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The document discusses U.S. health policy in 2009, noting that the majority of Americans received health insurance through employers while 45.6 million were uninsured. It also addresses issues in mental health, pointing out upward trends in both depression and PTSD. Changes proposed for 2020 mental health care included quantifying illness severity while treating based on symptoms, and predicting issues' onset through advanced screening. The document proposes a triple checkpoint system as a way to implement changes, with the first two steps requiring significant resources.
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Agenda Comparison Grid and Fact Sheet or Talking Points Brief Assignment Template for Part 1 and Part 2
Part 1: Agenda Comparison Grid
Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas.
You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment.
Identify the Population Health concern you selected.
Mental Health Issue (Depression)
Describe the Population Health concern you selected and the factors that contribute to it.
Depression is the foremost cause leading young population to death in the USA. According to Cockerham, depression is a mental disorder, which is caused by psychological, persistent social and biological pain. This leads to disinterest of social life and committing suicide. Yet, if depression is not treated, it may lead to dementia, stroke and heart attack. In the past six to ten years, researchers such as Disease Control and Prevention found that youngsters at the age of 18 to 24 years, experience depression and going through suicidal thoughts. Unlike citizens 45 to 65 years of age, reports have reported that deaths among these particular group have been significantly rising. Mental health illnesses have brought many US presidents attention, which most of them have taken various steps allowing easy access to treatments and medicines.
Administration (President Name)
(Current President)
Donald Trump
(Previous President)
Barack Obama
(Previous President)
George W. Bush
Describe the administrative agenda focus related to this issue for the current and two previous presidents.
- To renovate the Patient Protection and Affordable Care Act, president Donald Trump came up with a different strategy, a new healthcare bill.
- Diminishing the amount of Medicaid is one of the undertaken steps of Donald Trump’s administration. This way, insurance plan will only cover substance use and mental issues meanwhile majority of them depend on low income.
- Obama signed an act, the Patient Protection and Affordable Care Act. It is also known to be Obamacare, allowing the extension of federal mental parity to Medicaid.
- The purpose of the act is to support people with mental illnesses and people who are disable. In 2010, president Obama signed the Frank Melville Supportive Housing Investment Act.
- In 2002, George W Bush shaped a commission, which involved experts in the mental health field.
- President George W Bush wanted to bring the anguishes undergone by mentally ill citizens to an end. President George W Bush signed the Pete Domenici Mental Health Parity and Addictions Equity Act in 2008. An all-inclusive law that covers health insurance. The act states .
Rx16 tpp tues_330_1_gavin_2saddy_3gastfriend
This document summarizes a presentation on advances in treating chronic pain and addiction. It includes:
- Presenters from PRIUM, American Airlines, and the Treatment Research Institute
- Learning objectives around chronic pain, psychosocial issues, Medicaid requirements for the ASAM Criteria, and implementing the criteria
- Disclosures from presenters about relevant relationships
- Overview of topics like the bidirectional relationship between physical and mental health, impacts of adverse childhood experiences, and the influence of stigma on substance use treatment
- American Airlines' workers compensation program which saw a 40% reduction in claims and lower pharmacy costs and disability after redesigning their approach to focus on early intervention and additional resources for employees with chronic
Intensive Care for Medicaid McQ Quarterly 2005
This document summarizes a McKinsey report analyzing the unsustainable growth of Medicaid costs in the United States. It finds that by 2009, Medicaid will consume more than 75% of new state revenue in some states and 25-50% in many others. While opportunities exist to capture savings, actually doing so will require difficult decisions and creative leadership given political and structural challenges. Reform is needed to put Medicaid on a more stable long-term footing while still serving those in need.
Beth Kljajic Thesis 5-19-09
The document explores implementing mandatory advance health care directives for Medicare beneficiaries as a strategy to reduce astronomical end-of-life medical costs. It notes that without changes, Medicare spending could grow to over 1/3 of GDP by 2030 as baby boomers age. Advance directives allow people to outline their end-of-life wishes in case they become incapacitated. The document argues this could help control costs by limiting unnecessary or unwanted intensive end-of-life treatments for the 5% of Medicare beneficiaries who account for 30-35% of total spending in their final year. It also examines the political and economic implications of making advance directives mandatory for all Medicare recipients.
Medicaid Update - SCHA
The document discusses Medicaid expansion in South Carolina. It provides background on Medicaid and outlines some of the key debates around expansion in the state. It notes that the Supreme Court ruled the Medicaid expansion optional for states. It then discusses reasons for and against expansion in South Carolina, including costs and economic impacts. It concludes by outlining strategies for advocating for expansion.
Teach in jun17
The health care debate - up to date as of June 15, 2017
1) Health care troubles, 2) ACA accomplishments and problems, 3) 20 AHCA characteristics and problems, 4) Single payer as solution
The State of Mental Health as We Know it
The document discusses the state of mental health in the United States. It notes that in 2018, mental health issues among youth worsened while access to services increased, though over half of mentally ill Americans do not receive treatment. While 2017 saw breakthroughs in areas like genetics and technology that could help reduce doctor visits, translating these discoveries into public health plans is urgently needed, as indicated by statistics on conditions like schizophrenia, bipolar disorder, and anxiety disorders. According to the CDC, around 1 in 5 American adults experiences a mental illness each year, resulting in over $193 billion in lost earnings annually due to serious cases.
CORONAVIRUS FEARS AND MACROECONOMIC EXPECTATIONSCarola Bin
CORONAVIRUS FEARS AND MACROECONOMIC EXPECTATIONS
Carola Binder*
Abstract—The Federal Reserve cut interest rates on March 3, 2020, in re-
sponse to COVID-19. On March 5 and 6, I surveyed over 500 consumers
about their concerns about COVID-19, awareness of the Fed’s announce-
ment, and macroeconomic expectations. Most consumers were concerned
about effects of COVID-19 on the economy, their health, and their per-
sonal finances. About 38% were aware that the Fed had cut interest rates.
Greater concern is associated with higher inflation expectations and more
pessimistic unemployment expectations. I informed respondents about the
Fed’s announcement, which led some consumers to become more optimistic
about unemployment and revise inflation expectations downward.
I. Introduction
ON March 3, 2020, the Federal Reserve lowered the fed-eral funds rate target by 50 basis points to a range of 1%
to 1.25%. This was the first rate cut made outside of a regu-
larly scheduled Federal Open Markets Committee (FOMC)
meeting since 2008. The FOMC statement noted that “the
fundamentals of the U.S. economy remain strong. However,
the coronavirus poses evolving risks to economic activity … .
The Committee is closely monitoring developments and their
implications for the economic outlook and will use its tools
and act as appropriate to support the economy.”
In the press conference associated with the rate cut, chair-
man Jerome Powell added that the policy move would “help
boost household and business confidence.” The spread of
COVID-19 (coronavirus) is not neatly classified as either a
demand or a supply shock (Cochrane, 2020), but it may re-
sult in both “practical and psychological” demand shocks,
if consumers are prevented from getting to stores or post-
pone purchases in the face of huge uncertainty (Baldwin &
di Mauro, 2020).
On March 5 and 6, 2020, I conducted an online survey
using Amazon Mechanical Turk, a Web service that allows
requesters to post small tasks in exchange for a posted mon-
etary payment.1 I surveyed US consumers ages 18 and over
about their attention to and concerns about the coronavirus,
the news they heard about the Fed, and their expectations of
inflation and unemployment. I then provided the respondents
with the March 3 FOMC statement and information about
the rate cut and resolicited their expectations of inflation and
unemployment. I also collected information about respon-
dents’ demographics, numeracy, news sources, attention to
the stock market, and confidence in the Fed and the presi-
Received for publication March 13, 2020. Revision accepted for publica-
tion April 22, 2020. Editor: Olivier Coibion.
∗Binder: Haverford College.
This research received funding from the Haverford College faculty re-
search fund.
A supplemental appendix is available online at http://www.mitpress
journals.org/doi/suppl/10.1162/rest_a_00931.
1Mechanical Turk allows for recruitment of subject pools that are more
nationally representative than t ...
Medicare-For-All Brief
Healthcare will be one of the central issues of the 2020 election and Medicare-For-All will drive much of that debate. In a review of twenty-eight national surveys conducted over the last two years, I have attempted to decipher how voters view the issue of Medicare-For-All.
Question How is mental health provided in the United.docx
Mental health services in the US are provided through a variety of public and private options, though access remains inadequate, especially for low-income individuals. While the Affordable Care Act expanded Medicaid coverage for mental health, millions remain uninsured. Costs of untreated mental illness amount to over $500 billion annually in the US. Major drivers of high healthcare costs in the US include third-party payments, growth of expensive new technologies, an aging population, a focus on medical treatment over prevention, and high administrative expenses. Improving access to mental healthcare and reducing unnecessary spending could help address these challenges.
Medicare Spending Report
The document discusses Medicare spending in the United States. It reports that Medicare spending was reduced to 0.2% in 2013 compared to 1.8% between 2009-2012. This decrease may have resulted from the recession limiting spending, delivery system reforms to improve quality while reducing local costs, or a focus on patient-centered care. Statistical data from Medicare budget reports is cited to support the claims around reduced spending.
Health policies in u.s.a
The United States health care system is a multi-payer system with both private and public insurance plans. About 62% of Americans receive health insurance through their employers, while 18% are uninsured. Major public programs include Medicare for the elderly and disabled, Medicaid for low-income individuals, and the State Children's Health Insurance Program. These programs are financed through taxes and premiums paid by individuals, businesses, and various levels of government. While the U.S. spends more on health care than any other country, many Americans remain uninsured, costs are very high, and the system ranked 37th globally in 2000. Recent health reform aims to expand coverage and regulate insurers.
Rob Stone On Single Payer 10 24 09
The document discusses issues with the current US healthcare system including lack of insurance leading to poorer health outcomes, rising costs of premiums and medical bankruptcy. It argues the US spends much more than other countries on healthcare administration due to its complex private insurance system but gets lower quality outcomes. The document advocates for a single-payer healthcare system to provide universal coverage and lower costs.
3 postsRe Topic 4 DQ 1The US health system is complex and c.docx
3 posts
Re: Topic 4 DQ 1
The US health system is complex and can be difficult to understand. The system is run by different organizations of private and public entities. Public health system service provision is done mainly by the government working collaboratively with the community nonprofit and faith-based organizations (Green, 2018). Private health care is provided in hospitals, outpatients, mental health, home care, wellness center, long term or residential and other alternative medicine setting (Green, 2018). Nurses, physicians and other professionals are responsible for providing services to patients both in the private and public sector (Kahn, 2011).
According to the National Health Expenditures in 2014, 48 % of health care spending came from private funds, with 28% coming from households and 20 % from coming from private businesses. Financing of health care remains a big challenge in the United States. It is a major topic of debate everyday by politicians, insurance companies and those receiving services. One main method of financing is individuals must pay out of their pocket for services they receive, and most people cannot afford the cost. Most people can receive health service through their health insurance coverage. Health insurance is provided by the government or private company to ensure payment is made for healthcare services such as illnesses, injuries and health conditions (De lew et al. 1992).
Although, the US have the highest expenditure in the world for the provision of health service, however, they do not perform particularly well in terms of gross health outcome (Ridic et al. 2012). The main contributor in the weakness of the American health care outcomes is the fact there are 42 million of American without healthcare insurance. (De lew et al. 1992). This impedes a lot of people to access health care when most needed particularly people on low income bracket. They go to hospital when they are very sick. Another issue with health care provision in America is the inability to control of cost. The advantage of the America health care system is the advanced state of technology. Premature babies have high chance of survival in the US because of advanced technology, high life expectancy after 80 years compares to other countries and US is world leader in pharmaceutical innovation (Ridic et al. 2012).
The reforms resulting from the Affordable Care Act (ACA) over the past years have led to increase in health care coverage. According to Martin et al. (2014), about 20 -22 million individuals have obtained health care insurance since 2010 through the expansion of Medicaid and other policy adjustment. However, there still more than 25 million of US residents without health insurance. It is hoped that health care professionals, politicians and the general public will conclude that health care is a basic right for every person and not a privilege for few people. The solution to achieve this goal is a justified cause for modern.
Lesson 6 Mental Healthcare FinancingReadings Frank, R, Glie.docx
Lesson 6: Mental Healthcare Financing
Readings:
Frank, R, Glied, S. (2006). Changes in mental health financing since 1971: Implications for policymakers and patients. Health Affairs 25(3): 601-613.
Garland, R.I., Lave, J.R. & Donohue, J.M. (2010). Health reform and the scope of benefits for mental health and substance use disorder services. Psychiatric Services 61(11): 1081 – 1086.
Druss, B (2006). Rising mental health costs: What are we getting for our money? Health Affairs 25(3): 614-622.
Scheffler, RM, Eisenberg, D (2004). How money makes its way through the mental health system. Family Therapy Magazine March/April 2004: 12-19.
Insurance Market Reforms in the Patient Protection & Affordable Care Act and the Health Care & Education Reconciliation Act, Bazelon Mental Health Law Center http://www.bazelon.org/LinkClick.aspx?fileticket=rLF-G4_8dbw%3d&tabid=137.
Scan:
Barry, C.L., Huskamp, H.A. & Goldman, H.H. (2010). A Political History of Federal Mental Health and Addiction Insurance Parity. Milbank Quarterly 88(3): pp. 404-433.
Readings also of interest:
Honberg, R., Diehl, S., Kimball A., Gruttadaro, D., & Fitzpatrick, M. (2011). State mental health cuts: A national crisis. NAMI. http://www.nami.org/ContentManagement/ContentDisplay.cfm?ContentFileID=126233
Kliff, S. (December 17, 2012). Seven facts about America’s mental healthcare system. Washington Post. Retrieve at: http://www.washingtonpost.com/blogs/wonkblog/wp/2012/12/17/seven-facts-about-americas-mental-health-care-system/
Introduction
There are many sources of financing for mental health care in both the private and public sectors. Private sector financing includes private insurance, out-of-pocket payment and a modest amount of charitable and philanthropic sources (Garfield, 2011). In addition, the Patient Protection and Affordable Care Act (ACA) passed in 2010, which was discussed last week, will have a substantial impact on behavioral health financing.
The amount of funding for behavioral health care is substantial. Including those for the Affordable Care Act, private and public expenditures for mental health and substance abuse treatment are expected to be around $280.5 billion by 2020, an increase in spending from $171.7 billion in 2009. Growth in expenditures, however, will trail behind that of health care in general. This lesson will briefly discuss financing of the public mental health system.
Public sector financing includes Medicaid, Medicare and other sources of funding support at the federal, state and local level. The largest amount of funding from other public sources is primarily from the federal level, the Community Mental Health Services Block Grant. On the substance abuse side, the Substance Abuse Prevention and Treatment Block Grant is also a large source of financing.
Why examine the public mental health system? Garfield (2011) notes that there are differences in financing between general health and behavioral health in that “public s ...
Naked Hospital
Transparency has become even more important in the past year as we begin the health care reform discussion. There is not a signature event in Nashville to bring quality, marketing, transparency, and technology together. The Naked Hospital event will take the user experience from high level strategy through national and state legislative issues through practical hands on tools to walk away with. The event will focus on how and why health systems and hospitals should focus on quality reporting as well as financial reporting. At the end of the day, all of this puts additional strains on the information systems and resources deployed by most health systems and hospitals. How will they cope? What is the next step?
Doctors' Note on Medicare
This document is a letter from Republican physicians in Congress providing 10 facts about the challenges facing the Medicare program. It summarizes that Medicare costs have grown unsustainably, the program will face insolvency in the near future, and reforms are needed to strengthen and protect Medicare for current and future seniors. The letter aims to further an informed discussion about adopting bipartisan solutions to these issues.
1.In the article below, Michigan is offering financial incentive.docx
1.
In the article below, Michigan is offering financial incentives to improve health. Using economic model(s) demonstrate the impact of such policy on efficiency of the medical care system.
Public Health & Policy
Michigan Ties Behavior Change to Medicaid
Published: Jun 12, 2014
By Phil Galewitz , Kaiser Health News
Delayed by state lawmakers, Michigan did not expand Medicaid until the day after the federal online insurance exchange closed March 31 -- a move advocates feared would undermine signups.
Turns out, enrollment is exceeding expectations, which has pleased officials who seek to make the state among the first in the nation to add a heavy dose of "personal responsibility" to the federal-state entitlement program.
This spring, the Wolverine state became the second after Iowa to offer lower premiums and cost-sharing to recipients who agree to
do a health risk assessment with their doctor every year
and to commit to improve their health by taking steps such as quitting smoking or losing weight.
"There is a heavy consumer engagement piece in this, both in terms of finances and skin in the game, but also in terms of healthy behaviors and really trying to find ways in which we can make the population of Michigan healthier," Michigan Medicaid Director Stephen Fitton said in a briefing in Washington earlier this month. "We have a high obesity rate in Michigan. We don't do very well on some broad [health] measures, and we are really looking for ways to move the needle there."
The hope is that giving people a financial incentive to change their behaviors will improve their health and control Medicaid spending.
Other states, such as Pennsylvania, are also seeking to tie Medicaid coverage to personal responsibility by seeking federal approval for a plan that would prod unemployed people to search for jobs and get annual wellness exams in exchange for lower premiums.
In an effort to give Medicaid recipients more "skin in the game," as proponents call it, most newly eligible Michigan recipients will face
copays -- typically from $1 to $3 for most outpatient health services
. Those with incomes between 100 percent ($11,670) and 138 percent ($16,105) of the federal poverty level will also pay a premium of 2% of their income.
While many states impose similar cost-sharing, Michigan will be the first to ask enrollees to make those payments -- either copays or premiums or both -- through a health savings account.
Indiana Gov. Mike Pence, a Republican, has also recently proposed health savings accounts
as part of his Medicaid expansion plan.
Both the state of Michigan and individuals and potentially, their employers, will be asked to deposit money into those accounts based on enrollees' copays in the prior six months. If funds are left at the end of the year, they will be rolled over. If a beneficiary becomes ineligible for Medicaid, the balance will be put into a voucher they can use to buy private insurance.
Joan Alker, executive director of the Geo.
case analysis affordable care act
This document provides an analysis of the Patient Protection and Affordable Care Act (ACA). It discusses the goals and implementation of the ACA, including expanding health insurance coverage and controlling costs. It also examines the impacts of the ACA on various stakeholders in the healthcare system, such as hospitals, long-term care facilities, doctors, and patients. Challenges in implementing the ACA are also assessed, like increasing access to care and addressing shortages of primary care physicians.
Analysis of the Patient Protection and Affordable Care Act
This document provides an analysis of the Patient Protection and Affordable Care Act (ACA). It summarizes the goals of the ACA to increase availability of healthcare and reduce costs. It also discusses some of the challenges in implementing the ACA, such as people losing subsidies due to lack of documentation, narrow networks limiting choice of providers, and effects on jobs from the employer mandate. The document also compares the US healthcare system to Canada's single-payer system and their differences in achieving universal coverage, cost containment, and other factors.
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Analysis of the Patient Protection and Affordable Care Act
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Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
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Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
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The Nervous and Chemical Regulation of Respiration
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
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Final Presentation
- 1. U.S. Policy - 2009 Three Party Payer System – Insurers, Managers, recipients Majority of people insured through employers 45.6 million uninsured Gov’t enabled Medicare + Medicaid + COBRA
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- 3. Finances2
- 5. Mental Health: Changes in 2020 Quantify the severity of Mental Illnesses, yet treating people based on their symptoms. Predict the onset of mental health issues so as to plan accordingly- advanced screening
- 6. Going About the Change Triple Checkpoint System – Common first checkpoint; move to specifics First two steps require a significant amount of resources