Coverage

Srinath Reddy, Yasmine Rouai, Jeffrey L. Sturchio, Cicely Thomas, Tana Wuliji, Snow Yang, Pascal Zurn

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty. Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly. What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.

Framed is a wake-up call for those who think that race does not matter in Canada. The first book on the media’s coverage of race in Canadian politics, it provides an empirical analysis of print media combined with in-depth interviews of elected officials, former candidates, political staffers, and journalists. While there may be few examples of overt racism in newspapers, Erin Tolley reveals how racial assumptions and narratives frame news stories and the experiences of those who enter political life. Connecting the dots, she argues that current reporting trends are weakening Canada’s commitment to a robust, inclusive democracy.

A lively, clear explanation of the American healthcare reform movement from a noted expert—giving women the tools they need to demand fair and affordable coverage for all people Healthcare is one of America’s most dysfunctional and confusing industries, and women bear the brunt of the problem when it comes to both access and treatment. Women, who make 80 percent of healthcare decisions for their families, are disproportionately impacted by the complex nature of our healthcare system—but are also uniquely poised to fix it. Founder and CEO of Day Health Strategies Rosemarie Day wants women to recognize their trouble with accessing affordable care as part of a national emergency. Day encourages women throughout the country to share their stories and get involved, and she illustrates how a groundswell of activism, led by everyday women, could create the incentives our political leaders need to change course. Marching Toward Coverage gives women the clear information they need to move this agenda forward by breaking down complicated topics in an accessible manner, like the ACA (Affordable Care Act), preexisting conditions, and employer-sponsored plans. With more than 25 years working in healthcare strategy and related fields, Day helps the average American understand the business of national health reform and lays out a pragmatic path forward, one that recognizes healthcare as a fundamental human right.