democracy is a work in progress
Sources2021-05-27T13:56:27-05:00

Sources

Key Takeaways

Max Roser, “Why is life expectancy in the US lower than in other rich countries?”, Our World in Data, Oct 29, 2020, https://ourworldindata.org/us-life-expectancy-low, accessed May 21, 2021

Credit Suisse, “Global wealth report”, Oct 2020, https://www.credit-suisse.com/about-us/en/reports-research/global-wealth-report.html, accessed Apr 9, 2021

Kenneth D. Kochanek, M.A., Robert N. Anderson, Ph.D., and Elizabeth Arias, Ph.D., “Changes in life expectancy at birth 2010-2018”, CDC, Jan 2020, https://www.cdc.gov/nchs/data/hestat/life-expectancy/lifeexpectancy-H.pdf, accessed Apr 9, 2021

Papanicolas, L.R. Woskie, A.K. Jha, “Health care spending in the United States and other high-income countries”, JAMA, Mar 13, 2018, 1024-1039, https://www.ncbi.nlm.nih.gov/pubmed/29536101, synopsis: https://www.commonwealthfund.org/publications/journal-article/2018/mar/health-care-spending-united-states-and-other-high-income, accessed Feb 25, 2020

Rabah Kamal, Giorlando Ramirez, and Cynthia Cox, “How does health spending in the US compare to other countries?”, Health System Tracker, Dec 23, 2020, https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-spendingcomparison_gdp-per-capita-and-health-consumption-spending-per-capita-2019, accessed Mar 24, 2021

Eli Saslow, “‘Out here, it’s just me’: In the medical desert of rural America, one doctor for 11,000 square miles”, Washington Post, Sep 29, 2019, https://www.washingtonpost.com/national/out-here-its-just-me/2019/09/28/fa1df9b6-deef-11e9-be96-6adb81821e90_story.html, accessed Feb 24, 2020

Simon F. Haeder, “US health care system: A patchwork that no one likes”, The Conversation, Oct 18, 2017, https://theconversation.com/us-health-care-system-a-patchwork-that-no-one-likes-85252, accessed Apr 8, 2021

Patrick G. Lee, “Who Makes Sure Hospital Mergers Do No Harm? Almost Nobody.”, ProPublica, Jun 9, 2016, https://www.propublica.org/article/who-makes-sure-hospital-mergers-do-no-harm-almost-nobody, accessed Apr 8, 2021

Joe Eaton and M.B. Pell, “Lobbyists swarm Capitol to influence health reform”,  Center for Public Integrity, May 19, 2014, https://publicintegrity.org/health/lobbyists-swarm-capitol-to-influence-health-reform/, accessed Mar 24, 2021

Problem Definition

Advisory Board, “Who’s underinsured in America, in 4 charts”, Feb 8, 2019, https://www.advisory.com/en/daily-briefing/2019/02/08/underinsured, accessed May 18, 2021

Problem Scope

Robin A. Cohen, Michael E. Martinez, Brian W. Ward, “Health insurance coverage: Early release of estimates from the National Health Interview Survey, 2009”, National Center for Health Statistics, Jun 2010, https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201006.htm, accessed Apr 1, 2020

Edward R. Berchick, Jessica C. Barnett, And Rachel D. Upton, Health Insurance Coverage in the United States: 2018, US Census Bureau, Nov 2019, https://www.census.gov/content/dam/Census/library/publications/2019/demo/p60-267.pdf, accessed Apr 2, 2020

“US health insurance coverage in 2020: A looming crisis in affordability”, The Commonwealth Fund, Aug 19, 2020, https://www.commonwealthfund.org/publications/issue-briefs/2020/aug/looming-crisis-health-coverage-2020-biennial, accessed Mar 24, 2021

Lydia Saad, “More Americans Delaying Medical Treatment Due to Cost”, Gallup, Dec 9, 2019, https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx, accessed Apr 2, 2020

American Cancer Society, “Medical costs create hardships for more than half of Americans: 137 million adults in the United States suffered medical financial hardship in 2015/2017”, Science Daily, May 2,2019, https://www.sciencedaily.com/releases/2019/05/190502100818.htm, accessed Apr 2, 2020

Centers for Medicare and Medicaid Services, “Historical”, Last modified Dec 17, 2019, https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical, accessed Feb 25, 2020

Susan L. Hayes, Sara R. Collins, David C. Radley, “How Much U.S. Households with Employer Insurance Spend on Premiums and Out-of-Pocket Costs: A State-by-State Look”, The Commonwealth Fund, May 23, 2019, https://www.commonwealthfund.org/publications/issue-briefs/2019/may/how-much-us-households-employer-insurance-spend-premiums-out-of-pocket, accessed Apr 8, 2020

Rabah Kamal, Giorlando Ramirez, Cynthia Cox, “How does health spending in the U.S. compare to other countries?”, Peterson-KFF, Dec 23, 2020, https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-spendingcomparison_health-consumption-expenditures-per-capita-2019, accessed May 18, 2021

Consensus study report, “U.S. health in international perspective: shorter lives, poorer health”, National Academies Press, 2013, https://www.nap.edu/catalog/13497/us-health-in-international-perspective-shorter-lives-poorer-health, press release: http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=13497, accessed Feb 25, 2020

Papanicolas, L.R. Woskie, A.K. Jha, “Health care spending in the United States and other high-income countries”, JAMA, Mar 13, 2018, 1024-1039, https://www.ncbi.nlm.nih.gov/pubmed/29536101, synopsis: https://www.commonwealthfund.org/publications/journal-article/2018/mar/health-care-spending-united-states-and-other-high-income, accessed Feb 25, 2020

Diane Archer, “Medicare is more efficient than private insurance”, Health Affairs, Sep 20, 2011, https://www.healthaffairs.org/do/10.1377/hblog20110920.013390/full/, accessed Feb 25, 2020

Pew Charitable Trusts, “Payment policies to manage pharmaceutical costs”, Mar 16, 2017,  https://www.pewtrusts.org/en/research-and-analysis/reports/2017/03/payment-policies-to-manage-pharmaceutical-costs, accessed Feb 26, 2020

Alisa Tank, “Physician salary report 2020: Salaries rising prior to COVID-19 impacts”, Weatherby Healthcare, Jun 17, 2020, https://weatherbyhealthcare.com/blog/annual-physician-salary-report, accessed May 18, 2021

Emily Rappleye, “4 trends in physician pay”, Beckers Hospital Review, Dec 5, 2019, https://www.beckershospitalreview.com/compensation-issues/4-trends-in-physician-pay.html, accessed May 18, 2021

Greg Rosalsky, “Are Doctors Overpaid?”, NPR/Planet Money, Mar 12, 2019, https://www.npr.org/sections/money/2019/03/12/702500408/are-doctors-overpaid, accessed May 18, 2021

Reed Abelson, “When hospitals merge to save money, patients often pay more”, New York Times, Nov 14, 2018, https://www.nytimes.com/2018/11/14/health/hospital-mergers-health-care-spending.html, accessed Feb 25, 2020

Diane Archer, “No Competition: The Price Of A Highly Concentrated Health Care Market”, Health Affairs, Mar 6, 2013, https://www.healthaffairs.org/do/10.1377/hblog20130306.028873/full/, accessed May 18, 2021

Phil Galewitz, “The startlingly high cost of the ‘free’ flu shot”, Kaiser Health News, Nov 19, 2019, https://khn.org/news/the-startlingly-high-cost-of-the-free-flu-shot/, accessed Feb 25, 2020

Robert M. Pearle, MD, “Are You A Patient Or A Healthcare Consumer?”, Forbes, Oct 15, 2015, https://www.forbes.com/sites/robertpearl/2015/10/15/are-you-a-patient-or-a-health-care-consumer-why-it-matters/?sh=72c3d02f2b4d, accessed May 26, 2021

JK Wall, “Think Again: Health Insurers Have No Reason To Reduce the Price of Health Care”, The Health Care Blog, Jan 1, 2016, https://thehealthcareblog.com/blog/2016/01/01/think-again-health-insurers-have-no-reason-to-reduce-the-price-of-health-care/, accessed May 19, 2021

Marshall Allen, “Why Your Health Insurer Doesn’t Care About Your Big Bills”, NPR, May 25, 2018, https://www.npr.org/sections/health-shots/2018/05/25/613685732/why-your-health-insurer-doesnt-care-about-your-big-bills, accessed May 19. 2021

Johanna Butler, “Independent Analysis Finds Montana Has Saved Millions by Moving Hospital Rate Negotiations to Reference-Based Pricing”, National Academy for State Health Policy, Apr 5, 2021, https://www.nashp.org/new-analysis-finds-montana-has-saved-millions-by-moving-hospital-rate-negotiations-to-reference-based-pricing/, accessed May 19, 2021

Eli Saslow, “‘Out here, it’s just me’: In the medical desert of rural America, one doctor for 11,000 square miles”, Washington Post, Sep 29, 2019, https://www.washingtonpost.com/national/out-here-its-just-me/2019/09/28/fa1df9b6-deef-11e9-be96-6adb81821e90_story.html, accessed Feb 24, 2020

American Hospital Association, “AHA Rural Report: challenges facing rural communities and the roadmap to ensure local access to high-quality, affordable care”, page 5, https://www.aha.org/system/files/2019-02/rural-report-2019.pdf, accessed Feb 24, 2020

L Skinner, DO Staiger, DI Auerbach, PI Buerhaus, “Implications of an aging rural physician workforce”, New England Journal of Medicine, July 25, 2019, 299-301, https://www.ncbi.nlm.nih.gov/pubmed/31340091, accessed Feb 24, 2020

Michael Braga, Jennifer F. A. Borresen, Dak Le, Jonathan Riley, “‘Leaving billions of dollars on the table,’ rural hospitals foundering in states that declined Obamacare”, GateHouse Media, USA Today Network News, Jul 28, 2019, https://gatehousenews.com/ruralhospitals/financialtroubles/, accessed Feb 24, 2020

Karen E. Joynt, Nguyen Nguyen, Lok Wong Samson, and John E. Snyder, (ASPE) with Amanda Lechner and Omotomike Ogunwumiju (Mathematica Policy Research), “Rural hospital participation and performance in value-based purchasing and other delivery system reform initiatives”, ASPE Issue Brief, US Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, Oct 19, 2016, https://aspe.hhs.gov/pdf-report/rural-hospital-participation-and-performance-value-based-purchasing-and-other-delivery-system-reform-initiatives, accessed Feb 24, 2020

Michael Braga, Jennifer F. A. Borresen, Dak Le and Jonathan Riley, “Rural hospitals foundering in states that declined Obamacare”, Gatehouse Media/USA Today, Jul 28, 2019, https://stories.usatodaynetwork.com/ruralhospitals/financialtroubles/, accessed Apr 2, 2020

Kaiser Family Foundation, “Status of State Action on the Medicaid Expansion Decision”,  May 19, 2021, https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/?activeTab=map&currentTimeframe=0&selectedDistributions=status-of-medicaid-expansion-decision&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D, accessed May 19, 2021

American Association of Medical Colleges, “New findings confirm predictions on physician shortage”, Apr 23, 2019, https://www.aamc.org/news-insights/press-releases/new-findings-confirm-predictions-physician-shortage, accessed Feb 26, 2020

Limits to What We Know

Adam Smith, The Wealth of Nations, Amazon Kindle, loc 1278

UN Universal Declaration of Human Rights, Dec 10, 1948, https://www.un.org/en/about-us/universal-declaration-of-human-rights, accessed May 27, 2021

Larisa Antonisse, Rachel Garfield, Robin Rudowitz, Madeline Guth, “The effects of Medicaid expansion under the ACA: updated findings from a literature review”, Kaiser Family Foundation, Aug 15, 2019, https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-august-2019/, accessed Feb 25, 2020

Kyle Dropp, Brendan Nyban, “One-third don’t know Obamacare and Affordable Care Act are the same”, New York Times, Feb 7, 2017, https://www.nytimes.com/2017/02/07/upshot/one-third-dont-know-obamacare-and-affordable-care-act-are-the-same.html, accessed Mar 15, 2020

Juliette Cubanski, Tricia Neuman, Gretchen Jacobson, Cristina Boccuti, “What Are the Implications of Repealing the Affordable Care Act for Medicare Spending and Beneficiaries?” KFF, Dec 13, 2016, https://www.kff.org/health-reform/issue-brief/what-are-the-implications-of-repealing-the-affordable-care-act-for-medicare-spending-and-beneficiaries/, accessed May 27, 2021

Bob Cesca, “Keep your goddamn government hands off my Medicare!” HuffPost, Sep 5, 2009, updated Dec 6, 2017, https://www.huffpost.com/entry/get-your-goddamn-governme_b_252326, accessed Mar 15, 2020

Timothy Noah, “The Medicare-isn’t-government meme”, Slate.com, Aug 5, 2009, https://slate.com/news-and-politics/2009/08/help-slate-track-the-medicare-isn-t-government-meme.html, accessed Mar 15, 2020

Margot Sanger-Katz, “They want it to be secret: how a common blood test can cost $11 or almost $1,000”, New York Times, Apr 30, 2019, https://www.nytimes.com/2019/04/30/upshot/health-care-huge-price-discrepancies.html, accessed Feb 25, 2020

Steven‌ ‌Brill,‌ ‌“Bitter‌ ‌pill:‌ ‌why‌ ‌medical‌ ‌bills‌ ‌are‌ ‌killing‌ ‌us”,‌ ‌Time,‌ ‌Apr‌ ‌4,‌ ‌2013,‌ ‌https://time.com/198/bitter-pill-why-medical-bills-are-killing-us/, accessed‌ ‌Feb‌ ‌25,‌ ‌2020‌

Steffie Woolhandler, David U. Himmelstein, “The relationship of health insurance and mortality: is lack of insurance deadly?”, Annals of Internal Medicine, Sep 19, 2017, https://annals.org/aim/fullarticle/2635326/relationship-health-insurance-mortality-lack-insurance-deadly, accessed Feb 24, 2020

What is at Stake?

David Cecere, “New study finds 45,000 deaths annually linked to lack of health coverage”, Harvard Gazette, Sep 17, 2009, https://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage, accessed Feb 24, 2020

Benjamin D. Sommers, Katherine Baicker, Arnold M. Epstein, “Mortality and access to care among adults after state Medicaid expansions”, New England Journal of Medicine, Sep 2012, 1025-34, https://www.ncbi.nlm.nih.gov/pubmed/22830435, accessed Feb 24, 2020

Sandy McDowell, “Study: lack of insurance linked to higher breast cancer death rates in black women”, American Cancer Society, Oct 16, 2017, https://www.cancer.org/latest-news/study-lack-of-insurance-linked-to-higher-breast-cancer-death-rates-in-black-women.html, accessed Feb 24, 2020

Dan Witters, “Millions in U.S. lost someone who couldn’t afford treatment”,  Gallup, Nov 12, 2019, https://news.gallup.com/poll/268094/millions-lost-someone-couldn-afford-treatment.aspx, accessed Feb 25, 2020

Liz Hamel, Mira Norton, Karen Pollitz, Larry Levitt, Gary Claxton, Mollyann Brodie, “The burden of medical debt: results from the  Kaiser Family Foundation/New York Times medical bills survey”, Jan 2016, https://www.kff.org/wp-content/uploads/2016/01/8806-the-burden-of-medical-debt-results-from-the-kaiser-family-foundation-new-york-times-medical-bills-survey.pdf, accessed Feb 24, 2020

Steffie Woolhandler, David U. Himmelstein, “Medical bankruptcy: still common despite the Affordable Care Act”, American Journal of Public Health, March 2019, http://www.pnhp.org/docs/AJPHBankruptcy2019.pdf, accessed Feb 24, 2020

A.M. Gilligan, D.S. Alberts, D.J. Roe, G.H. Skrepnek, “Death or debt? National estimates of financial toxicity in persons with newly-diagnosed cancer”, American Journal of Medicine, Oct 2018, 1187-99, https://www.amjmed.com/article/S0002-9343(18)30509-6/fulltext, accessed Feb 25, 2020

Government Accounting Office, “The Nation’s Fiscal Health: After Pandemic Recovery, Focus Needed on Achieving Long-Term Fiscal Sustainability”, Mar 23, 2021, https://www.gao.gov/products/gao-21-275sp, accessed May 20, 2021

Congressional Budget Office, “The 2021 Long-Term Budget Outlook”, Mar 2021, https://www.cbo.gov/publication/57038, accessed May 20, 2021

Committee for a Responsible Federal Budget, “American health care: health spending and the federal budget”, May 16, 2018, https://www.crfb.org/papers/american-health-care-health-spending-and-federal-budget, accessed Feb 25, 2020

Potential Obstacles

Bradley Jones, “Increasing share of Americans favor a single government program to provide health care coverage”, Pew Research Center, Sep 29, 2020, https://www.pewresearch.org/fact-tank/2020/09/29/increasing-share-of-americans-favor-a-single-government-program-to-provide-health-care-coverage/, accessed Mar 24, 2021

Bill Adair and Angie Drobnic Holan, “PolitiFact’s Lie of the Year: ‘A government takeover of health care’”, PolitiFact, Dec 16, 2010, https://www.politifact.com/article/2010/dec/16/lie-year-government-takeover-health-care/, accessed Mar 30, 2021

Open Secrets, “Industries”, https://www.opensecrets.org/federal-lobbying/industries?cycle=a, accessed Mar 29, 2021

Adam Cancryn, “The army built to fight ‘Medicare For All’”, Politico, Nov 25, 2019, https://www.politico.com/news/agenda/2019/11/25/medicare-for-all-lobbying-072110, accessed Mar 25, 2021

Ian K. Kullgren, “Does 20% of the population really use 80% of health care dollars?”, PolitiFact, Feb 23, 2012, https://www.politifact.com/factchecks/2012/feb/23/alan-bates/does-20-percent-population-really-use-80-health-ca/, accessed Mar 30, 2021

Dr. Simon Haeder, interview with Ciara McLaren, Mar 30, 2021

Key Considerations

Congressional Budget Office, “An Update to the Budget Outlook: 2020 to 2030”, Oct 6, 2020, https://www.cbo.gov/system/files/2020-09/56517-Budget-Outlook.pdf, accessed Mar 30, 2021

Abigail Abrams, “Total cost of her COVID-19 treatment: $34,927.43”, TIME, Mar 19, 2020, https://time.com/5806312/coronavirus-treatment-cost/, accessed Mar 30, 2021

CDC, “Risk for COVID-19 infection, hospitalization, and death by race/ethnicity”, Mar 12, 2021, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html, accessed Mar 30, 2021

FAQs

Larisa Antonisse, Rachel Garfield, Robin Rudowitz, Madeline Guth, “The effects of Medicaid expansion under the ACA: updated findings from a literature review”, Kaiser Family Foundation, Aug 15, 2019, https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-august-2019/, accessed Feb 25, 2020

American Association of Medical Colleges, “New findings confirm predictions on physician shortage”, Apr 23, 2019, https://www.aamc.org/news-insights/press-releases/new-findings-confirm-predictions-physician-shortage, accessed Feb 26, 2020

Peter O’Dowd, “Rural hospitals say ‘Medicare for all’ would end up ‘closing our doors’”, Here and Now, WBUR radio, Aug 16, 2019, https://www.wbur.org/hereandnow/2019/08/16/rural-hospitals-medicare-for-all-health-care, accessed Feb 25, 2020

Chapin White, “Contrary to cost-shift theory, lower Medicare hospital payment rates for inpatient care lead to lower private payment rates”, Health Affairs, May 2013, https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2012.0332, accessed Feb. 25, 2020

Austin Frakt, “JAMA Forum: hospitals don’t shift costs from Medicare or Medicaid to private insurers”, JAMA, Jan 4, 2017, https://newsatjama.jama.com/2017/01/04/jama-forum-hospitals-dont-shift-costs-from-medicare-or-medicaid-to-private-insurers/, accessed Feb 25, 2020

Michael D. Frakes, Jonathan Gruber, “Defensive medicine: evidence from military immunity”, NBER Working Paper No. 24846, National Bureau of Economic Research, Jul 2018, https://www.nber.org/papers/w24846, accessed Feb 26, 2020

Congressional Budget Office, “Limit medical malpractice claims”, Dec 8, 2016, https://www.cbo.gov/budget-options/2016/52241, accessed Feb 26, 2020

Rajender Agarwal, Olena Mazurenko, and Nir Menachemi, “High-deductible health care plans reduce health care cost and utilization, including use of needed preventive services”, Health Affairs, Oct 2017, https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0610, accessed Apr 1, 2021

Related Problems: National Debt, Income & Wealth Inequality

Contributors: Eric Seaborg, Ciara McLarenGeorge Linzer

Review: Pending

Published: May 27, 2021

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