Cutting Health Care

In April 2001, the Prime Minister established the Commission on the Future of Health Care in Canada. Its mandate was to review medicare, engage Canadians in a national dialogue on its future, and make recommendations to enhance the system's quality and sustainability. The 47 recommendations in this report outline actions that must be taken in 10 critical areas, starting by renewing the foundations of medicare and considering Canada's role in improving health around the world.

Wasting Away examines the logic and results of cost-cutting and privatization. Care providers and patients offer evidence that many of the recent changes have reinforced these problems. The current medical model emphasizes aggressive, curative treatments, while fewer and fewer Canadians enjoy access to good care. Wasting Away is essential reading for Canadians concerned with contemporary - and future - health care.

"Rationing can be defined as a way of limiting products in short supply in order to assure equal distribution." World History has examples of rationing. Examples have included the USA during World War II and Cuba since 1961. Recent examples in Medicine have included Oregon and the Czech Republic. Recently, Great Britain [with its National Health System] has considered rationing. According to the BBC News Article: "Rationing: 'Only Option' for NHS" [dated February 7, 2001], the representatives of the British Medical Association, Royal College of Nursing, Patients, Private Health Care Providers, and the Pharmaceutical Industry concluded: "Increased rationing is the only way to go forward." BBC Look North of East Yorkshire/Lincolnshire [UK Local TV News Program] [on January 14, 2005] had a segment on how "Doctor Visits have been replaced by Paramedics."

"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

Cracking Health Costs reveals the best ways for companiesand small businesses to fight back, right now, against risinghealth care costs. This book proposes multiple, practical stepsthat you can take to control costs and increase the effectivenessof the health benefit. The book is all about rolling back health care costs to savecompanies and employees money. Working hand-in-hand with theiremployees, businesses need to ensure that, whenever feasible,employees with the most expensive diagnoses get optimal treatmentat hospitals not practicing “volume-driven” medicinefor higher profits. Less than 10% of employees incur 80% of costs.About 20% of patients have been completely misdiagnosed, while manyothers are simply the victims of surgeons who are either practicingbad medicine or overtreating for profit. For example, some companies, such as Walmart and Lowe’s,are turning to the “Centers of Excellence” approachauthor Tom Emerick helped to pioneer while running benefits forWalmart. By determining which hospitals are adopting the higheststandards of care, benefits managers can reduce the number ofunnecessary high-cost surgeries and improve employees’overall health. The solution-based approach offered by the book isunique, because it can be implemented by businesses today.

The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.

This new Fourth Edition of Financial Management of Health Care Organizations, offers an introduction to the most-used tools and techniques of health care financial management, including health care accounting and financial statements; managing cash, billings and collections; making major capital investments; determining cost and using cost information in decision-making; budgeting and performance measurement; and pricing. New to this edition: The Perspectives sections and the glossary have been updated. The book features a cutting-edge view of the health care landscape in 2013 and beyond after passage and pending implementation of the Affordable Care Act. Areas of expanded content include revised examples of financial statements for both private non-profit hospitals and investor-owned hospital management companies, changes in bad debt and charity care, the role of financial statements, the discount rate or cost of capital, lease financing section, use of cost information, budgeting, cost centers, and current forms of reimbursement Content new to this edition includes valuation of accounts receivable and the "waterfall" effect of cash collections, differences between Posting-Date and Service-Date reporting methodologies, calculation of effective annual interest rate, application of time value of money in perspectives, and Activity-Based Costing from the perspective of labor, supplies, and equipment.