Health Care Policy Concept Paper & Outline
Write a 2-3 page introduction to your health policy topic and an outline of the paper. Include a problem statement and basic content you plan to cover in the paper (see the main points listed below). Describe why you believe covering pre-existing conditions are important to health care policy. Include at least five scholarly references. Please give a very thorough concept paper and outline.

Specific items that the paper should address:
a. Describe the policy issue/problem (access, use, quality, and/or cost), including what is known about the population(s) affected and previous efforts to address the issue.
b. Define and describe the strategy. Discuss organizational and financial aspects of clinical health services and/or public health systems relevant to the strategy.
c. Discuss how the strategy addresses the problem and improves access, quality and/or reduces cost. Cite relevant literature. (Reputable websites are acceptable though research literature must also be used.).
d. Explain who you think the stakeholders are and who would support and argue against the policy change and why (provide evidence based on the literature).
e. Summarize your analysis, stating your informed policy recommendation on whether or not you support the health reform strategy and why.

The purpose of the health care policy assignment is to synthesize course content by examining current health reform efforts that address cost, quality and/or access issues and are based on the patient Protection and Affordable Care Act (Public Law No. 111-148)

HEALTHCARE FINANCE


You are assigned this week to provide perspective on your local health care delivery model. Write a paper answering the following:
? Part I: What is your opinion regarding the delivery of health care in your local area in the contexts of "system" and "fragmentation". These concepts are not necessarily mutually exclusive. Instead, within a locale, some aspects can be systematic while others are disjointed. (250-300 words)
? Part II: What common themes did you find from the various models proposed in this week's readings? Analyze the major attributes of the various models within the context of political and economic realities. (250-300 words)

Readings
Eaton, S. (2006). Definition of 'affordable' a key issue in new Mass. health care reform law. Massachusetts Nurse. 77 (8), 2-3.
Kaebnick, G.E. (2006). Bipartisan health reform? Hastings Center Report, 36 (5), 2-2.
Murray, C., Kulkarni, S., et al. (2006). Eight Americas: Investigating mortality disparities across races, counties, and race-counties in the United States. Medicine. 3, (8), 260.
Romano, M. (2006) Consumers, HSAs don't mix?. Modern Healthcare, 36 (33), 8-9.
Arias, D.C. (2006). Cost-conscious health plans less satisfying. Nation's Health. 36, (1) 22-22.
Recommended
The Corporatization of American Hospitals. (Excellent look at the evolution of hospital ownership in the context of predictions from Paul Starr. Starr authored The Social Transformation of American Medicine, arguably the definitive work on the history of the U.S.health care system.)

Political Science

Position Paper about Health Reform ( ask questions and answer yourself )

Must demostrate command of the topic, argue the pros and cons, and chose a side based on the strength of arguments. the paper should be written in a persuasive manner to convince the reader of the author's conclusions. should include a bibliography and appropriate notations.

Description
ANALYZING THE HEALTH REFORM PROPOSAL EXPLAIN WHICH COMPONENTS TAKING EFFECT IN 2011 ARE LIKELY TO BE IMPORTANT, NEEDED COMPONENTS, WHICH YOU THINK ARE EFFORTS TO SATISFY SOME LOBBY OR VOTER GROUP, AND WHY. IF YOU WERE DESIGNING THIS, WHAT WOULD YOU CHANGE AND WHY?

SOME SUGGESTED LINKS: YOU CAN START YOUR REVIEW BY LOOKING AT THESE LINKS. REMEMBER TO CITE YOUR SOURCES IF YOU HAVE CONSULTED OTHER MATERIALS.
HTTP://KFF.ORG/ (GO TO "EXPLAINING HEALTH REFORM:QUESTIONS ABOUT THE TEMPORARY HIGH RISK POOL") HTTP://WWW.WHITEHOUSE.GOV/HEALTHREFORM HTTP://HEALTHCAREFORAMERICANOW.ORG/ HTTP://USECONOMY.ABOUT.COM/OD/FISCALPOLICY/F/OBAMA_HEALTHCARE_REFORM.HTM

I hosted a seminar last month on the Health Reform Act as you will see in the powerpoint slides I will provide. I need to write a research paper which will have all the contents of my slide presentation. Although there is so much information available concerning the Health Reform Act, I was concentrating on the impact to Employers and individuals from a tax standpoint, not touching on anything relating to the health insurance side. I will be providing the "requirements and sample paper" you will need to follow. I will also provide various documents I have gathered to be able to put together the slide presentation, but, I am having a hard time putting it all together on paper. I would like the documents I found footnoted and referenced plus a few more you can find. The only slide I would like to add, is one on Florida and other states that have been filing lawsuits against the government and brief outcome to that case. As the requirements state, I will need an abstract, a title page, endnotes or footnotes. I will be checking my email quite frequently, I am am hoping the writer will contact me to discuss this information.
There are faxes for this order.

Short answers (1 paragraph or more)

Typed, single spaced (line spacing 1.15), using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA format.

"Simkins v. Moses H. Cone Memorial Hospital"
Categorize the sources of law and each corresponding branch of government that apply to this case. Assess the role that each played.
Compare how the concepts of due process and stare decisis may affect judicial decisions. In this case, state the ramifications, if any, of these two legal concepts.

"Case Study: Woodyard, Insurance Commissioner v. Arkansas Diversified Insurance Co."
Devise an explanation as to how the Blue Cross health plan can fall under the definition of ?hospital and medical service corporation.?
Examine how this type of corporation fits into the health care system overall and explain how its unique characteristics serves its members and the doctors who subscribe to it. Discuss if this type of plan is ideal for you and your loved ones. Provide a rationale.

?Describe at least three efforts at health reform in the 20th century, the outcome of each, and what factors led to the outcomes.

?Study the Affordable Health Care Act and determine what reforms have been successful according to 50% or more of the public. As a health care administrator, discuss what your findings mean to you.

?During a hospital in-patient stay, explain how and when a contract is legally terminated between the physician and the patient. Determine what the physician?s duties will be following the termination of the relationship with the patient. As an administrator, identify what steps you would take to ensure the patients are aware of the legal aspect of the relationship.

?Explain when a physician may become susceptible to legal action due to strict liability versus negligence.

?A patient was given a medication by an unfamiliar physician that caused a severe reaction. This physician was covering for the physician who normally treated the patient. Analyze why a case alleging a breach of contract might be easier to prove than a standard case alleging negligence in a hospital setting.

?Justify why a physician who uses a procedure that is different from one he or she promised to use may be liable for breach of contract. Assess how such an action places a medical facility at risk and what the facility can do to protect itself.

?Determine the importance of a thorough understanding of the legal liability of health care institutions from the Chief Medical Officer?s viewpoint. When you come across a legal issue that you do not understand, describe what your action steps might be.

?Differentiate between corporate liability and liability under respondent superior, and how expert testimony might be needed in each instance.

?Explain who has the authority to admit a patient to the hospital. In most cases, patients do not have the right to be admitted. Assume you were part of a training team responsible for assimilating patient registration teams to the policies of a facility. Develop a policy that educates them on patient administration and discuss what you deemed significant to point out.

?Evaluate the types of issues a hospital and physician may confront when discharging a patient. Develop a policy for staff to implement based on the issues identified.

?Should you observe a member of a medical staff conducting illegal or unethical practices, describe the steps that you would take to bring this conduct to the proper authorities. Then, assume you were the chief administrator of a medical firm. Determine who would be the proper authority. Provide your rationale.

?Peer review is generally the way that medical facilities assess medical staff performance. Create an alternative method for performance reviews that would not rely upon peer involvement.

?If you were a medical professional and came across an individual needing immediate aid, determine how the Good Samaritan Law might affect your willingness to assist. Then discuss an actual case where the law did not apply to the ?hero.?

?You just received a patient in the emergency room for a broken leg which requires immediate surgery. Your hospital is able to provide the surgical services required. However, the patient is refusing care and requesting to be transferred to another hospital for the same services. Explain the course of action that the hospital should take to meet the standards of the Emergency Medical Treatment and Active Labor Act (EMTALA).

In 2 pages APA style - Why do you think the Clinton health reform never succeeded but the Obama health reform has?

Details:



1) Submit a paper (1,250-1,500 words) focusing on public health reform. Provide an overview of the current status of public health in the United States.

2) Review a portion of the Affordable Care Act and present the strengths and weaknesses of the plan, as well as make suggestions for plan improvement.

3) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Analyze the impact of health reform on health care delivery in your practice area (Inpatient hospital urban area large population of under/uninsured). Carefully describe service delivery, how it is financed and what the impact of this service is on the health status of the target population and the community. Critically analyze the intended impact of reform on the access to and the cost and quality of health care services in your practice area. Are there any unintended consequences - either negative or positive - to this reform? Please identify what you think is the most important/positive contribution of health reform in your practice area and provide rationale for your response. Please identify an issue of concern (Healthcare Right vs Privilege disparities in healthcare coverage and its impact) about health reform in your practice area and provide rationale for your response. Given that change/reform is a constant characteristic of health care, what role do you see yourself(nurse administrator) playing in promoting positive change in care delivery in your practice area. Use The Publication Manual of the American Psychological Association, 6th Ed. for format of the paper.

First draft
Topic
Statement of purpose
Well-defined content outline
Bibliography
Due 10/23

_3_ ___ Clearly defines / describes one of five issues confronting the health care delivery system.

_7_ ___ Paper integrates the course content and readings in a thoughtful analysis of the issue from one of two perspectives:
a) a clear direction for the US health care system and its justification or
b) an analysis the strengths and limitations of the options for the US health care delivery system.

_7_ ___ Discuss the opportunities for nursing to be involved in the growth/changes around this issue in health care delivery.

_3_ ___ The paper should be well crafted and no longer than 12 pages, exclusive of References. Use APA format for style and citations.

TOPIC: Health Care Reform


After much public and political debate, in March 2010, the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. The PPACA is one of many health care reform efforts that have sought to correct key features of the U.S. health care system such as financing, service delivery, and care coordination. This week, you will examine the passage of PPACA as a milestone along the historical continuum of health care reform in the United States.

To prepare:


Review this week?s Learning Resources and media presentation, reflecting on the evolution of health care in the United States and the public?s response to health care reform efforts historically and currently.


1. Consider: What principal features of the U.S. health care system helped or hindered the enactment of federal health reform in March 2010? What challenges were encountered?


2. How do these conditions and/or challenges reflect characteristics of the policy process and the political environment?

Post a cohesive response that addresses the following:

A. Analyze at least one important feature of the U.S. health care system that is of particular interest to you. Explain why you think this feature is significant in terms of health policy and reform.


B. Describe one or more conditions or challenges specifically related to the passing of the PPACA.
C. Explain how this exemplifies the nature of the policy-making process, and evaluate how it could relate to the question of why health reform in the United States has been so difficult.

Use California as the State.

The overall goal of the Session Long Project is to examine health care delivery in the United States from a personal perspective.

Assignment expectations for module 5:

Research your state of residence for health reform initiatives
In a 2-3 page paper identify and discuss health care reform initiatives that have been implemented in the past 2-3 years.
Be sure to properly cite all of your references.

Proposals for comprehensive health reform have been defeated several times in U.S. history. The most recent of these was President Bill Clinton's health care reform plan in 1993-1994. Many people point to the role of interest groups, in the defeat of the Clinton plan. Although a few interest groups supported it , some powerful interest groups strongly opposed it, and some gave lukewarm support while opposing or questioning major parts of it.
Many people are hoping that the recent election of a new president will bring a new opportunity for enacting comprehensive reform.
Given the strong influence of interest groups(representing for example, physicians, nurses, hospitals, insurers and others), what might health reform advovates do to improve the likelihood of enacting health reform legislation? are there approaches to health reform that all(or most)interest groups might agree on--or, if not, are there ways to enact health reform legislation despite lack of agreement among interest groups? (Answers may be found in the following articles: Oberlander (2003), The politics of health reform: Why do bad things happen to good plans? Health affairs Suppl web Exclusives: W3-391-404. Oberlander (2007) Learning from failure in health care reform. N Engl J Med, 357(17), 1677-1679.)

The overall goal of the Session Long Project is to examine health care delivery in the United States from a personal perspective.

Assignment expectations for module 5:

Research your state of residence for health reform initiatives
In a 2-3 page paper identify and discuss health care reform initiatives that have been implemented in the past 2-3 years.
Be sure to properly cite all of your references.
Case assignment expectations:

Please be sure to cite all sources and provide a reference list at the end of the paper (at least 3 references).
The length of your paper should be 2-3 pages typed and single-spaced.
Please prepare your work using appropriate format.

There are faxes for this order.

The purpose of the topic reports is for the student to explore current developments in some aspect of health care in the U.S. and in other countries. These reports should relate to a particular problem/challenge that a U.S. state government (Report 1)


a) define the problem/issue, (b) provide relevant background information to understand the issue and (c) describe current practices/strategies used by the state/nation to meet goals.

Topic Report 1 will focus on some aspect of health care reform in a particular state as it relates to expanding access to health care services, protecting existing providers and consumers, using innovation in a particular state program (e.g., Medicaid) to improve services to beneficiaries, reduce health care costs, increase access to pharmaceuticals, etc. For example, the student may choose to find out how the state of Wisconsin uses state programs to provide childrens health insurance OR describe how managed competition works in the state of Minnesota.

My state of choice is Kansas:



Topic Report 1: as a startup idea, my first report is going to focus on the implementation of the (affordable health care act) in state of Kansas. The new health reform was established mainly to increase the access of care and to drop the cost. This report will discuss the expansion of health insurance coverage in state of Kansas in many areas. Some of which are: establishing the health insurance marketplace, increasing access to Medicaid, provide new coverage options for young adults, covering preventative services and unreasonable premium increases. The other angle of this discussion is going to be about how the new care act support preventing illness and promoting health. Finally, the grants that Kansas received will be discussed towards the end of it.
http://www.healthcare.gov/law/information-for-you/ks.html

at least 5 resources

1. This essay MUST be original. I will be uploading it to a website that checks its originality percentage. NO direct quotes - and always paraphrase.
2. APA 6th edition formatting is a must!! This goes for in-text citations as well as a APA reference page!
3. PLEASE double-check your spelling.
4. I will be uploading chapters from the textbook as a resource. Base the content of the essay on this chapter text. You should refer to the chapter text and concepts should be based on the chapters.
5. Quality of content is important.

Consider changes in health care structure, operations, practice, and leadership in for-profit hospitals, not-for-profit hospitals, health systems, and long-term care facilities:
What significant changes have you noted over the past 5??"20 years in hospitals, health systems, and long-term care health facilities?
How do you see health reform impacting these areas, and what will this mean to patients and consumers of these types of health services? For leaders?

There are faxes for this order.

Customer is requesting that (researchpro) completes this order.

TOPIC: Issues in Health Care Reform (Interview)



According to the AACN (2006), " Political activism and commitment to policy development are central elements of professional nursing practice" (p. 13). Throughout this course, you will hone the skills and competencies required for this type of involvement in policy.

Research is an essential step in the process of acquiring the skills and competencies, and interviews are one form of research that can serve as a valuable source of information. As such, this Application Assignment (which you will start this week, and submit by the end of Week 9) provides an opportunity for you to identify a health reform issue of interest and discuss the issue with a state or national politician (or their aide).

To prepare:

Identify a state or national politician (state representative or legislator, senator, congressman, governor, etc.), or aide, whom you would like to interview regarding current issues in health care reform.

As soon as possible, contact the individual's office to request a meeting. Keep in mind that it may be difficult to get on their calendar, so plan accordingly. You may conduct the interview in person or by phone.

In advance of the interview, ask yourself:

What health care policy issue is important to me personally?

What issue do I want to bring to this person's attention?

With this in mind, develop your list of questions for the interview around your selected health policy issue. In addition, you may wish to include questions related to health care reform:

What are your constituents most concerned about regarding health care reform?

What are the trade-offs associated with recent health care reform policy?

To complete:

Write a 3- to 4-page paper providing a summary and analysis of the interview and the health care reform issues you discussed.


Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate.

THIS IS A MAKE BELIEVE INTERVIEW ON THE PHONE WITH A STATE REPRESENTATIVE OR LEGISLATOR,SENATOR,CONGRESSMAN,GOVERNOR ETC.

You can write about any healthcare reform apart from the PPACA. It should be related to healthcare. if ORIENTED IS NOT BUSY CAN THE WRITER WRITE THIS PAPER FOR ME. THANKS

This assignment is about health, and you need to watch the link first to know how to answer the activities. Here are the activities you should answer:

Watch Olsen, E. (2008). SWOT Analysis: How To Perform One For Your Organization (Webcast). Virtual Strategist.

3 Activity


To meet the direction of health reform, what do the strategies and objectives need to be for the context you work in?
What might be some of the measures?
Describe one thing you will do differently with respect to health care planning as a result of something you learned from these readings.




4 Activity
Google strategic planning in health care and find other approaches and models.






5 Activity


By reflecting on the readings 10-17 who are these applicable to your local situation with respect to incorporating community participation in the planning process.
Describe one way that you could strengthen community participation in your current planning activities.
What will you differently and/or do more of?

This is MBA (Master of Business Administration) level

Please write two pages on what you believe will or will not occur in health care over the next year.
Please see attached summary of new health reform law

MANAGING OUT: THE PUBLIC SECTOR IN THE COMMUNITY

Process Analysis ??" (2500 words)

Analyse a process of managing out that has been implemented or changed in the Australian public health care sector. The analysis should be presented in the formats of an internal report. (REFER UNDER FOR PROCESS CHOSEN FOR ANALYSIS)

The analysis should cover the following points:

1. The context, including any relevant (but very brief) historical background leading up to the process being implemented.

2. Process outline, including a brief description of what was actually implemented in terms of managing out with various parties.

3. The challenges and complexity for management, including but not limited to potential risks or problems and why there might be local variations in service delivery in what is supposed to be a coherent and consistent system.

4. Resource implications, including financial, associated with addressing the challenges.

5. Possible management strategies.

Notes for Assistance

? Include in the report a definition of managing out.
? Internal report needs to have the scope to cover all five points above. (The 5 points could also be used as headings- demonstrating the requirements).
? Need to demonstrate an ability to cover the appropriate style, content and analysis.

? When management strategies are developed they need to take into account the availability of such resources as:

??key staff with appropriate competencies

??operating funds

??capital funds

??capital equipment

??office space and fittings

??telecommunications

??other related agency needs

??appropriate policies

??standard operating procedures.

The existence and extent of these elements determine whether management has properly designed, sequenced and resourced the strategy.

? The overall aim is to relate contextual understanding of trends in Australian public policy to a particular process of managing out and enable analysis of concrete problems entailed in managing out and to explore potential solutions.

? Need to demonstrate clear understanding of the relationship between the managing out process and some of the main themes, concepts, problems and resources

? Need to demonstrate ability to apply theoretical and contextual understanding to a concrete example.

? Choose a process of managing out that gives scope to raise the issues. It is not the subject of the process that is important ??" it is analysing and managing the issues associated with the process.

? Avoid lengthy descriptions of the process.



Comments
Has the public health sector (agency) outsourced a function previously managed in-house?
The outsourcing might have been to the private sector, the not for profit sector or even to another tier of government.
The assessment task is to identify, within the public health sector, the people and or the records of the outsourcing process.
The selected example then needs to be described, (who did what to whom, when and why and with what results) and analysed, using the 5 points (described above).

THE PROCESS CHOSEN ??" to form the basis of the internal report

A background paper was previously prepared concerning this topic, yet it doesnt analyse a process of managing out ??" see background.doc

Prior to implementation of the National Health Reform (see 7 below) New South Wales (NSW) comprised 8 Area Health Services, including Northern Sydney Central Coast Health ??" in 2009 this Area Health Service undertook an Area-wide VMO Quinquennium Process (see 1 and 2) to reappoint VMOs to Hospitals within the Area. The process involves a required Committee ??"Medical and Dental Appointments Advisory Committee (see 5). VMOs may be considered contractors, in that they are not employees of the organization.

As a result of the National Health Reform Agreement ??" the former Northern Sydney central Coast Health has been split into:
- Northern Sydney Local Health District
- Central Coast Local Health District
With each District now being governed by a Board ??" the Northern Sydney LHD Board has asked for a background paper on the VMO Reappointment process.

Write an Internal Report to the Northern Sydney Local Health District Board (see 10 and 6 below) concerning the Visiting Medical Officer (VMO) Quinquennium (reappointment) Process (to analyse the process used and provide lessons learnt).

To support this task in the former Northern Sydney Central Coast health a centralised unit was formed ??" the Senior Medical Staff Unit. ??" (see attach 1). The process undertaken was compliant with the NSW Health Policy (see 1 and 2 below and attach 2 and 3). From a governance perspective, at the time ??" accountabilities were:
- Director Medical Workforce (reports to) Director Workforce (reports to) Chief Executive (reports to) Director-General.
- Under the new National Health Reform Agreement the future of the Senior Medical Staff Unit is still in question ??" staff will have to be split to support the 2 Local Health Districts (no further resources are available). The Unit is currently based within the footprint of the Northern Sydney LHD though.

The process resulted in the appointment of 700 Visiting Medical Officers (Hi Nel, Using the former organisaton configuration (NSCCAHS approx 15,163 headcount) VMO's make up approx 5.3% of the workforce (Headcount, 700 in quinquinnium ??" email from Director Workforce Informatics, 20 July 2011 to Nel Buttenshaw


1. Visiting Medical Officer (VMO) Model Service Contracts - http://www.health.nsw.gov.au/policies/pd/2009/PD2009_052.html


2. Visiting Practitioners Appointment
http://www.health.nsw.gov.au/policies/pd/2005/PD2005_496.html



3. Application for Appointment Senior Medical and Dental Practitioners
http://www.nscchealth.nsw.gov.au/employment/documents/seniormedicalpractitione-applicationforemployment.pdf



4. Annual Report ??" NSW Health 2009/10 (pg 293 for Northern Sydney Central Coast Health)
http://www.health.nsw.gov.au/pubs/2010/pdf/annualreport10.pdf


5. Corporate Governance & Accountability Compendium for NSW Health (pg 93 ??" medical & dental appointments advisory committee)
http://www.health.nsw.gov.au/resources/policies/manuals/corp_gov_compendium_pdf.asp



6. Local Health Boards Announcement ??" Ministers Media Release
http://www.health.nsw.gov.au/news/2011/20110701_00.html


7. Background ??" National Health Reform
http://www.health.nsw.gov.au/initiatives/healthreform/background.asp



8. Visiting practitioners and staff specialists delineation of clinical privileges policy for implementation

http://www.health.nsw.gov.au/policies/pd/2005/pdf/PD2005_497.pdf


9. Visiting Medical Officers' Fee-for-Service Agreement
http://www.health.nsw.gov.au/policies/PD/2005/PD2005_434.html


10. Northern Sydney Local Health District
http://www.health.nsw.gov.au/services/lhd/ns/index.asp#

There are faxes for this order.

1. I'm in favor of the present healthcare reforms
2.The basis theme of the paper is comparing US healthcare system to that of the French healthcare system
3. Identify some the advantages and disadvantages of the two healthcare systems
4. hospital waiting times of the two systems
5. percent of GNP and dollars Per capita per individual of the two systems
6. how much the present US health reforms will cost and will it decrease the national debt
7. conclusion on which healthcare system might be better
8. final note if you need to add one a page could you e-mail first.

GM and Starbucks present two different views toward providing healthcare for their employees. While Starbucks invests a lot in the healthcare insurance of its employees, GM has been looking at a way to reduce its generous health benefits, so as to bring down costs.

complete the following research activity.

* CBS Broadcasting Inc (Producer), & Pelley, S. (Interviewer) (2006, April 23). Howard Schultz: The Star Of Starbucks. [Interview & Video]. CBS News. Available from the CBS News Web site http://www.cbsnews.com/stories/2006/04/21/60minutes/main1532246.shtml


* EDITORIAL: The unkindest of cuts. (2005, October 19). Kansas City Star, The (MO). Retrieved September 21, 2006, from the EBSCO HOST Newspaper Source database. (AN 2W60442457420).

* Moroni, R. (2005, August 29). Foreign Competition May Push U.S. Health Reform. Grand Rapids Business Journal. 23 (36), p4-4, 1/3p. Retrieved September 21, 2006, from the EBSCO HOST Regional Business News database. (AN 18097323).

* Yip, P. (2005, October 18). General Motors health-care deal an example of changes over time. Dallas Morning News, The (TX). Retrieved September 21, 2006, from the EBSCO HOST Newspaper Source database. (AN 2W62009610037).

Prepare a two-page paper explaining how these attitudes toward employee healthcare could be so different in these two organizations, considering their history and structure.

Comment on the following:

* How these two organizations view of healthcare has affected their presence in the global market place?


* How corporate culture influences the organizations view on healthcare?


Conclude your paper with a position statement regarding the following question:

Should healthcare be included in employee incentive plans?

Substantiate your positions throughout the paper with figures, other facts, and calculations, citing references.

Canada

Write a 3-5 page essay, comparing the U.S. health care system with the health system of your choosing (PLEASE NOTE: The main body of the paper should be 3-5 pages minimum in length. This page count does not include the title/cover page, abstract, table of contents, or references). The written paper is to be prepared in accordance with the following guidelines and must contain all of the following components:
TITLE PAGE (Follow APA guidelines)
ABSTRACT- Limit the abstract to 150 words. Do not repeat the title at the beginning of the abstract and do not cite references in it. Avoid abbreviations. Include the purpose of the article, main findings, and principle conclusions. Although the abstract is at the beginning of the paper, it is often easier to write the paper and then go back and write your abstract.
TABLE OF CONTENTS
INTRODUCTION (overview of the topic - usually one to two paragraphs)
REVIEW OF LITERATURE ??" Write an overview of the background and development of the US health care system as well as the background and development of the health care system of the nation you choose. Be sure to review the 4 basic components of health services delivery: financing, insurance, delivery, and payment and how they function in each the US system vs. the other system (see pgs. 5-7 of the textbook for more information).
o Reference citations must be present within the body of the paper and should be included for all information obtained from an outside source. All reference citations should have a corresponding full reference listed on the reference page. In order to add depth to your paper, I fully anticipate students using supplemental references (journal articles, web sources, and books) in addition to the text book. Please note that Wikipedia is not considered a scholarly source for use in academic papers- Please avoid using it ?
DISCUSSION - analysis of the information presented in the review of literature. Compare and contrast the features of the US health care system and the system of the nation/country you choose. Discuss how the system components impact health professionals as well as patients (positively and/or negatively).
CONCLUSION - Based on information presented in discussion
RECOMMENDATIONS - student's personal thoughts or suggestions for change. Identify any system features that you would like to see incorporated into the US system.
REFERENCES: Students are responsible for the accuracy and completeness of references and must follow the APA guidelines for citations.
***Please note: Papers must include headings for each of the sections listed above. Headings should centered and capitalized.
Additional information:
Manuscript Preparation: Assignment should be prepared in Microsoft Office as a .doc or .docx file. The manuscript shall be typewritten double-spaced with 1" margins on all four sides. The pages are to be numbered consecutively, beginning with the first page of text. The page number should in the upper right hand corner of each page. The font for the type should 12 point Times Roman or Times New Roman.

Text Requirements: The cover page should contain the title and authors names. The abstract should be on a separate page. The Table of Contents should be on a separate page. The main text should begin on a separate page and be not less than 3-5 pages double-spaced pages. You may exceed 3-5 pages of text for the body of your paper. However, papers that are shorter in length will have points deducted.

Illustrations (optional): If tables, graphs, figures, etc., are included they should be appropriately identified.

Assignment Submission: Submit as an attached document under the Written Assignment tab. Click on View/Complete Assignment: Written Assignment #1. Scroll down to attach local file and upload your Word Document. Click submit.
* Please refrain from emailing assignments to the instructor.
***Some APA resources have been placed in the Course materials section for your convenience. Here you will find information on writing a title page, how to paraphrase, how to cite references within the paper etc.

The book:

Delivering Healthcare in America.

A Systems Approach

F O U R T H E D I T I O N
Leiyu Shi, DrPH, MBA, MPA Professor, Johns Hopkins School of Public Health Co- Director, Johns Hopkins Primary Care Policy Center for the Underserved Johns Hopkins University Baltimore, Maryland

Douglas A. Singh, PhD, MBA Associate Professor, School of Public and Environmental Affairs Indiana University South Bend South Bend, Indiana

Jones and Barlett Publishers
Sudbury ,Massachusetts.
Boston,London,Toronto,Singapore.

Context: Canada:Canada implemented its national health in-surance system referred to as Medicare under the Medical Care Act of 1966. Currently, Medicare is composed of 13 provincial and territorial health insurance plans sharing basic standards of coverage as defined by the Canada Health Act ( Health Canada 2006). The bulk of financing for Medicare comes from general provincial tax revenues; the federal government provides a constant amount that is independent of actu-al expenditures. The public pays for nearly 70 percent of total health care expenditures in Canada. The remaining 30 percent, paying for supplementary services such as drugs, dental care, and vision care, is financed pri-vately ( Canadian Institute for Health Infor-mation 2005). Provincial and territorial departments of health have the responsibili-ty to administer medical insurance plans, de-termine reimbursement for providers, anddeliver certain public health services. Prov-inces are required by law to provide reason-able access to all medically necessary services and to provide portability of bene-fits from province to province. The program provides comprehensive coverage, but ex-cludes dental care. Coverage for home health care and prescription drugs varies across the provinces. To cover these exclusions, many Canadians have supplemental coverage through private insurance provided by em-ployers. Patients are free to select their providers ( Akaho et al. 1998). Several prov-inces have established contracts with providers in the United States for certain specialized services. However, contrary to popular per-ceptions, few Canadians have to obtain health care services in the United States due to waiting times or unavailability of technol-ogy in their own country ( Katz et al. 2002). Nearly all the Canadian provinces ( On-tario being one exception) have resorted to regionalization by creating administrative districts within each province. The objective of regionalization is to decentralize authori-ty and responsibility to more efficiently ad-dress local needs and to promote citizen participation in health care decision- making ( Church and Barker 1998). The majority of Canadian hospitals are operated as private nonprofit entities run by community boards of trustees, voluntary organizations, or mu-nicipalities, and most physicians are in pri-vate practice ( Health Canada 2006). Most provinces use global budgets and allocate set reimbursement amounts for each hospital. Physicians are paid fee- for- service rates ne-gotiated between each provincial govern-ment and medical association ( MacPhee 1996; Naylor 1999). Over the years, federal financial support to the provinces was drastically reduced. Un-der the increasing burden of higher costs,certain provinces, such as Alberta and On-tario, have started small- scale experimenta-tion with privatization. However, in 2003, the Health Council of Canada, comprised of rep-resentatives of federal, provincial, and terri-torial governments, as well as health care experts, was established to assess Canadas health care system performance and establish goals for improvement. The Councils 2003 First Ministers Accord on Health Care Re-newal created a five- year, $ 16 billion Health Reform Fund targeted to improving primary health care, home care, and catastrophic drug coverage ( Health Council of Canada 2005).

Imagine you work for a particular health or health care-related interest group. You want to attract the attention of specific policymakers (legislators or regulatory bodies), or other health care leaders, that are key to changing some policy that will better your cause. Knowing that their time is valuable, and their attention spans are short, try to formulate a memo to catalyze action. You will find examples of concise policy memos within the websites of scores of interest groups. You must choose the format, which you feel is the most effective.

Students are to write a 3 page letter/statement (single-spaced) that could be used to influence a legislator/regulatory body or health system leader on a specific issue that would be of particular interest for your group.

The letter should:

Present a clear discussion of the scope of the issue/problem

Offer a concise history of the issue

Inform the legislator/regulator/health care leader why the issue/legislation/regulation is important to your particular interest group, or individuals/groups like yours

Clearly present the pros/cons of a policy swinging in a particular direction

Explain why a legislator/regulatory body/health care leader should respond in a specific manner. Specifically state why this issue should be important to them



SAMPLE PAPER

Ethical and Financial Issues Surrounding Medical Bankruptcies

Introduction

On October 20, 2009, the Senate Judiciary Administrative Oversight and the Courts Subcommittee held a hearing on medical bankruptcies, which illustrated two, different views on this issue. On the one hand, the Democrats and their supporters contended that the government needed to alter the bankruptcy regulations to make it easier for individuals with significant medical debt to file for Chapter 7 protection; this group also supported a bill that would allow these debtors to keep their homes. The conservatives countered by stating that any changes in these laws would increase consumer malfeasance and harm the economy. Both parties arguments were mediated by larger economic and social justice issues. My paper will explore this topic further by looking at recent literature and legislative initiatives surrounding this issue as well as by assaying the Judiciary Subcommittee hearing.

Literature Review

Most of the men and women, who participated in the Judiciary Subcommittee hearing, conflated issues confronting medical debtors in general with problems specific to the portion of that group which filed for bankruptcy protection. As a result, I will provide a brief analysis of some of the recent scholarly literature on these subjects in order to help readers better understand a few of the important themes which permeated the hearing.
Over the past few years, researchers have produced numerous, scholarly articles which deal with the issue of medical debt. Some of the most popular of these essays share several, key hypotheses. First, they argue that a large number of Americans, perhaps as many as 72 million people[have] problems with payment of medical bills, accrued debt, or both. Many of these individuals owe thousands of dollars in medical expenses. The writers go on to assert that the men and women who accrue these debts are, by and large, productive, responsible citizens rather than malcontents or slackers; these individuals run into financial difficulties as a result of economic or health issues that are beyond their control. Perhaps most importantly, the authors attempt to demonstrate that many of these people have trouble getting access to medical equipment or forgo seeking treatment for ailments due to their medical debts.
Researchers utilize the same arguments when discussing the portion of this debtor group that decides to file for bankruptcy. For instance, they contend that these people are, by and large, productive, responsible citizens. David Himmelstein, whose most recent essays were mentioned by several of the witnesses at the Judicial Committee hearing, adds to this discussion by asserting that medical debt accounted for 62.1% of all bankruptcies in 2007. Perhaps most importantly, he also contends that a large number of these people have difficulties finding jobs and paying their bills even after declaring bankruptcy. This fact might indicate that these people still have unresolved issues arising from their medical debt (or perhaps from chronic illnesses).
I was not able to find any recent, scholarly articles that adhere to opposite viewpoints with regards to individuals who have medical debt but are still solvent. However, I did locate essays that assert that most people do not declare bankruptcy to eliminate their unpaid medical bills. Rather, according to these authors, the vast majority of these men and women file for bankruptcy because they have amassed unrelated credit card debt or other non-medical expenses. While these researchers might have valid arguments, I do not delve into this topic in any depth in this paper.

Government Legislation

In 2005, the Republicans were still in control of the White House and the Congress; in April of that year, they managed to push through a key piece of bankruptcy legislation, the Bankruptcy Abuse, Prevention, and Consumer Protection Act of 2005. It represented a compromise between the various stakeholders; therefore, it did include some important sections on consumer protection and other issues important to liberals. At the same time, the legislation made it more difficult for people, including those individuals with medical debts, to file for Chapter 7 bankruptcy protection. The bill also forced these petitioners to receive debt management counseling before they could officially declare bankruptcy.
Perhaps in response to the 2005 act, the Democrats proposed three separate bills between 2008 and 2009, which aimed to, among other things, make it easier for medical debtors to file for Chapter 7 bankruptcy protection. The first of these legislative documents, proposed by a Democratic House member in early 2008, failed to make it out of committee. The liberals might be more successful with the next two bills they sponsored, as these documents are still being debated in their respective committees. The Senate bill, the Medical Bankruptcy Fairness Act of 2009, is the one discussed by the Judiciary Subcommittee. It mandates waiving the counseling requirement implemented by the 2005 act, and it also allows people to file for Chapter 7 bankruptcy but still retain their home if it is valued at $250,000 or less. Additionally, the legislation makes it easier for these men and women to liquidate all of their debts via bankruptcy.

The Judicial Subcommittee Hearing

On October 20, 2009, [t]he Senate Judiciary Administrative Oversight and the Courts Subcommittee held a hearing on proposed legislation to change current U.S. bankruptcy laws to reduce the number of people filing for bankruptcy because of medical debt. Sheldon Whitehouse, a Democratic Senator from Rhode Island, chaired the conference. He was joined at this meeting by fellow Democratic Senators, Russell Feingold of Wisconsin and Al Franken of Minnesota. Jeff Sessions, a Senator from Alabama, was the only Republican congressman to attend the hearing. These individuals listened to testimony from two proponents of the bill, Elizabeth Edwards, Senior Fellow at the Center for American Progress, and John Pottow, a law professor at the University of Michigan. The senators also heard from two people opposed to the legislation, Aparna Mathur, a research fellow at the American Enterprise Institute, and Diana Furchtgott-Roth, a senior fellow at the Hudson Institute and a prior chief economist at the U.S. Department of Labor. The senators also listened to testimony from Kerry Burns, who, along with her husband, had to file for medical bankruptcy due to her sons illness.

The chair started the conference with some opening statements; he then let each of the witnesses speak. After tht part was over, the senators took turns querying their guests. These individuals particular statements are not as important as the general themes that were espoused by the proponents and opponents of the legislation.
The Democrats and their supporters assert that a large percentage of people who file for bankruptcy do so in order to eliminate medical debts. They also contend that these individuals are, by and large, hardworking citizens who can no longer afford to pay for the hospital and doctor bills that they or their loved ones have incurred. Following on this hypothesis, the liberals advocate for waiving the counseling requirements for individuals who declare medical bankruptcy, as they claim it is both an unnecessary and humiliating process. The senators and their supporters use some of the same logic to support their calls for a waiver of the means test.
The Democratic senators and the other proponents of the Medical Bankruptcy Fairness Act argue that the federal government should waive the means testing requirements for people filing Chapter 7 bankruptcy as a result of medical debts. The proponents of the bill also suggest allowing these individuals to keep up to $250,000 of equity in a house. They suggest these things in part because they believe that these Americans are generally hard working, responsible people who should not be punished for getting sick. They also point to figures linking medical debt and limited healthcare access and outcomes. In other words, they proclaim that sick individuals, who are filing for bankruptcy, will not be able to obtain quality healthcare if they have no equity or if they have to pay back a part of the debt via Chapter 13 adjudication.
The supporters of bankruptcy legislation utilized Kerry Burns testimony to help them provide listeners with an experiential example to support their hypotheses. She represented the hardworking, model citizen who had to file for bankruptcy because of the costs associated with her childs 13 month hospitalization. Her story succeeded in its goal of providing an emotional base for the otherwise dry, fact based testimony from Edwards, Pottow, and the Democratic senators.
The opponents of this legislation argued against changing the current laws for several reasons. First, they asserted that at least 80% of people who file for medical bankruptcy can enter a Chapter 7 plea. Second, they argued that some Americans will try to cheat the system if the Medical Bankruptcy Fairness Act passes. Finally, the opponents of the bill contended that healthcare costs will go up if everyone who files for medical bankruptcy is allowed to liquidate all of their debts instead of entering into Chapter 13.
The opponents of the Medical Bankruptcy Fairness Act are not as successful in supporting their hypotheses for two, key reasons. First, their analysis of the situation is dichotomous; if most people with medical debt can file for Chapter 7 bankruptcy, why would it harm the economy to allow a few more people to do it. Second, one of their witnesses, Diana Furchgott-Roth, came to the meeting unprepared to discuss the issue of medical bankruptcies; rather, she focused all of her ire on the general issue of healthcare reform.

Reflections

The issues revolving around medical bankruptcies are complex. For one thing, it is difficult if not impossible at this time to assay how severe the problem is and what impacts the solutions, posited in the Medical Bankruptcy Fairness Act of 2009, will have on debtors as well as on the overall market. The opponents of this legislation might be correct when they state that the economy will suffer if the bill is enacted into law. On the other hand, it might increase productivity by improving the health outcomes for some of these individuals. At this time, I do not feel that researchers have enough data to make this decision. Nonetheless, I feel that the government should strongly consider implementing this legislation.
While it might be difficult to posit a solid utilitarian argument in support of the Medical Bankruptcy Fairness Act given the dearth of available information on outcomes, I still think America should pass the legislation. In the United States, we espouse notions of fairness and justice, which are based on meritocratic ideals. Inspired by this philosophical model, we often criticize individuals who do not earn a living. As an example, many Americans oppose steroid use by athletes because they believe that it gives them an unfair advantage on the playing field. However, if we want to remain true to these tenets, we should allow people to eliminate debts which they do not incur through any fault of their own.

Doty, Michelle M., Collins, Sara R., Rustgi, Sheila D., and Kriss L. Jennifer. Seeing Red: The Growing Burden of Medical Bills and Debt Faced by U.S. Families, Commonwealth Fund 1164, vol. 42 (August 2008): 1, Retrieved from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2008/Aug/Seeing%20Red%20%20The%20Growing%20Burden%20of%20Medical%20Bills%20and%20Debt%20Faced%20by%20U%20S%20%20Families/Doty_seeingred_1164_ib%20pdf.pdf
Also see Doty et al. 2, 3.
Also see Jha, Shweta, Study: More than 57 Million Americans Had Medical Debt in 2007. Commonwealth Fund, September 24, 2008. Retrieved from: http://www.commonwealthfund.org/Content/Newsletters/Washington-Health-Policy-in-Review/2008/Sep/Washington-Health-Policy-Week-in-Review---September-29--2008/Study--More-than-57-Million-Americans-Had-Medical-Debt-in-2007.aspx?view=print.
Also see Seifert, Robert W. and Rukavina, Mark, Bankruptcy is the Tip of a Medical-Debt Iceberg, Health Affairs 25(2): 89-90. Retrieved from: http://healthaff.highwire.org/cgi/reprint/25/2/w89.
Jha (2008).
Doty, 2,4; Seifert, 91.
Doty 3-4; Seifert, 91
Seifert, 89-90; Himmelstein, David U., Thorne, Deborah, and Warren, Elizabeth, Woolhandler, Steffie, Medical Bankruptcy in the United States, 2007: Results of a National Study, The American Journal of Medicine xx, x (2009): 3-5, Retrieved from: http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf.
Himmelstein et. al, 1. Also see Himmelstein, David U., Warren, Elizabeth, Thorne, Deborah, and Woolhandler, Steffie, Illness and Injury as Contributors to Bankruptcy, Health Affairs (web exclusive article): 63-64, Retrieved from: http://content.healthaffairs.org/cgi/reprint/hlthaff.w5.63v1.
Himmelstein et al., Illness and Injury, 68-69.
Bankruptcy and Medical Debt; Senate Committee Judiciary|Administrative Oversight and the Courts C-Span (October 2009) http://www.c-spanvideo.org/program/289547-1. Elizabeth Edwards and others espouse this argument.
Scott III, Robert H., Bankruptcy Abuse Prevention and Consumer Protection Act of 2005: How Credit Card Industrys Perseverance Paid Off, Journal of Economic Issues, XLI, No. 4 (December 2007): 951, Retrieved from:
http://bluehawk.monmouth.edu/~rscott/articles/Scott-JEI%20Bankruptcy.pdf.
Also See Dranova, David and Millenson, Michael L., Medical Bankruptcy: Myth Versus Fact, Health Affairs 25, vol. 2: 75. Retrieved from: http://healthaff.highwire.org/cgi/reprint/25/2/w74.
Govtrack.us website, Retrieved from: http://www.govtrack.us/congress/billsearch.xpd. The information not taken from the Govtrack site is common knowledge.
C-span
Ibid; Scott III, 951; Himmelstein et al. 1.
C-span.


SAMPLE 2

On October 20, 2009 the Kaiser Family Foundation held a briefing and panel discussion on the Community Living Assistance Services and Supports (CLASS) Act. The CLASS Act, introduced for the first time in 2004 by Senator Edward Kennedy and included in the House and Senate Health Education Labor and Pensions (HELP) Committee health reform bills (S.1679 / H.R.3962), would create a national voluntary insurance program for individuals who are functionally impaired (Kaiser, 2009).

According to supporters of the provision, the daily cash benefitprovided by the CLASS Act would allow individuals with functional impairments to remain in their homes and gain access to the long-term supports and services that would enable many of them to remain working members of their communities. And, because the CLASS Act is not a poverty-based model, it would allow individuals to retain their assets and stay off of Medicaid (Kaiser, 2009).

In 2005, approximately 10 million people in the United States needed long-term supports and services to help with activities of daily living such as dressing, bathing and toileting (Houser, 2007). Unfortunately, even though approximately two-thirds of Americans will need long-term care at some point in their lives, many hold misconceptions about disabled populations (Georgetown, 2003). For example, most Americans believe that only older individuals require long-term care when in fact about 40 percent are less than 65 years of age (Kaiser Health Poll, 2005).

Americans are also misinformed about the means by which most long-term services and supports are funded. Approximately 30 percent believe that private insurance will be a primary funding source for their long-term care needs and 13 percent believe Medicare or Medicaid will be a primary funding source (Kaiser Health Poll, 2007). Today, the Medicaid program is the primary funding source for long-term care expenditures (40 percent), followed by Medicare (23 percent), out-of-pocket expenditures (22 percent), and private insurance (9 percent) (Houser, 2007). Medicare??"which approximately 30 percent of individuals believe is the primary government source of funding for low-income individuals??"will only pay for long-term services and supports immediately following a stay in an acute care hospital (Kaiser Health Poll, 2007).

Many researchers and advocates for the elderly and the disabled argue that there are numerous problems with relying on Medicaid as the primary financing mechanism for long-term care. Because Medicaid has strict income eligibility requirements it requires individuals to spend down their assets to near poverty before they qualify for benefits (OBrien, 2004). And, because the Medicaid program is financed through a partnership between the federal and state governments, state Medicaid expenditures for the elderly and disabled are taking up increasingly large proportions of the state Medicaid budget, forcing states to limit provider payments and restrict benefits for the larger Medicaid population, to include low-income women and children. In response to budget pressures, many states have opted to limit Medicaid payments to long-term care providers (OBrien, 2004). Recent studies have shown that these low provider payments create access problems for beneficiaries and quality problems in nursing homes (OBrien, 2004). Finally, and importantly, federal and state Medicaid laws are structured such that individuals are often forced to receive care in an institutional setting, such as a nursing home, even when they would rather remain in their homes (OBrien, 2004).

The issue of major long-term care reform, much like the issue of larger health care reform, was last on the national stage in the early 1990s. In September of 1990, the US Bipartisan Commission on Comprehensive Health Care??"the Pepper Commission??"issued a call for action that included reform of the long-term care system (Rockefeller, 1991). Unfortunately, like health reform, long-term care reform did not materialize. As noted above, however, the House and HELP Committee health reform bills currently include the CLASS Act (Thomas, S.1679 / H.R.3962). The Senate Finance Committee bill, which is expected to be merged with the HELP bill early next week, does not. The Senate Finance Committee bill does, however, include some important Medicaid reform provisions that will help reduce the institutional bias in Medicaid long-term care funding and will allow more people to receive long-term supports and services in their homes. The question remains as to whether or not the CLASS Act and the Medicaid provisions will be included in the final merged Senate health reform bill.

The Kaiser Family Foundation CLASS Act briefing appears to have been organized in an effort to elevate public awareness of the provision in the health reform bills and to mobilize public support for the provision in the merged Senate bill. The panel members included:

Judy Feder, Professor of Public Policy at Georgetown University and Senior Fellow at the Center for American Progress
Connie Garner, Policy Director for Disability and Special Populations for the late Senator Edward M. Kennedy
Paul N. Van de Water, Senior Fellow at the Center on Budget and Policy Priorities
Richard G. Frank, Deputy Assistant Secretary for Planning and Evaluation and Director the HHS office on Disability Aging and Long-Term Care Policy
Nora Super, Director of Federal Government Relations for Health and Long-Term Care at AARP
Larry Minnix, President and CEO of the American Association of Homes and Services for the Aging
Marty Ford, Director of Legal Advocacy for The Arc and UCP Disability Policy Collaboration
Unfortunately, the panel did not include representatives in opposition to the CLASS Act, so in an effort to provide a balanced report, this memo will include some discussion of the opposing views reported in the press. The primary opposition to the CLASS Act is the private long-term care insurance industry. Although the CLASS Act is intended to work in conjunction with wrap around private insurance coverage, insurers are concerned that the program will produce the perception that long-term care insurance coverage is no longer needed. The private long-term care insurance industry has a continuing problem with market penetration; currently, only about 20 percent of Americans hold a long-term care insurance policy (Kaiser Health Poll, 2007).

Congressional opponents of the CLASS Act argue that the provision is not fiscally and actuarially sound; that it produces an unfunded mandate on employers who must administrate the payroll deductions; and that the benefit provided by the CLASS Act is not nearly enough to warrant the risk of establishing an entirely new federal entitlement program. Unfortunately, several of the Members of Congress who are opposed to the CLASS Act are powerful members of the Senate Finance Committee, making the chances of the provision in the final merged Senate bill far less likely. For example, Senator Kent Conrad was recently quoted in an Inside Health Policy article calling the CLASS Act a Ponzi scheme. In addition, seven fiscally conservative Senators, including Senators Blanche Lincoln and Ben Nelson, recently sent a letter to Senator Reid asking that the CLASS Act not be included in the final version of the Senate bill.

At the Kaiser briefing, each of the individuals on the panel offered his or her perspective on the need for the CLASS Act, as well as a rebuttal to the various reasons for opposition to the program. Most noted that the Congressional Budget Office estimates the CLASS Act will reduce the budget deficit by $74 billion over a ten-year period. Connie Garner also commented on an amendment to the CLASS Act made by Senator Gregg that would require the Secretary of the Department of Health and Human Services to adjust premiums as necessary in order to ensure the program remains actuarially sound over a 75 year period. Richard Frank announced that his office has modeled the CLASS Act extensively and is entirely persuaded that reasonable premiums, solid participation rates, and financial solvency over the 75-year period can be maintained. Finally, the AARP and the American Association of Homes and Services for the Aging ??" an association for small, non-profit nursing homes ??" announced their support for the program and asked that the audience call their Members of Congress to ask that the provision be included in the final Senate health reform bill (Kaiser, 2009).

In my professional life, Im working on a team ofconsultants hired by the National Council on Aging to coordinate several disability and aging advocacy organizations with the common goal of making long-term care reform a part of overall health care reform. Weve been working on the project for several months and, although we were initially advocating for several long-term care bills, weve slowly whittled our request down to including the CLASS Act and the Senate Finance Committee Medicaid reform provisions in the final health reform bill. Personally, I believe the CLASS Act is a great first step toward helping individuals with disabilities finance long-term services and supports. I agree that the daily benefit of approximately $75 per day is small, but I believe the disability population needs a legislative foothold from which it can work to gain greater access to the supports and service for which it has been asking for some time. However, I am becoming increasingly skeptical about the chances of the CLASS Act in the final health reform bill given the opposition of key Senators on the Senate Finance Committee.








































References

Feder, J., Komisar, H.L. Niefeld,M. (2000). Long-Term Care in the United States: An
Overview. Health Affairs (May/June 2000): 42.

Georgetown University Long-Term Care Financing Project. (2003) Fact Sheet: Who needs
long-term care? Retrieved from the web on November 2, 2009 at: www.ltc.georgetown.edu.

Houser, A. (2007). Long-Term Care Fact Sheet. AARP Public Policy Institute. Retrieved
from the web on November 2, 2009 at: http://www.aarp.org/ppi.

Kaiser Family Foundation (2009). The Sleeper in Health Reform: Long-Term Care and the
CLASS Act briefing materials. Retrieved from the web on November 2, 2009 at: http://www.kff.org/healthreform/kcmu102009pkg.cfm.

Kaiser Family Foundation. (2005). Kaiser Health Poll Report: The Publics Views on Long-
Term Care. Retrieved from the web on November 2, 2009 at: www.kff.org/healthpollreport.

OBrien, E. Elias, R. (2004). Medicaid and Long-Term Care. Kaiser Commission on Medicaid
and the Uninsured.

Rockefeller, J. (1991). Call for Action: The Pepper Commissions Blueprint for Health Care
Reform. Journal of the American Medical Association. 265: 2507 ??" 2510.






There are faxes for this order.

The historical evolution of medical treatment and the role of government in delivering health care.

Answer the following two questions in APA format

1. I have always been fascinated not only by advances in medical treatment throughout recorded history but also by changes in the paradigms about what the healing arts considered proper treatment. (If you look at a Merck Manual from the 1950s, as I have, you would see such changes!! Bleeding and leeches were the standard cures for many a malady when our Republic was founded!!) From your readings, identify and briefly discuss 2 or 3 of the major developments or advances in medicine since the Moors occupied Spain (or our own Declaration of Independence, if you will.) what advances cost very little in money for their enormous impact and benefit and for advances prior to the election of John F. Kennedy as President! Just talk about on and cite the source in APA format

2. As you are aware, there is an enormous public sector devoted to regulating and delivering health services in the USA (made all the more so by recent "health reform" legislation)...despite our abhorrence of socialized medicine. From your research and experiences, identify 2 or 3 important (and not-so-visible but nonetheless important) agencies at the Federal level which impact how Americans receive health care services today or will obtain them under the reform law. Why are the agencies you cited significant players and what is their statutory mandate? In your view, how have these agencies met their missions? If you could reform any aspect of their operations, what might you propose, fiscal matters aside?

The overall goal of the Session Long Project is to examine health care delivery in the United States from a personal perspective.

Assignment expectations for module 5:

1.Research Pennsylvania for health reform initiatives
2.In a 2-3 page paper identify and discuss health care reform initiatives that have been implemented in the past 2-3 years.
3.Be sure to properly cite all of your references.


Case assignment expectations:

Please be sure to cite all sources and provide a reference list at the end of the paper (at least 3 references).
The length of your paper should be 2-3 pages typed and single-spaced.