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Articles 1 - 15 of 15
Full-Text Articles in Health Policy
Confronting Wartime Sexual Violence: Public Support For Survivors In Bosnia, Douglas D. Page, Samuel Whitt
Confronting Wartime Sexual Violence: Public Support For Survivors In Bosnia, Douglas D. Page, Samuel Whitt
Political Science Faculty Publications
Existing research on conflict-related sexual violence focuses on the motivations of perpetrators and effects on survivors. What remains less clear is how postconflict societies respond to the hardships survivors face. In survey experiments in Bosnia, we examine public support for financial aid, legal aid, and public recognition for survivors. First, we find a persistent ethnocentric view of sexual violence, where respondents are less supportive when the perpetrator is identified as co-ethnic and survivors are perceived as out-groups. Second, respondents are less supportive of male survivors than female survivors, which we attribute to social stigmas surrounding same-gender sexual activity. Consistent with …
An Analysis Of Political And Legal Debates Concerning Medicaid Expansion In Virginia, Rick Mayes, Benjamin Paul
An Analysis Of Political And Legal Debates Concerning Medicaid Expansion In Virginia, Rick Mayes, Benjamin Paul
Political Science Faculty Publications
The Supreme Court’s historic June 2012 ruling regarding the Affordable Care Act (ACA) in National Federation of Independent Business v. Sebelius set the stage for a massive federalism battle over Medicaid expansion in the United States. The original language of the Act was intended to nationalize Medicaid by having every state expand their program’s eligibility to all individuals up to 138% of the federal poverty level. This would have significantly reshaped Medicaid, a joint federal-state health insurance program, into a universal entitlement for all low-income citizens. Currently, Medicaid eligibility varies dramatically from state to state. The Court held that the …
Strategies For Health Care Cost Containment (1980s-Present), Rick Mayes
Strategies For Health Care Cost Containment (1980s-Present), Rick Mayes
Political Science Faculty Publications
The U.S. health care system during the past three decades has been over two interrelated questions: first, who will control the manner in which medical care is paid for, and, second, how much will it cost? Many health care experts believe that Medicare's efforts at cost control, primarily in the form of the program's seminal transition to and continual modification of prospective payment of health care providers, has both triggered and repeatedly intensified the economic restructuring of the U.S. health care system. Medicare is an almost $600 billion public health insurance program for individuals sixty-five years of age and older; …
Catholic Claims Stretch The First Amendment, Ellis M. West
Catholic Claims Stretch The First Amendment, Ellis M. West
Political Science Faculty Publications
The Obama administration recently issued a regulation requiring all employers except religious organizations to include contraceptives in their employees' health insurance. The Catholic Church and various politicians have accused the administration of violating the church's religious freedom. Although the administration has modified its original regulation, it continues to be attacked for "waging war" on religious freedom.
Beyond Capitation: How New Payment Experiments Seek To Find The 'Sweet Spot' In Amount Of Risk Providers And Payers Bear, Rick Mayes, Austin B. Frakt
Beyond Capitation: How New Payment Experiments Seek To Find The 'Sweet Spot' In Amount Of Risk Providers And Payers Bear, Rick Mayes, Austin B. Frakt
Political Science Faculty Publications
A key issue in the decades-long struggle over US health care spending is how to distribute liability for expenses across all market participants, from insurers to providers. The rise and abandonment in the 1990s of capitation payments—lump-sum, per person payments to health care providers to provide all care for a specified individual or group—offers a stark example of how difficult it is for providers to assume meaningful financial responsibility for patient care. This article chronicles the expansion and decline of the capitation model in the 1990s. We offer lessons learned and assess the extent to which these lessons have been …
Postmortems On The Affordable Care Act (Book Review), Rick Mayes
Postmortems On The Affordable Care Act (Book Review), Rick Mayes
Political Science Faculty Publications
Nearly two years after the Affordable Care Act became law, books are appearing by Washington insiders who detail how the legislation came about. The two reviewed here discuss and dissect topics related to the health reform law from decidedly different points of view.
Pay-For-Performance Reimbursement In Health Care: Chasing Cost Control And Increased Quality Through "New And Improved" Payment Incentives, Rick Mayes, Jessica Walradt
Pay-For-Performance Reimbursement In Health Care: Chasing Cost Control And Increased Quality Through "New And Improved" Payment Incentives, Rick Mayes, Jessica Walradt
Political Science Faculty Publications
Pay-for-performance (P4P) reimbursement has become a popular and growing form of health care payment built on the belief that payment incentives strongly affect medical providers' behavior. By paying more to those providers who are deemed to deliver better care, the goal is to increase quality and, hopefully restrain cost growth. This article provides a brief explanation of: (1) how previous P4P plans in the U.S. have fared, along with their special relationship to primary care, and (2) how England's experience with P4P and newer versions of these kinds of plans being pursued in places such as Massachusetts might provide valuable …
The Way It Was In Health Policy, And Probably Will Be: Learning Lessons By Rashi Fein (Book Review), Rick Mayes
The Way It Was In Health Policy, And Probably Will Be: Learning Lessons By Rashi Fein (Book Review), Rick Mayes
Political Science Faculty Publications
Learning Lessons by Rashi Fein is an enjoyable memoir from a scholar and policy adviser unlike any other. Fein’s influential involvement in health care policy dates back to John F. Kennedy’s administration, and his career as a leading health economist paralleled the significant growth in the political influence of health economists following the enactment of Medicare and Medicaid in 1965. Now an emeritus professor of the economics of medicine at Harvard Medical School, Fein writes here about the lessons he learned in medicine, economics, and public policy. His view of the policy process, as a way of coming to …
Medicating Children: The Enduring Controversy Over Adhd And Pediatric Stimulant Pharmacotherapy, Rick Mayes, Jennifer L. Erkulwater, Catherine Bagwell
Medicating Children: The Enduring Controversy Over Adhd And Pediatric Stimulant Pharmacotherapy, Rick Mayes, Jennifer L. Erkulwater, Catherine Bagwell
Political Science Faculty Publications
Attention Deficit Hyperactivity Disorder (ADHD) holds the distinction of being both the most extensively studied pediatric mental disorder and one of the most controversial. This is partly due to the fact that it is also the most commonly diagnosed mental disorder among minors. On average, one in every ten to 15 children in the U.S. has been diagnosed with the disorder and one in every 20 to 25 uses a stimulant medication—often Ritalin, Adderall, or Concerta—as treatment. The biggest increase in youth diagnosed with ADHD and prescribed a stimulant drug occurred during the 1990s, when the prevalence of physician visits …
Pursuing Cost Containment In A Pluralistic Payer Environment: From The Aftermath Of Clinton’S Failure At Health Care Reform To The Balanced Budget Act Of 1997, Rick Mayes, Robert E. Hurley
Pursuing Cost Containment In A Pluralistic Payer Environment: From The Aftermath Of Clinton’S Failure At Health Care Reform To The Balanced Budget Act Of 1997, Rick Mayes, Robert E. Hurley
Political Science Faculty Publications
Following a decade in which Medicare operated as the leading ‘change agent’ within the US health care system, the private sector rose to the fore in the mid 1990s. The failure of President Clinton’s attempt at comprehensive, public sector-led reform left managed care as the solution for cost control. And for a period it worked, largely because managed care organizations were able to both squeeze payments to selective networks of medical providers and significantly reduce inpatient hospital stays. There was a lot of ‘fat’ in the nation’s convoluted health care system that could be (and was) eliminated through competitive negotiations …
The Origins Of And Economic Momentum Behind "Pay For Performance" Reimbursement, Rick Mayes
The Origins Of And Economic Momentum Behind "Pay For Performance" Reimbursement, Rick Mayes
Political Science Faculty Publications
"Pay for performance," a reimbursement method under which some physicians and hospitals are paid more than others for the same services because they have been deemed to deliver better quality care and their patients appear to have better outcomes, is enormously controversial. Disputes invariably arise over how "quality" should (or even can) be measured. Nevertheless, differentiating between medical providers, financially, lies at the heart of this new reimbursement innovation developed by insurance companies and employers. Its two main objectives are: (1) to increase the overall quality of health care that patients receive, and (2) to encourage behavioral change on the …
Medicare And America's Healthcare System In Transition: From The Death Of Managed Care To The Medicare Modernization Act Of 2003 And Beyond, Rick Mayes
Political Science Faculty Publications
This article traces the transition-in Medicare, specifically, and in the American healthcare system, generally-from the aftermath of the Balanced Budget Act of 1997 to the passage of the Medicare Modernization Act of 2003. During this time, restrictive managed care died under an onslaught of resurgent cost pressures, legislative and legal attacks, and a vehement physician and consumer backlash. The subsequent reversion to more generous (and more expensive) health plans coincided with a recession in 2001 to trigger a return to rapidly escalating healthcare spending and yet another in the Nation's series of healthcare crises. Current trends suggest that future policymakers …
Universal Coverage And The American Health Care System Crisis (Again), Rick Mayes
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 …
Did A Rising Tide Lift All Boats? The Nih Budget And Pediatric Research Portfolio, Daniel P. Gitterman, Robert S. Greenwood, Keith C. Kocis, Rick Mayes, Aaron N. Mckethan
Did A Rising Tide Lift All Boats? The Nih Budget And Pediatric Research Portfolio, Daniel P. Gitterman, Robert S. Greenwood, Keith C. Kocis, Rick Mayes, Aaron N. Mckethan
Political Science Faculty Publications
This paper examines National Institutes of Health (NIH) pediatric research spending in absolute terms and relative to the doubling of the NIH overall budget between fiscal years 1998 and 2003. Pediatric spending increased by an average annual rate of 12.8 percent during the doubling period (almost on par with the NIH average annual growth rate of 14.7 percent). However, the proportion of the total NIH budget devoted to the pediatric portfolio declined from 12.3 to 11.3 percent. We offer recommendations for implementing existing commitments to strengthen the pediatric research portfolio and to protect the gains of the doubling period.
Older Americans' Attitudes Toward The Medicare Catastrophic Coverage Act Of 1988, Christine L. Day
Older Americans' Attitudes Toward The Medicare Catastrophic Coverage Act Of 1988, Christine L. Day
Political Science Faculty Publications
Congress repealed the Medicare Catastrophic Coverage Act of 1988, which expanded Medicare benefits, after vigorous protests by groups of older people nationwide. Surveys show, however, that older Americans were deeply divided in their opinions. This study examines four explanations for divisions among the elderly on this issue: symbolic politics, socioeconomic status, distrust in government, and direct self-interest. The results of probit analysis indicate that high income, younger age (under 75), Republican partisanship, and distrust in government all contributed to older Americans' opposition to government catastrophic health care coverage. Direct self-interest—that is, perceived direct impact on one's own taxes and benefits—was …