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The Irony Of Health Care’S Public Option, Allison K. Hoffman 2020 University of Pennsylvania Carey Law School

The Irony Of Health Care’S Public Option, Allison K. Hoffman

Faculty Scholarship at Penn Law

The idea of a public health insurance option is at least a half century old, but has not yet had its day in the limelight. This chapter explains why if that moment ever comes, health care’s public option will fall short of expectations that it will provide a differentiated, meaningful alternative to private health insurance and will spur health insurance competition.

Health care’s public option bubbled up in its best-known form in California in the early 2000s and got increasing mainstream attention in the lead up to the 2010 health reform, the Patient Protection and Affordable Care Act ...


The Effects Of Eighth Years Of Compulsory Schooling Enforcement In Turkey, Muhammed Tumay 2020 The Graduate Center, City University of New York

The Effects Of Eighth Years Of Compulsory Schooling Enforcement In Turkey, Muhammed Tumay

Dissertations, Theses, and Capstone Projects

This dissertation consists of two chapters that cover Education, Labor and Health Economics.

Chapter 1. Impacts of Compulsory Schooling Reform on Higher Education and Intergenerational Educational Mobility: we estimate the effects of an exogenous increase in mandatory schooling (5 years to 8 years of schooling), as a result of a change in compulsory schooling law, on higher education, potential intergenerational educational mobility, and labor market outcomes among women in Turkey. Our empirical strategy addresses a well-known identification problem where women’s years of schooling are endogenous to individual characteristics. The Law took effect in 1997, whereby girls born before January ...


Effect Of Short- And Long-Term Use Of Home And In-Office Bleaching With Carbamide Peroxide And Hydrogen Peroxide On Enamel Microhardness, Nazila Ameli, Niloofar Kianvash Rad, Farzane Nikpour, Raheb Ghorbani, Shadi Mohebi 2020 Department of Orthodontics, Dental School, Semnan University of Medical Sciences, Semnan, Iran

Effect Of Short- And Long-Term Use Of Home And In-Office Bleaching With Carbamide Peroxide And Hydrogen Peroxide On Enamel Microhardness, Nazila Ameli, Niloofar Kianvash Rad, Farzane Nikpour, Raheb Ghorbani, Shadi Mohebi

Journal of Dentistry Indonesia

Bleaching is a well-known esthetic dental treatment performed to lighten the tooth shade. Among different cosmetic dental procedures, including direct and indirect tooth-colored restorations, bleaching is likely the most conservative approach. Bleaching has been accepted well by patients and proven as a safe and effective approach. Objective: Tooth bleaching can be conducted at home or in offices. This study was performed to compare the enamel microhardness before bleaching and one and eight weeks after the application of different bleaching agents. Methods: Forty human premolars were randomly divided into four groups, and their buccal surface underwent a Vickers microhardness test before ...


Oral Rehabilitation Of A Patient With Congenital Erythropoietic Porphyria: A Rare Case Report, Raif Alan, Hakkı Çelebi, Fahriye Kilinc, Recep Dursun 2020 Department of Periodontology, Faculty of Dentistry, Canakkale Onsekiz Mart University, 17100, Canakkale, Turkey

Oral Rehabilitation Of A Patient With Congenital Erythropoietic Porphyria: A Rare Case Report, Raif Alan, Hakkı Çelebi, Fahriye Kilinc, Recep Dursun

Journal of Dentistry Indonesia

Congenital erythropoietic porphyria (CEP) is an extremely rare disorder involved in chronic porphyrias. One of the recommended evaluations to determine disease severity and needs of a person with CEP is dental assessment. Objective: To present a case of CEP and its oral rehabilitation. Case Report: A 32-year-old female patient was admitted to the clinic with hyperkeratinization, skin fragility, fissures, and wounds in her perioral region and hands. Intraoral gingival bleeding, mucogingival stress, and missing teeth were recorded. After medical consultation, phase I and II periodontal therapies were performed. The patient expressed satisfaction of the results of the procedures in terms ...


Direct Composite Resin Restoration Of Anterior Maxillary Teeth And Esthetic Smile Design: A Case Report, Christina Widya Nugrohowati, Wignyo Hadriyanto, Tunjung Nugraheni 2020 Department of Conservative Dentistry, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia

Direct Composite Resin Restoration Of Anterior Maxillary Teeth And Esthetic Smile Design: A Case Report, Christina Widya Nugrohowati, Wignyo Hadriyanto, Tunjung Nugraheni

Journal of Dentistry Indonesia

Dental esthetic complex involves more than one caries with malformed shape and malposition. Dental trauma most commonly affects maxillary anterior teeth, and subsequently affects the esthetics, functions, and psychological well-being of the individual. Composite resins have become an integral part of contemporary restorative and minimally invasive dentistry. Objective: To summarize the successful use of direct composite resin restoration in the management of a 29-year old male patient. Case Report: A 29-year old male patient presenting with multiple secondary caries and crown fractures in the anterior maxillary teeth, resulting in an unaesthetic smile. Comprehensive esthetic dental treatment was carried out. The ...


Treatment Of A Class I Malocclusion With Severe Crowding Using Passive Self-Ligating Brackets, Agita Pramustika, Retno Widayati 2020 Orthodontics Residency Program, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia

Treatment Of A Class I Malocclusion With Severe Crowding Using Passive Self-Ligating Brackets, Agita Pramustika, Retno Widayati

Journal of Dentistry Indonesia

Presently, dental crowding is the most common problem among orthodontic patients. The prevalence of crowding in the dental arch is significantly increased in modern dentitions, and it is the most common reason why patients pursue orthodontic treatment. Objective: To report an advanced bracket systems, namely self-ligating brackets, to increase the efficacy of orthodontic treatment especially in patients with severe crowding. Case Report: A 22-year-old female patient presented with severe crowding of the maxillary and mandibular arches. In the upper arch, both second premolars were palatally positioned; in the lower arch, the lower right canine was lingually positioned and the lower ...


Effectiveness Of Lentinus Edodes Mushroom Extract On Eradication Of Enterococcus Faecalis Biofilm, Putri Lestari Anggiarini, Meiny F Amin, Juanita A Gunawan, Armelia Sari Widyarman 2020 Postgraduate Program, Faculty of Dentistry, Trisakti University, Jakarta 11440, Indonesia

Effectiveness Of Lentinus Edodes Mushroom Extract On Eradication Of Enterococcus Faecalis Biofilm, Putri Lestari Anggiarini, Meiny F Amin, Juanita A Gunawan, Armelia Sari Widyarman

Journal of Dentistry Indonesia

Sodium hypochlorite is a commonly used irrigation solution in endodontic procedures, but it irritates tissues and has toxic effects. Lentinus edodes is a mushroom that has antibacterial properties. Enterococcus faecalis is an anaerobic bacterium that can cause root canal treatment failure. Objective: This study aimed to determine the effect of L. edodes extract on the eradication of E. faecalis biofilms. Methods: Phytochemical tests of L. edodes were performed to analyze alkaloids, steroids, triterpenoids, phenolics, tannins, flavonoids, and glycosides from this extract qualitatively. E. faecalis ATCC 29212 was cultured in brain heart infusion broth for 24 h at 37 ...


Revisiting A Funding Model For University-Led Dental Clinics: The Case Of Complete Denture Fabrication, Rohana Ahmad, Nur Amalina Zul, Siti Anisah Mohtar, Marc Tennant, Tuti Ningseh Mohd-Dom 2020 Department of Prosthodontics, Faculty of Dentistry, University Teknologi MARA, 47000 Sungai Buloh, Malaysia; Integrative Pharmacogenomics Institute, 42300 Puncak Alam, Selangor, Malaysia

Revisiting A Funding Model For University-Led Dental Clinics: The Case Of Complete Denture Fabrication, Rohana Ahmad, Nur Amalina Zul, Siti Anisah Mohtar, Marc Tennant, Tuti Ningseh Mohd-Dom

Journal of Dentistry Indonesia

Objectives: University-led dental clinics are rarely seen as core to the national healthcare system. Thus, when publicly funded universities experience a decline in government support, dental clinic services operated by students are confronted by a potentially inadequate operating budget. Prompted by the need for strategic resource allocation, this study seeks to quantify the resources consumed in the construction of complete dentures by undergraduate students in an effort to identify opportunities for cost-cutting measures. Methods: Clinical cases were retrieved from the logbooks of graduating students of Class 2015, and patient records were reviewed to identify and quantify all clinical and laboratory ...


Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman 2020 University of Maine

Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman

Electronic Theses and Dissertations

Each year, Americans spend more money on health care than any other industrialized nation, despite comparable mortality rates for people with risk factors for heart disease. The reasons for this lack of health care value in the US are numerous and complex – including market distortions like supplier-inflated pricing and regulatory structures that enable consumers to utilize ubiquitous, high-cost medical technologies that yield uncertain benefits. Health insurance, once thought to be an insignificant contributor to rising health spending, has changed considerably in the past few decades in ways that make it more accessible and more generous in coverage. Health insurance design ...


A Rational-Choicemodel Of Covid-19 Transmission With Endogenous Quarantining And Two-Sided Prevention, Joydeep Bhattacharya, Shankha Chakraborty, Xiumei Yu 2020 Iowa State University

A Rational-Choicemodel Of Covid-19 Transmission With Endogenous Quarantining And Two-Sided Prevention, Joydeep Bhattacharya, Shankha Chakraborty, Xiumei Yu

Economics Working Papers

This paper offers a parsimonious, rational-choice model to study the effect of pre-existing inequalities on the transmission of COVID-19. Agents decide whether to "go out" (or self-quarantine) and, if so, whether to wear protection such as masks. Three elements distinguish the model from existing work. First, non-symptomatic agents do not know if they are infected. Second, some of these agents unknowingly transmit infections. Third, we permit two-sided prevention via the use of non-pharmaceutical interventions: the probability of a person catching the virus from another depends on protection choices made by each. We find that a mean-preserving increase in pre-existing income ...


Who Can Work And Study From Home In Pakistan: Evidence From A 2018-19 Nationwide Household Survey, Syed Hasan, Attique Rehman, Wendong Zhang 2020 Lahore University of Management Sciences

Who Can Work And Study From Home In Pakistan: Evidence From A 2018-19 Nationwide Household Survey, Syed Hasan, Attique Rehman, Wendong Zhang

Economics Working Papers

In this article, we examine the feasibility of working and studying from home in Pakistan. We take advantage of the recently released 2018–19 Pakistan Social and Living Standards Measurement (PSLM) Survey. PSLM is a nationally representative household survey with extensive information on employment outcomes, children’s educational attainment, as well as internet and computer access and prior usage information. Modifying Dingel and Neiman [2020]’s approach, we define the feasibility of jobs that can be done from home based on the percentage of tasks that can be switched online and accounting for internet accessibility. We also investigate the possibilities ...


The Aca’S Choice Problem, Allison K. Hoffman 2020 University of Pennsylvania Carey Law School

The Aca’S Choice Problem, Allison K. Hoffman

Faculty Scholarship at Penn Law

The Affordable Care Act (ACA) is in many ways a success. Millions more Americans now have access to health care, and the ACA catalyzed advances in health care delivery reform. Simultaneously, it has reinforced and bolstered a problem at the heart of American health policy and regulation: a love affair with choice. The ACA’s insurance reforms doubled down on the particularly American obsession with choice. This article describes three ways in which that doubling down is problematic for the future of US health policy. First, pragmatically, health policy theory predicts that choice among health plans will produce tangible benefits ...


Opioid Overdoses Among High-Risk Medicaid Members: Healthcare Cost, Service Utilization, And Risk Factor Analysis, Judith A. Savageau, Melissa Brindisi, Faye Miller, Laura A. Sefton, Adam Stoler, Margaret Harvey, Dana Bernson 2020 University of Massachusetts Medical School

Opioid Overdoses Among High-Risk Medicaid Members: Healthcare Cost, Service Utilization, And Risk Factor Analysis, Judith A. Savageau, Melissa Brindisi, Faye Miller, Laura A. Sefton, Adam Stoler, Margaret Harvey, Dana Bernson

Commonwealth Medicine Publications

Research Objective: Identify risk factors associated with opioid overdoses among three high-risk populations of Medicaid members related to cost and service utilization.

Study Design: Repeated cross-sectional study using five years of Massachusetts Medicaid (MassHealth) claims and state agency data.

Population Studied: MassHealth members aged 11-64 years considered to be high-risk (homeless, unstably housed, and/or criminal justice-involved) and in need of support services, especially those with extensive behavioral health (BH) needs. These three populations were identified as being particularly vulnerable to non-fatal and/or fatal opioid overdoses.

Principal Findings: MassHealth members who were both justice-involved and unstably housed were at ...


Improving Care Coordination Between Accountable Care Organizations And Community Partners: Early Findings From The Massachusetts Delivery System Reform Incentive Payment (Dsrip) Program, Aparna Kachoria, Amy Leary, Faye Miller, Laura A. Sefton, Joanne Nicholson, Jay Himmelstein 2020 University of Massachusetts Medical School

Improving Care Coordination Between Accountable Care Organizations And Community Partners: Early Findings From The Massachusetts Delivery System Reform Incentive Payment (Dsrip) Program, Aparna Kachoria, Amy Leary, Faye Miller, Laura A. Sefton, Joanne Nicholson, Jay Himmelstein

University of Massachusetts Medical School Publications

Research Objective: The Massachusetts’ Medicaid and Children’s Health Insurance Program (MassHealth/MH) initiated the Delivery System Reform Incentive Payment (DSRIP) program in 2017, as part of its section 1115 Demonstration, to coordinate care for Medicaid members, reduce healthcare costs and improve patient outcomes. Central to this program was a requirement that Accountable Care Organizations (ACOs) develop relationships with all behavioral health and at least 2 long-term care service MH contracted Community Partner agencies (CPs) operating in their service areas to be responsible for coordinating care and developing care plans for members. This presentation will describe barriers and facilitators to ...


Uptake Of Direct Acting Antivirals For Hepatitis C Virus In A New England Medicaid Population, 2014-2017, Karen M. Clements, Parag Kunte, Bonnie C. Greenwood, Carter Pratt, Laura A. Sefton, Melissa Clark, Sharina D. Person, Deborah Gurewich 2020 University of Massachusetts Medical School

Uptake Of Direct Acting Antivirals For Hepatitis C Virus In A New England Medicaid Population, 2014-2017, Karen M. Clements, Parag Kunte, Bonnie C. Greenwood, Carter Pratt, Laura A. Sefton, Melissa Clark, Sharina D. Person, Deborah Gurewich

University of Massachusetts Medical School Publications

Introduction

Introduction of the direct acting antiviral (DAA) sofosbuvir (SOV) in 2013 offered significant improvement over previous options for hepatitis C virus (HCV) treatment. Initial uptake was low in Medicaid and other populations, perhaps in part due to high drug cost and prior authorization (PA) restrictions related to fibrosis stage, prescribing provider specialty, and sobriety. Both the subsequent introduction of ledipasvir/sofosbuvir (LDV/SOV), an all-oral regimen for most genotypes, and lifting of PA restrictions were expected to increase overall uptake, but little is known about recent prescribing patterns. We examined trends in DAA uptake in a Medicaid population and ...


The Full Impact Of The Affordable Care Act On Political Participation, Charles J. Courtemanche, James Marton, Aaron Yelowitz 2020 University of Kentucky

The Full Impact Of The Affordable Care Act On Political Participation, Charles J. Courtemanche, James Marton, Aaron Yelowitz

Economics Faculty Publications

This article examines the impact of both the Medicaid expansion and the private insurance-related components of the Affordable Care Act (ACA) on voter turnout and registration. We employ a difference-in-difference-in-differences identification strategy exploiting variation over time, state Medicaid expansion status, and within-state local area pre-ACA uninsured rates. Using data between 2006 and 2016 from the November Current Population Survey and the Census Bureau's Small Area Health Insurance Estimates, our results suggest little effect of the ACA on voter turnout or registration.


What Do We Know About Health Insurance Choice?, Megan McCarthy-Alfano 2020 University of Pennsylvania

What Do We Know About Health Insurance Choice?, Megan Mccarthy-Alfano

Issue Briefs

No abstract provided.


Setting Standards For Affordable Health Care, Janet Weiner 2020 University of Pennsylvania

Setting Standards For Affordable Health Care, Janet Weiner

Issue Briefs

In the run-up to the presidential election, the affordability of health care remains a top concern of the American voting public. But how do we know when health care is affordable? On a policy level, how do we set a standard for affordability that can be implemented in a reformed system? Sometimes policy debates about affordability focus only on whether insurance premiums are affordable, although consumers tend to be concerned about both premiums and out-of-pocket costs. At Penn LDI’s Medicare for All and Beyond conference, a panel of researchers, policy experts, and consumer advocates discussed and debated affordability ...


Medical Resource Use And Costs Of Treating Sickle Cell-Related Vaso-Occlusive Crisis Episodes: A Retrospective Claims Study, Nirmish Shah, Menaka Bhor, Lin Xie, Jincy Paulose, Huseyin Yuce 2020 Duke University

Medical Resource Use And Costs Of Treating Sickle Cell-Related Vaso-Occlusive Crisis Episodes: A Retrospective Claims Study, Nirmish Shah, Menaka Bhor, Lin Xie, Jincy Paulose, Huseyin Yuce

Publications and Research

Background: The study investigated the economic burden of vaso-occlusive crisis (VOC) among sickle cell disease (SCD) patients, through assessment of overall utilization and costs and costs per VOC episode (regarding the number of VOC episodes and health care setting, respectively).

Methods: Using the Medicaid Analytic Extracts database, the first SCD-related diagnosis claim (index claim) between June 1, 2009–December 31, 2012 was identified among eligible adults. Patients were required to have continuous medical and pharmacy benefits for 6 months pre- and 12 months post-index. Discrete VOC claims identified within a 3-day gap were combined as a single VOC episode. Annual ...


Professional Sporting Events Increase Seasonal Influenza Mortality In Us Cities, Alexander Cardazzi, Brad Humphreys, Jane E. Ruseski, Brian P. Soebbing, Nicholas Watanabe 2020 West Virginia University

Professional Sporting Events Increase Seasonal Influenza Mortality In Us Cities, Alexander Cardazzi, Brad Humphreys, Jane E. Ruseski, Brian P. Soebbing, Nicholas Watanabe

Economics Faculty Working Papers Series

The COVID-19 pandemic shut down sporting events worldwide. Local policy makers and league officials face important decisions about restarting play, especially in professional leagues that draw large numbers of spectators to games. We analyze the impact of professional sporting events on local seasonal influenza mortality to develop evidence that will help inform sports league reopening policy decisions. Results from a difference-in-differences model applied to data from a sample of US cities that gained new professional sports teams over the period 1962-2016 show that the presence of games in these cities increased local influenza mortality by between 4% and 24%, depending ...


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