a right but something people choose to buy or not in a marketplace. And so maybe, rather than getting that new iPhone that they just love, and they want to go spend hundreds of dollars on that, maybe they should invest in their own health care. When nine of the ten best-paid occupations involve medicine, doctors have little incentive to change the system. Perhaps more important, about half of Americans have their health insurance provided by their employers see map. This resulted from a quirk of history.

That gave companies a stake in the system, which successive tax exemptions have helped maintain. So now America has a version of a problem seen the world over: voluntary insurance cannot ensure that everybody gets coverage.


The Affordable Care Act expanded Medicaid—the health-insurance system for the very poorest Americans—and subsidised slightly less poor ones to buy health insurance in statewide marketplaces. This cut the number of uninsured people from 44m to 28m, but still left a gap among people not poor enough to qualify for Medicaid but not rich enough to buy private insurance. Following a Supreme Court decision in that allowed states to opt out of expanding Medicaid, 18 did just that, leaving more people uninsured.

Last year the Republican-controlled Congress tried and failed to repeal the Affordable Care Act, but it keeps chipping away at some of its provisions. At the same time the Democrats were buoyed by their successful opposition to the repeal. Today the standard view among Democrats is that the time has come to travel the last mile towards universal health care. This is an important shift. The next Democratic candidate for president will almost certainly campaign under the banner of universal health care.

Outrageous fortune

But how? Does each person pay when receiving care?

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Do people contribute regular amounts in advance so that their care will be paid for when they need it? When a person contributes in advance, might the contribution be used for care given to someone else? If so, who should pay how much? Health care financing in the United States evolved to its current state through a series of social interventions. Each intervention solved a problem but in turn created its own problems requiring further intervention.

This chapter will discuss the historical process of the evolution of health care financing. The four basic modes of paying for health care are out-of-pocket payment, individual private insurance, employment-based group private insurance, and government financing Table 2—1. These four modes can be viewed both as a historical progression and as a categorization of current health care financing. Percentage of National Health Expenditures, Principal Source of Coverage.

Republican Health Plans Have Winners And Losers, Just Like Obamacare | FiveThirtyEight

Percentage of Population, Source: Data extracted from Martin A et al. Recession contributes to slowest annual rate of increase in health spending in five decades. Health Affairs. Public expenditures are far higher per population because the elderly and disabled are concentrated in the public Medicare and Medicaid programs.

ACA and AHCA: Don Berwick Breaks It Down

Fred Farmer broke his leg in His son ran 4 miles to get the doctor, who came to the farm to splint the leg. Fred gave the doctor a couple of chickens to pay for the visit. His great-grandson, Ted, who is uninsured, broke his leg in He was driven to the emergency room, where the physician ordered an x-ray and called in an orthopedist who placed a cast on the leg. One hundred years ago, people like Fred Farmer paid physicians and other health care practitioners in cash or through barter.