Medicine and Health Sciences Commons^™

Non-Elderly Adults On Disability In The Cf Population, Lea Nolan, Semret Seyoum, Julanne Wilson, Marsha Regenstein

Health Policy and Management Issue Briefs

No abstract provided.

Dance/Movement Therapy And A Search For Wholeness Under Capitalism, Autumn Wright

Dance/Movement Therapy Theses

Wellness, as it is currently defined in late capitalism, is a luxury good for the ruling class. Capitalism and the commodification of wellness go largely unaddressed in current dance/movement therapy research. In the United States, dance/movement therapists operate within the for-profit healthcare system. The United States is the only industrialized democracy in the world without a national health insurance program. Despite the access to state licensure for the past 20 years, dance/movement therapists still have no guarantee that health insurance companies will pay for their services. Concurrently, there has been a surgency of self-proclaimed wellness coaches. These …

Risk Indicators Of Food Insecurity In The Cf Population, Semret Seyoum, Marsha Regenstein, Lea Nolan

Health Policy and Management Issue Briefs

No abstract provided.

Cost, Coverage, And The Underuse Of Medications Among People With Cf, Semret Seyoum, Marsha Regenstein, Lea Nolan

Health Policy and Management Issue Briefs

No abstract provided.

Mhpaea & Marble Cake: Parity & The Forgotten Frame Of Federalism, Taleed El-Sabawi

Dickinson Law Review (2017-Present)

No abstract provided.

Chapter: “Health Law And Ethics”, Allison K. Hoffman, I. Glenn Cohen, William M. Sage

All Faculty Scholarship

Law and ethics are both essential attributes of a high-functioning health care system and powerful explainers of why the existing system is so difficult to improve. U.S. health law is not seamless; rather, it derives from multiple sources and is based on various theories that may be in tension with one another. There are state laws and federal laws, laws setting standards and laws providing funding, laws reinforcing professional prerogatives, laws furthering social goals, and laws promoting market competition. Complying with law is important, but health professionals also should understand that the legal and ethical constraints under which health systems …

Time Banks As Aging-In-Place Initiatives, Calli Sajnani

Walden Dissertations and Doctoral Studies

There has been growing concern over how state and federal governments can support the increasing population of aging Americans and their need for long-term care. Current insurance funding models cover acute hospitalization and skilled care only, leaving unskilled care needs and homemaker services at the full expense of those in need. Time banking allows individuals to exchange or barter time for goods or services without monetary payment. There is insufficient evidence to determine if members believe time banks to be a viable alternative to support aging-in-place care needs. This phenomenological study explored time banking as a potential vehicle for nonskilled …

Maintaining Public Health Insurance Benefits: How Primary Care Clinics Help Keep Low-Income Patients Insured, Rose L. Harding, Jennifer D. Hall, Jennifer Devoe, Heather Angier, Rachel Gold, Christine Nelson, Sonja Likumahuwa-Ackman, John Heintzman, Aleksandra Sumic, Deborah J. Cohen

Patient Experience Journal

Low-income families struggle to obtain and maintain public health insurance. We identified strategies used by Community Health Centers (CHCs) to assist patients with insurance applications, and assessed patients’ receptivity to these efforts. Observational cross-case comparative study with four CHCs in Oregon. We observed insurance assistance processes, and interviewed 26 clinic staff and 18 patients/family members. Qualitative data were analyzed using a grounded theory approach. Patients’ understanding of eligibility status, reapplication schedules, and how to apply, were major barriers to insurance enrollment. Clinic staff addressed these barriers by reminding patients when applications were due, assisting with applications as needed, and tracking …

Knowledge Of Health Insurance Concepts And The Affordable Care Act Among Rural Residents, Erika C. Ziller Phd

Health System Reform

Health insurance literacy is central to identifying eligibility for coverage and subsidies, choosing a plan, and using optimal healthcare services under the Affordable Care Act (ACA) or other insurance reform initiatives. To fully benefit from policy efforts to improve health insurance access, rural residents must have the ability to select the plan that best meets their healthcare needs. However, a higher proportion of rural residents possess characteristics that may put them at risk of lower health insurance literacy, including lower incomes and educational attainment, less experience with private insurance, and historically higher uninsured rates. Using Health Reform Monitoring Survey data …

Breast Cancer Care In California And Ontario: Primary Care Protections Greatest Among The Most Socioeconomically Vulnerable Women Living In The Most Underserved Places, Kevin M. Gorey, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty

Social Work Publications

Background: Better health care among Canada’s socioeconomically vulnerable versus America’s has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. Methods: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists. The optimal care criterion was being diagnosed early with node negative disease and received breast conserving surgery followed by adjuvant radiation …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Health Insurance Co-Ops: Product Availability And Premiums In Rural Counties, Erika C. Ziller Phd, Zachariah T. Croll Ba, Andrew F. Coburn Phd

Access / Insurance

Created by the Affordable Care Act (ACA), Consumer Operated and Oriented Plans (CO-OPs) are private, non-profit health insurers that were designed to increase insurance plan choice and lower premiums in the Health Insurance Marketplaces. Early analyses of the ACA suggested that CO-OPs may be particularly beneficial for rural communities, where fewer individual and small group health insurance options have traditionally been available.

This Research and Policy Brief, authored by research staff at the Maine Rural Health Research Center, explores the early availability and role of CO-OPs in rural and urban counties. We describe the regional distribution and market prevalence of …

Pharmacy Use By Dual-Eligible Non-Elderly Veterans With Private Healthcare Insurance, Brian C. Lund, Mary E. Charlton, Alan N. West

Dartmouth Scholarship

The Veterans Health Administration (VHA) is the largest nationally integrated healthcare system in the United States, operating 168 medical centers and more than 1000 community based outpatient clinics. However, many veterans seek care outside the VHA system, particularly when they are also covered by state or federal programs such as Medicare or Medicaid, or have access to private health insurance, often through employment. Concerted efforts have been made to facilitate communication and coordinate care between VHA and private sector healthcare, but concurrent use of these systems adds to an already fragmented U.S health care system.

Economic Windfalls And The Affordable Care Act: A Policy Proposal, Joshua Congdon-Hohman, Victor Matheson

Economics Department Working Papers

This paper identifies a major issue with windfall payments under either possible interpretation of the ACA as it currently stands. Several alternatives are proposed that would eliminate the windfalls. We advocate the establishment of a tort award funded “Federal Stabilization Fund” to improve the economic efficiency of future health care awards in the age of the Affordable Care Act

A Socio-Ecological Model Of Affordable Care Act Acceptance, Pratiksha Vaghela

USF Tampa Graduate Theses and Dissertations

Background: Since 1965, there have not been any major revisions of the healthcare laws in the United States, until the recent implementation of the Affordable Care Act (ACA). However, ACA is not well understood and is often controversial. The purpose of this study is to: (1) evaluate the relationship between the employers’ and the employees’ perceptions regarding the ACA mandates for small businesses, (2) evaluate the relationship between the self-reported and the tested knowledge of individuals regarding the ACA mandates for small businesses, and (3) determine if socio-demographic factors influence individual’s perception of the law. Based on the gathered information, …

Breast Cancer Among Women Living In Poverty: Better Care In Canada Than In The United States, Kevin M. Gorey, Nancy L. Richter, Isaac N. Luginaah, Caroline Hamm, Eric J. Holowaty, Guangyong Zou, Madhan K. Balagurusamy

Social Work Publications

This historical study estimated the protective effects of a universally accessible, single-payer health care system versus a multipayer system that leaves many uninsured or underinsured by comparing breast cancer care of women living in high-poverty neighborhoods in Ontario and California between 1996 and 2011. Women in Canada experienced better care, particularly as compared with women who were inadequately insured in the United States. Women in Canada were diagnosed earlier (rate ratio [RR] = 1.12) and enjoyed better access to breast conserving surgery (RR = 1.48), radiation (RR = 1.60), and hormone therapies (RR = 1.78). Women living in high-poverty Canadian …

Social Actors Fight The Rising Tide Of Hiv In U.S. Southern Poor, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

The greatest number of persons living with HIV in the United States are now living in the South, and they face poorer health outcomes and increased AIDS-related deaths as compared to the rest of the country. The southern United States has a disproportionate share of low-income individuals, with many lacking access to health care and health insurance. Health facilities are also comparatively fewer and more difficult to reach than in other areas of the United States. The impacts of this already poor health infrastructure on low-income people living with HIV in the South can be life-threatening.

This policy brief summarizes …

Understanding Hiv Care Delays In The Us South And The Role Of The Social-Level In Hiv Care Engagement/Retention: A Qualitative Study, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

Introduction: In a significant geographical shift in the distribution of HIV infection, the US South - comprising 17 states - now has the greatest number of adults and adolescents with HIV (PLHIV) in the nation. More than 60% of PLHIV are not in HIV care in Alabama and Mississippi, contrasted with a national figure of 25%. Poorer HIV outcomes raise concerns about HIV-related inequities for southern PLHIV, which warrant further study. This qualitative study sought to understand experiences of low-income PLHIV on the AIDS Drug Assistance Program in engagement and retention in continuous HIV care in two sites in Alabama. …

Lack Of Access To Chemotherapy For Colon Cancer: Multiplicative Disadvantage Of, Kevin M. Gorey

Social Work Publications

No abstract provided.

Heterogeneity In The Purchase And Use Of Health Insurance : Lessons From The Massachusetts Health Insurance Reform, Jihyun Shin

Legacy Theses & Dissertations (2009 - 2024)

This dissertation presents a set of analyses that are thematically linked to the trajectory of research inquiries about the relation between the health care reform and insurance demand and the association between health insurance and use of primary care services.

"Choices" Florida's Version Of Obamacare, Jason Lamarr Wasden

UNLV Theses, Dissertations, Professional Papers, and Capstones

"CHOICES" Florida's version of ObamaCare was a unique case voted in by the public in Alachua County Florida. A mixed methods research design was utilized and provided context in which policy entrepreneurs operated, as well as an explanatory model of internal determinants. Social, economic and political factors were examined to determine the predictor variable in the adoption of the "CHOICES" health services program. The results revealed that voters 51 years of age and older had a greater probability of voting for the Alachua Referendum. "CHOICES" legality has not been under contention but its effectiveness has. This study found that "CHOICES" …

The Patient Protection And Affordable Care Act: Why It Is Important For Women’S Health, Mary Fanning

Journal of Interdisciplinary Feminist Thought

President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA) on March 23, 2010 ending the long history of disparity in access to health care services between insured and uninsured persons. Disparity between women and men in obtaining health insurance coverage is also corrected in the act. Women’s organizations that have focused attention on women’s distinctive health needs over the past century and a half laid the foundation for provisions in the legislation that address women’s health. This article addresses health insurance coverage, its impact on health, the particular challenges women have confronted in seeking coverage, …

Influences Of Health Insurance And Primary Care On Breast And Cervical Cancer Screening Among Black Women In Boston, Gail Barlow Gall

Graduate Doctoral Dissertations

Healthy People 2010 promoted breast and cervical cancer screening to reduce cancer among all women and reduce disparities in cancer deaths between Black and White women. The REACH 2010 program targeted improving screening rates among Black women and funded a demonstration project to provide outreach, screening, patient navigation and case management for Black women in Boston. The purpose of this study was to describe associations between health insurance and primary care (having a primary care provider [PCP], quality of communications and relationship with PCP) on differences in breast and cervical cancer screening reported by Black women born in the United …

Risky Business: Effectiveness Of State Market-Based Health Programs, Christopher Stream, Nathan Myers

Public Policy and Leadership Faculty Publications

Since the 1990s, state governments have been leaders of health care reform. Today, approximately 47 million people are without health insurance. As health care costs and uninsurance levels continue to rise, states are pursuing a variety of government- and market-based strategies to address this growing social problem. Health care research has indicated that state-based programs have proven to be successful in extending access to coverage. However, the question remains as to whether the market-based programs have had a positive impact on state health care. Advocates for market-based state health programs argue that the reforms benefit the greater good because they …

The Effectiveness And Adoption Of Market-Based State Health Care Expansion Programs, Nathan Gregory Myers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Market-based state health expansion programs are alternatives to government programs like Medicaid and SCHIP which also seek to expand access to health insurance for uninsured populations. These programs either utilize the private health insurance market or function according to market principles. The market-based policies at issue in this research are state high-risk health insurance pools, limited benefit plans, group purchasing arrangements, reinsurance programs, and Health Insurance Flexibility and Accountability waivers. This research addresses two separate but related research questions: (1) Do these market-based programs provide general economic and social benefits for the citizens of a state? (2) What role does …

The Health Insurance Debate In Canada: Lessons For The United States?, Mary Anne Bobinski

Faculty Articles

This Essay begins with an intentionally ambiguous title. Are comparisons to Canada relevant and useful for policy-makers in the United States and, if so, what lessons can we learn? Part II of this Essay highlights some of the risks and benefits of cross-border comparisons between the United States and Canada. In Part III, I analyze some of the key data points often cited in comparing the two health care systems. Part IV explores the current Canadian debate about private health insurance. Finally, in Part V, I focus on the lessons from Canada for the health insurance debate in the United …

Update - September 2005, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Just Care: Rationing in a Public Health Crisis
-- Editorial
-- Graduate profiles
-- Jack W. Provonsha Lecture Series: Physician-Assisted Suicide: A Religious Perspective

The Road To Universal Health Coverage In Massachusetts: A Story In Three Parts, John E. Mcdonough

New England Journal of Public Policy

In 1988, the Massachusetts Legislature passed a new law, a “play or pay” employer mandate, requiring all employers with six or more workers to provide health insurance coverage for their employees. A few years later, with Medicaid identified as a “Budget Buster,” the Weld administration sought deregulation as the way to cut costs and expand access by establishing MassHealth, which dropped the employer mandate and expanded Medicaid, and eventually distinguished Massachusetts as the state with the greatest percent of covered citizens. But MassHealth enrollment has declined as premium costs have risen, and the Uncompensated Care Pool is once again faced …

Universal Coverage And The American Health Care System Crisis (Again), Rick Mayes

Political Science Faculty Publications

Ten years after President Clinton’s ambitious attempt at comprehensive health care reform died, several old and new issues with the health care system have emerged. First, the number of uninsured Americans rose to 43.6 million in 2002—and the numbers have since increased. Also, the costs for those who do not have insurance are rapidly increasing. In addition health care related problems are one of the leading causes of personal bankruptcy in the United States. Finally, the government’s two primary health insurance programs—Medicare and Medicaid—are experiencing considerable financial strain. Dr. Mayes examines these problems in depth before and revisits President Clinton’s …

Dirigo Health: A Small Business Perspective, Deborah Cook

Maine Policy Review

In her commentary Deborah Cook, executive director of the Maine Small Business Alliance, discusses Dirigo Health from the viewpoint of small businesses, whose employees and families, along with the self-employed, represent the largest proportion of uninsured in Maine’s population. She notes that rising costs of health care and insurance are a major threat to the viability of small businesses.