Recommended Resources.
Web Sites:
The Alabama Pre-Existing Condition Insurance Plan: Eligible residents of Alabama can apply for coverage through the Pre-Existing Condition Insurance Plan program run by the U.S. Department of Health and Human Services.
To qualify for coverage:
- You must be a citizen or national of the United States or lawfully present in the United States.
- You must have been uninsured for at least the last six months before you apply.
- You must have a pre-existing condition or have been denied coverage because of your health condition.
PCIP covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, even if it’s to treat a preexisting condition.
www.Healthcare.gov The groundbreaking web site developed under the PPACA health care reform act. The site is presently in its early phases, an invaluable source of information about insurance options. They promise there will be more added as time goes by.
The Wikipedia description of Universal Health Care is impressive for its scope and detail. (7/24/10)
Books:
Landmark: America’s New Health-Care Law and What It Means for Us All. By the Staff of the Washington Post. 2010
A remarkable book, published just 30 days after the passage of the Reconciliation Act. It contains a history of the bill’s passage through Congress, a description of its meaning to Insurers, the Insured, the Under Thirty, etc. The last 60+ pages go through each section of both the bill and the reconciliation act, translating the meaning of each section into English. Thoroughly readable, a must-have reference work. Price $9.32 at Amazon (7/11/10)
A Second Opinion. Rescuing America’s Health Care. Arnold S. Relman, M.D. The Century Foundation. 2007
While Dr. Relman’s name is not a household word outside the medical profession, his biography speaks to both his credibility and the readability of his book.
Deadly Spin. Wendell Potter Bloomsbury Press, New York, 2010.
“An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans.”
The Healing of America. A Global Quest for Better, Cheaper and Fairer Health Care. T.R. Reid. The Penguin Press, 2009
Mr. Reid is a professional journalist who has toured France, Germany, Japan, the U.K. and Canada, examining health systems in detail, and comparing the prescriptions he’d received in each for his chronically ailing shoulder. He’s been described as like a “great teacher you had once who made a potentially dull and ponderous subject entertaining and relevant.” Great bedside reading.
Understanding Health Policy, Fifth Edition. Thomas Bodenheimer. 2008.
I haven’t read this, but an Amazon.com reviewer wrote “Difficult to find a better overview for students, I used this book in undergraduate health policy programs and in one health care administration graduate elective. The majority of students found it to be a useful introduction to the difficult area of health policy. By incorporating pertinent examples and graphs students found the text more understandable and useful than, say. other required readings like Paul Starr's classic. Whatever their level of understanding coming into class, students were able to glean valuable information and insight.” Five editions say something, but the book is a bit dated after the debates of 2009. Starr’s classic is still referred to with a hint of reverence from time to time.
D. Brad Wright, who blogs at Wright on Health, recommends five books:
“Delivering Health Care in America: A Systems Approach by Leiyu Shi and Douglas Singh is a must-read if you're trying to understand the current U.S. health care system. Granted, much is likely to change with the enactment of health reform, but this text covers the basic structure of health care finance, delivery, and consumption in both the public and private sectors.”
“The Heart of Power: Health and Politics in the Oval Office is written by two of the best health politics and policy folks around: David Blumenthal and Jim Morone. If you're looking to place President Obama's leadership (or lack thereof) into proper historical context, this book is the place to start.”
“Sick” Jonathan Cohn provides a readily accessible overview of the U.S. health care system and the myriad problems plaguing it. The book is written as a series of case studies and it is incredibly personal. You really get the feel for what it's like to fall through the gaps in our system. Fortunately, health reform goes a long way in filling those gaps, but it won't get to them all. If you've ever thought--like so many do--"I have a job and health insurance, why should I support reform?" then you need to read this book.
“How Doctors Think” by Jerome Groopman. I don't want to give too much of the book away, so I'll just say a few things about how doctors think according to Groopman. First, they don't think like you might think they do. Second, they are typically trained to think that way. Third, the way they think doesn't always work well from the patient's perspective (translation: it might kill you). This one's not so much a "policy" book as it is entertainment with a clinical focus, but that doesn't mean it has no policy relevance. Insofar as certain health policies aim to influence physician behavior, it is vital to understand how physicians think. But as this is an engaging book that could also help you have a better doctor-patient relationship
“Paul Farmer's Pathologies of Power. Farmer, like Groopman, is a faculty member at Harvard, but his focus is much more international. In Pathologies, Farmer looks at the intersection of health, human rights, and what he calls the "new war" on the poor. The book is fascinating if you're really into understanding health and poverty and/or international health, but it's a tough read. It took me about a month to wade through, but that's just because it's so full of information and I didn't want to miss anything by skimming. Farmer looks most closely at drug-resistant tuberculosis in Russian prisons and the HIV/AIDS epidemic in Haiti among other topics. But, again, this is not a book for the faint of heart and gets a 4 on the Wonk Scale. Ironically, most people who would dare to read this book have probably already read it, but in case you missed it, here's your reminder.”
Legislation:
The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. These are it.
Wikipedia has a reasonable summary of the Act and of its consequences. There’s also a section-by-section summary in the book, Landmark, described above.
This is a three-page summary of the bill, prepared by the Congressional Committees most involved in its development. It’s a .pdf file, needing Adobe Reader or Mac’s Preview to read.
This is a seven-page detailed summary of the bill, with what gets put in place each year. It’s also a .pdf file.
AARP’s summary.
The American College of Physicians 91 page summary.
Of historical interest:
The Kennedy-Dingell bill of 2007, that would have allowed people to buy into Medicare. The bill went nowhere. (The hyperlink leads to the Kennedy bill, introduced in the Senate. Congressman Dingell introduced the same bill in the House.)
HR 676. The Conyers bill, subtitled “Medicare for All”. This is the classic ‘single payer’ bill.
S.703 American Health Security Act of 2009. Senator Bernie Sanders ‘single payer’ bill as introduced in the Senate.
HR 4789, Rep. Alan Grayson’s “Medicare You Can Buy Into” Act. (Hyperlink leads to discussion of the bill and, indirectly, to the bill’s text.)
Articles and Blogs:
8/13/03. Proposal of the Physicians’ Working Group for Single-Payer National Health Insurance. JAMA 290(6); 798-805. Aug 13, 2003. The classic definition of single-payer health care.
Frequently Asked Questions from the PNHP web site.
The Universal Declaration of Human Rights of the United Nations. Article 25 pertains to health care.
2/20/07 Ever wonder why specialists in this country earn so much more than primary care doctors? There was a great article, a couple of years ago, that provides much of the answer. The Primary Care–Specialty Income Gap: Why It Matters. Thomas Bodenheimer, MD; Robert A. Berenson, MD; and Paul Rudolf, MD, JD
7/19/09 History of health care reform. Text and pictures. New York Times
7/30/09 U.S. Health Care Reform Interactive Timeline. New England Journal
8/12/09. Health Affairs. What People Don’t Know About Health Insurance Exchanges
11/07/09. International Federation of Health Plans. 2009 Comparative Price Report. .pdf file. Medical and Hospital Fees by Country. This is a disturbing set of slides comparing fees for medical services in this country with fees for the same services abroad.
7/26/11. The Commonwealth Fund. Multinational Comparisons of Health Systems Data, 2010. “… we use data collected by the Organization for Economic Cooperation and Development (OECD) to compare health care systems and performance on a range of topics, including spending, hospitals, physicians, pharmaceuticals, prevention, mortality, and quality of care. We present data across several industrialized countries: Australia, Canada, Denmark, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.”
11/23/11 OECD Comparative Health Measures (graphs)
3/17/10. The Committee on Energy and Commerce of the U.S. House of Representatives has released an analysis of the impact of the health reform legislation on residents of each Congressional District. The analysis for the 6th Congressional District in Alabama (home for this web site) is here.
6/13/2010. An Accountable Care Organization reading list, from the authoritative journal, Health Affairs.
6/26/2010. A Commonwealth Fund Report provides an overview of the health systems of 13 countries -- Australia, Canada, Denmark, England, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. The report highlights who and what is covered under the various country health systems as well as each system's organization of the delivery (Squires, 6/23/2010).
7/11/2010. The Kaiser Family Foundation has produced a Health Reform Subsidy Calculator. Beginning in 2014 there will be tax credits available to people under age 65 who purchase health insurance on their own through insurance Exchanges and who are not covered by their employer. This web site will let you calculate how much of a tax credit you’d be entitled to.
Timothy Stoltzfus Jost, J.D., holds the Robert L. Willett Family Professorship of Law at the Washington and Lee University School of Law. He is a coauthor of a casebook, Health Law, used widely throughout the United States in teaching health law, and of a treatise and hornbook by the same name. For more biography, see the hyperlink from his name in the articles that follow. He has authored a series of scholarly articles on the Health Affairs Blog discussing the implementation of the new health law.
Implementing Health Reform: The Appeals Process See also
Implementing Health Reform: Preventive Services
Implementing Health Reform: A Patients Bill of Rights
Implementing Health Reform: Grandfathered Plans
Implementing Health Reform: Standards for Tax-Exempt Hospitals
Implementing Health Reform: The Small Employer Tax Credit
Implementing Health Reform: The Web Portal and Early Retiree Reinsurance
Implementing Health Reform: Young Adult Coverage
Implementing Health Reform: Pre-existing Condition Coverage
Implementing Health Reform: The Premium Review Regulation
Implementing Health Reform: The Medical Loss Ratio
Implementing Health Reform: Insurance Exchanges
Implementing Health Reform: Little-Noticed but Important Guidances.
Health Insurance Exchanges and the Affordable Care Act: Key Policy Issues
Health Insurance Exchanges and the Affordable Care Act: Eight Difficult Issues.
The Independent Payment Advisory Board
8/12/10. Health Care Reform and Cost Control Peter R. Orszag and Ezekiel J. Emanuel N Engl J Med 2010; 363:601-603 August 12, 2010 . Note the sentence buried in the rest: implementation of the cost-savings measures of the Affordable Care Act should lower health care costs as a fraction of GDP by 0.5% by 2030. But by then, health care costs as a fraction of GDP are projected to have risen from 16% today to 22%. So all those cost-savings measures reduce it to 21.5%?????
9/14/10. A Health Affairs Issue Brief: Patient Centered Medical Homes. .pdf
10/31/10. A Health Affairs Issue Brief: ‘Grandfathered’ Health Plans. Pdf
4/15/11. A Health Affairs Issue Brief: Improving Quality and Safety
5/18/11. A Health Affairs Policy Brief: The Class Act.
9/25/10. Health Care Reform will Succeed without Individual Mandate. Provocative post by Howard Dean, speaking of his experience with health care reform in Vermont during the days he was Governor there.
September-October 2010. Thought-provoking series of articles by Dr. Aaron Carroll at the Incidental Economist:
What makes the US health care system so expensive-Introduction
What makes the US health care system so expensive-Inpatient Care
What makes the US health care system so expensive-Outpatient Care
What makes the US health care system so expensive-Drugs
What makes the US health care system so expensive-Administration and Insurance
What makes the US health care system so expensive-Investment in Health
What makes the US health care system so expensive-Health Care Workers
What makes the US health care system so expensive-Areas of Underspending
What makes the US health care system so expensive-Red Herrings
What makes the US health care system so expensive-Conclusion
What makes the US health care system so expensive-Responses to comments
What makes the US health care system so expensive-Responses to comments, continued.
10/25/10. Dr. Alice A. Chenault wrote a thought-provoking post on whether health care is a right? Pippa Abston added: “Then I started reading some of the substantial work done on the concept of human rights (non-medical). The whole concept of "positive rights", which conservatives call entitlements and have included things like public education, and "negative rights", which conservatives like-- "freedom from" things like the right not to be imprisoned without due process-- is actually obsolete. It turns out that every single thing we call a right is actually a complex mixture of positive and negative factors. For example, the right not to be taxed without representation could be framed as a negative right-- but it requires positive duties from the government such as establishing polling places, paying legislators for their time, funding the IRS, etc. The right not to be murdered requires provision of a police force, courts, prisons... There really is no "freedom from" right that does not require some sort of entitlement to accomplish it.”
10/29/10 Health Affairs Policy Brief: Grandfathered plans.
01/18/11 Health Affairs Policy Brief: Small Business Tax Credits
11/22/10 Update on Health Insurance Exchanges.
12/6/10. Katherine Hayes and Sara Rosenbaum of HealthCare GPS present a Summary of the arguments in the debate over constitutionality of the new law.
12/22/10. Wendy K. Mariner, J.D., M.P.H., George J. Annas, J.D., M.P.H., and Leonard H. Glantz, J.D Can Congress Make You Buy Broccoli? And Why That’s a Hard Question New England Journal of Medicine December 22, 2010. DOI: 10.1056/NEJMp1014367
12/28/10. The HealthReform GPS Blog notes that the Congressional Budget Office has released a publication, “Selected CBO Publications Relating to Health Reform Legislation, 2009-2010.” A .pdf file.
1/4/11. The ACA Litigation Blog. “A place to find news updates, legal analysis, and all official documents related to the various constitutional challenges to the Patient Protection and Affordable Care Act.”
1/19/2011. The Worst Case, Jonathan Cohn. Described by Ezra Klein thus “This is the single best article you'll read on the legal fight over the individual mandate”
2/28/2011. Navigators to be part of the new state health insurance exchanges. “Navigators must ‘conduct public education activities’ to raise awareness about qualified health plans, distribute ‘fair and impartial information’ regarding premium tax credits and enrollment, facilitate plan enrollment, provide referrals for enrollees who have grievances, complaints, or questions regarding enrollment or coverage, and provide information in a ‘culturally and linguistically appropriate manner’”
5/22/2011 Dr. Donald Light is a visiting professor at Stanford University, teaching the course: International Health Policy: Advanced Health Care Systems (How did other affluent countries attain universal health care and manage challenges of technology, recessions, and rising chronicity?) This is the syllabus for the course (.pdf), including required and recommended readings.
Materiel of particular interest to faith communities.
Faithful Reform in Health Care, www.faithfulreform.org. This site has a Tool Kit of Interfaith Resources for: Candlelight Vigils, Prayer Breakfasts, and general Prayer Services. Check their web site out and look for the “Let Our Light Shine!” link.
The United States Conference of Catholic Bishops, www.usccb.org/healthcare/
The Sojourners website, www.sojo.net, (click the link to Sojourners Resources on Health Care Reform).
“Faith Works: How to Live Your Beliefs and Ignite Positive Social Change” by Jim Wallis.
Church Health Center’s web site, www.hopeandhealing.org,
I would like to hear of materiel particularly relevant to other religions to add to this page. info@healthcareforeveryone-alabama.org
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