Changeset 21610 in main


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Timestamp:
09/21/20 18:43:43 (5 weeks ago)
Author:
Katherine Benson
Message:

Updated text and content for Insurance health topic.

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1 edited

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  • adopters/hi/branches/2.3/src/main/webapps/ibisph-view-content/xml/topic/html_content/Insurance.xml

    r18891 r21610  
    1919                        <TITLE>Description</TITLE>
    2020                        <CONTENT>
    21                                 Health insurance is a contract between an individual and an insurance company. The insurance
    22                                 plan specified in the contract provides part or complete payment of specified health care costs
    23                                 for the enrollee(s). Coverage of health care costs depends on the plan. Some plans are provided
    24                                 by employers, some by government programs such as Medicare, and others are purchased directly by
    25                                 individuals from insurance companies.
    26                                 <br/><br/>
    27                                 Health care spending includes the costs of obtaining a wide variety of goods and services, from
    28                                 hospital care and prescription drugs to dental services and medical equipment. Most health care
    29                                 spending is for care provided by hospitals and physicians.
     21                                Access to comprehensive, quality health care services is important for promoting and maintaining
     22                                health, preventing and managing disease, reducing unnecessary disability and premature death, and
     23                                achieving health equity for all Americans. Three components of access to consider are: insurance
     24                                coverage, availability of services (both geographically and timewise), and finding a health care
     25                                provider that the patient trusts (personal relationship).
     26                                <br/><br/>
     27                                Health insurance is a contract between an individual and an insurance company. The insurance plan
     28                                specified in the contract provides part or complete payment of specified health care costs for the
     29                                enrollee(s). Coverage of health care costs depends on the plan. Some plans are provided by employers,
     30                                some by government programs such as Medicare, and others are purchased directly by individuals from
     31                                insurance companies. The Hawaii Prepaid Health Care Act specifies that employees who work at least
     32                                20 hours per week for four consecutive weeks are entitled to health care coverage where the employer
     33                                pays at least half of the premium.
    3034                        </CONTENT>
    3135                </ibis:ExpandableContent>
     
    3438                        <TITLE>Why It's Important</TITLE>
    3539                        <CONTENT>
    36                                 Most people need medical care at some time in their lives. Medical care is often quite expensive
    37                                 and is becoming more expensive. Health insurance covers all or some costs of care and protects people
    38                                 from very high expenses. People without health coverage have to cover all costs. This can sometimes
    39                                 lead people into debt or even bankruptcy. Rising health care costs make insurance less affordable
    40                                 for individuals, families, and businesses.
     40                                Most people need health care at some time in their lives. Health care includes medical care, oral
     41                                health care and mental health care and is becoming more expensive. Health insurance covers all or
     42                                some costs of care and protects people from very high expenses. People without health coverage have
     43                                to cover all costs. This can sometimes lead people into debt or even bankruptcy. Rising health care
     44                                costs make insurance less affordable for individuals, families, and businesses.
    4145                                <br/><br/>
    4246                                People without health insurance are more likely to lack a usual source of medical care, such as a
    43                                 primary care provider. They more often skip routine and preventive medical care thus increasing their
    44                                 risk for developing serious and disabling health conditions that cost more to treat.
     47                                primary care provider. More often than not, they skip routine and preventive medical care thus
     48                                increasing their risk for developing serious and disabling health conditions that cost more to treat
     49                                and can result in premature death.
    4550                                <br/><br/>
    4651                                Concerns about rising health care costs and affordability of health care insurance led to enactment
    4752                                of the Affordable Care Act, or ACA. The key challenge moving forward will be finding the best mix of
    48                                 policies that promote health and prevent illness, and also ensure that government, corporate, and private
    49                                 health spending is as efficient as possible and best meets the health care needs of the nation.
     53                                policies that promote health and prevent illness, while also ensuring that government, corporate, and
     54                                private health spending is as efficient as possible and best meets the health care needs of the nation.
    5055                        </CONTENT>
    5156                </ibis:ExpandableContent>
     
    5459                        <TITLE>What Is Known</TITLE>
    5560                        <CONTENT>
    56                                 Health care costs per capita in the U.S. grew an average 2.4 percentage points faster than the GDP
    57                                 from 1970 to 2012. In addition, the share of economic activity (gross domestic product, or GDP)
    58                                 devoted to health care has increased from 7.2% in 1970 to 17.9% in 2010. In 2010, the U.S. spent
    59                                 $2.6 trillion on health care, an average of $8,402 per person. Many experts believe that new
    60                                 technologies and the spread of existing ones account for a large portion of medical spending and its
    61                                 growth. The U.S. spends substantially more on health care than other developed
    62                                 countries.<span class="SmallerFont"><sup><a href="#ref1">1</a></sup></span>
    63                                 Though the rapid growth in spending for prescription drugs has received considerable
    64                                 attention recently, as of 2010, it accounted for 10% of total costs. Private funds are the largest
    65                                 contributor to health care payments (55% in 2010 compared to 45% from government funds).
     61                                Health care costs per capita in the U.S. grew an average 2.4 percentage points faster than the GDP from
     62                                1970 to 2012. Although this rapid increase has leveled off in recent years, the share of economic activity
     63                                (gross domestic product or GDP) devoted to health care was 17.9% in 2017 compared to 7.2% in 1970. In 2017,
     64                                the U.S. spent $3.5 trillion on health care, an average of $10,739 per person. Many experts believe that
     65                                new technologies and the spread of existing ones account for a large portion of medical spending and its
     66                                growth. The U.S. spends substantially more on health care than other developed countries.1 Though the rapid
     67                                growth in spending for prescription drugs has received considerable attention recently, as of 2017, it
     68                                accounted for 10% of total costs. The largest shares of total health spending in 2017 were paid for by the
     69                                federal government and households (28% each) followed by private business (20%), state and local governments
     70                                (17%) and other private revenues (7%).
    6671                                <br/><br/>
    6772                                Health care expenditures in Hawaii have historically been lower and have grown more slowly than expenditures
     
    7075                                advancements, and the limits of managed care to contain costs may cause per capita expenditures to rise.
    7176                                As a percentage of per capita income, per capita expenditures for medical care slowly increased from 1993
    72                                 to 2009.
     77                                to 2014.
    7378                                <br/><br/>
    7479                                Health care insurance costs more today than ever. Health insurance premium increases have consistently
    75                                 outpaced inflation and the growth in workers' earnings. And families are also paying more out-of-pocket
     80                                outpaced inflation and the growth in workers' earnings. Families are also paying more out-of-pocket
    7681                                for health care. Concurrently, employer shares of payroll going toward health insurance costs continue
    7782                                to rise. In addition, eligibility standards for public programs such as Medicaid and CHIP do not keep
    7883                                pace with rapid increases in the cost of health coverage.
    79                                 <br/><br/>
    80                                 <hr/>
    81                                 <div class="SmallerFont">
    82                                         <a name="ref1"></a>1. Health Care Costs: A Primer, Kaiser Family Foundation. (2012).
    83                                         Downloaded on 8/7/2014 from <a href="http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7670-03.pdf">
    84                                         http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7670-03.pdf</a>.
    85                                         <br/>
    86                                 </div>
    8784                        </CONTENT>
    8885                </ibis:ExpandableContent>
     
    9996                                status declines, there is more need for medical services. Those with worse health use medical services
    10097                                more often. Women have higher medical services utilization than men.
     98                                <br/><br/>
     99                                Data from the <a href="https://www.cdc.gov/nchs/healthy_people/hp2020/hp2020_midcourse_review.htm">
     100                                Healthy People Midcourse Review</a> demonstrate that there are significant disparities in access to
     101                                care by sex, age, race, ethnicity, education, and family income. These disparities exist with all
     102                                levels of access to care, including health and dental insurance, having an ongoing source of care,
     103                                and access to primary care. Disparities also exist by geography, as millions of Americans living in
     104                                rural areas lack access to primary care services due to workforce shortages.
    101105                        </CONTENT>
    102106                </ibis:ExpandableContent>
     
    105109                        <TITLE>How To Reduce Risk</TITLE>
    106110                        <CONTENT>
    107                                 Numerous studies show that a disproportionate share of health spending is used to treat chronic and often
    108                                 preventable diseases and conditions. Efforts to improve population health could have a long-term effect
    109                                 on disease prevalence and help reduce health care spending. Many of the Affordable Care Act (ACA)
    110                                 provisions are an attempt to reduce the risk of illness and injury so that people won't require high
    111                                 cost health care in the first place. A critical component of the ACA was the creation of the National
    112                                 Prevention Council and the development of the nation's first ever National Prevention and Health Promotion
    113                                 Strategy.<span class="SmallerFont"><sup><a href="#ref2">2</a></sup></span> The strategies are designed to move us from a system of sick
    114                                 care to one based on wellness and prevention.<br/>
    115                                 <br/>
    116                                 The plan outlines 4 Strategic Directions:
    117                                 <br/>
    118                                 <ol class="Indent">
    119                                         <li>Healthy and Safe Community Environments</li>
    120                                         <li>Clinical and Community Preventive Services</li>
    121                                         <li>Empowered People</li>
    122                                         <li>Elimination of Health Disparities</li>
    123                                 </ol><br/>
    124                                 It includes 7 Priorities:
    125                                 <br/>
    126                                 <ol class="Indent">
    127                                         <li>Tobacco Free Living</li>
    128                                         <li>Preventing Drug Abuse and Excessive Alcohol Use</li>
    129                                         <li>Healthy Eating</li>
    130                                         <li>Active Living</li>
    131                                         <li>Injury and Violence Free Living</li>
    132                                         <li>Reproductive and Sexual Health</li>
    133                                         <li>Mental and Emotional Well-Being</li>
    134                                 </ol><br/>
    135                                 Other ACA provisions address health care costs and the ability of individuals to afford those costs including:
     111                                Healthy People 2020 states that future efforts will need to focus on the deployment of a primary care
     112                                workforce that is better geographically distributed and trained to provide culturally competent care
     113                                to diverse populations.
     114                                <br/><br/>
     115                                Specific issues that should be monitored over the next decade include:
    136116                                <br/>
    137117                                <ul class="Indent">
    138                                         <li>Changes to the way health coverage and health care are provided in public and private settings</li>
    139                                         <ul class="Indent">
    140                                                 <li>A requirement (with some exceptions) that people obtain health insurance</li>
    141                                                 <li>Creates new sources of coverage through health insurance exchanges</li>
    142                                                 <li>Provides for premium and cost-sharing subsidies for those with low incomes</li>
    143                                                 <li>Significantly expands Medicaid eligibility</li>
    144                                                 <li>Makes changes designed to slow the growth of Medicare spending</li>         
    145                                         </ul>   
    146                                         <li>Short-term cost containment provisions</li>
    147                                         <ul class="Indent">
    148                                                 <li>Reduces payments to providers for Medicare services</li>
    149                                                 <li>Eliminates unnecessary costs such as fraud and abuse in Medicare and Medicaid</li>
    150                                                 <li>Simplifies health insurance administration by creating uniform electronic standards and
    151                                                         operating rules for all private insurers, Medicare, and Medicaid</li>
    152                                                 <li>Establishes an approval process for generic biologic agents</li>
    153                                         </ul>
    154                                         <li>Long-term cost containment provisions</li>
    155                                         <ul class="Indent">
    156                                                 <li>Creates the Center for Medicare and Medicaid Innovation to evaluate experimental models</li>
    157                                                 <li>Establishes a new Independent Payment Advisory Board to recommend ways to slow the growth in
    158                                                         private nation health expenditure while preserving or enhancing quality of care</li>
    159                                                 <li>Creates a private Patient-Centered Outcomes Research Institute to identify and conduct research,
    160                                                         and disseminate results</li>
    161                                                 <li>Implements an excise tax on high-cost employer-sponsored health plans designed to encourage
    162                                                         employers to make their plans more efficient and to encourage workers to use fewer services</li>
    163                                         </ul>
     118                                        <li>Increasing and measuring insurance coverage and access to the entire care continuum (from
     119                                        clinical preventive services to oral health care to long-term and palliative care)</li>
     120                                        <li>Addressing disparities that affect access to health care (e.g., race, ethnicity, socioeconomic
     121                                        status, age, sex, disability status, sexual orientation, gender identity, and residential location)</li>
     122                                        <li>Assessing the capacity of the health care system to provide services for newly insured individuals</li>
     123                                        <li>Determining changes in health care workforce needs as new models for the delivery of primary care
     124                                        become more prevalent, such as the patient-centered medical home and team-based care</li>
     125                                        <li>Monitoring the increasing use of telehealth as an emerging method of delivering health care</li>
    164126                                </ul>
    165                                 <br/>
    166                                 <hr/>
    167                                 <div class="SmallerFont">
    168                                         <a name="ref2"></a>2. National Prevention Strategy. National Prevention Council. (2011). Washington,
    169                                         DC: U.S. Department of Health and Human Services, Office., downloaded on 8/7/2014 from
    170                                         <a href="http://www.surgeongeneral.gov/priorities/prevention/strategy/report.pdf">
    171                                         http://www.surgeongeneral.gov/priorities/prevention/strategy/report.pdf</a>.
    172                                         <br/>
    173                                 </div>
    174127                        </CONTENT>
    175128                </ibis:ExpandableContent>
     
    191144                                                Interview Survey (NHIS)</a> -  state level estimates for 43 states</li>
    192145                                        <li>The <a href="https://meps.ahrq.gov/survey_comp/household.jsp">Medical Expenditure
    193                                                 Panel Survey - Household Component (MEPS-HS)</a></li>
     146                                                Panel Survey - Household Component (MEPS-HC)</a></li>
    194147                                </ol>
    195148                                <br/>
     
    295248                                <ibis:SelectionsList>
    296249                                        <SELECTION>
    297                                                 <TITLE>Care Giving - helped someone, past 30 days</TITLE>
    298                                                 <LOCAL_URL>query/result/brfss/CareGiver/CareGiverCrude11_.html</LOCAL_URL>
    299                                         </SELECTION>
    300                                         <SELECTION>
    301                                                 <TITLE>Care Giving - managed household tasks in the past 30 days</TITLE>
    302                                                 <LOCAL_URL>query/result/brfss/CareGiveHouse/CareGiveHouseCrude11_.html</LOCAL_URL>
    303                                         </SELECTION>
    304                                         <SELECTION>
    305                                                 <TITLE>Care Giving - managed personal care in the past 30 days</TITLE>
    306                                                 <LOCAL_URL>query/result/brfss/CareGivePersCare/CareGivePersCareCrude11_.html</LOCAL_URL>
    307                                         </SELECTION>
    308                                         <SELECTION>
    309                                                 <TITLE>Care Giving - average hours per week providing assistance</TITLE>
    310                                                 <LOCAL_URL>query/definition/result/brfss/brfss_CareGiveHours_CareGiveHoursCrude11_.html</LOCAL_URL>
    311                                         </SELECTION>
    312                                         <SELECTION>
    313                                                 <TITLE>Care Giving - length of time providing care</TITLE>
    314                                                 <LOCAL_URL>query/definition/result/brfss/brfss_CareGiveLength_CareGiveLengthCrude11_.html</LOCAL_URL>
    315                                         </SELECTION>
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