Overview of Managed Care
UMDNJ - SPH
The Uninsured
Access to health coverage is a challenge for millions of low-income families. Because they are more likely to be low-wage workers and work in industries that do not offer health care benefits, access to job-based coverage is often problematic. Avenues for assistance are available to some through programs like Medicaid. However, despite these programs’ broadened focus on children and financially disadvantaged families, several categorical requirements still leave millions of people ineligible and often uninsured. Gathered here are some websites that look into this growing epidemic of “uninsurance” where the demographics and available help to the uninsured are discussed. The sites are rated on a fife star rating system on quality and substance.
Websites
The Kaisar Family Foundation is an independent philanthropy that focuses on major health care issues that are happening in our nation. This organization develops and funds its own research programs focusing on the analysis and presentation of facts about health care as it concerns the general public. The foundations work is focused in three main areas: Health Policy, Media and Public Education, and Health and Development in South Africa. Through such focuses the Kaisar Family Foundation provides information on wide variety of issues concerning health policy, the changing health care market, education and media coverage of health topics. In particular, through the Kaiser Commission on Medicaid and the Uninsured, the foundation has presented valuable information on the Medicaid program and the uninsured population as it pertains to health coverage. This site presents several resources on the number of the uninsured, their demographics, and the current problems they are facing. Especially, pay attention to a section labeled “Uninsured in America: A Chart Book, May 2000” for a current demographical information on the uninsured. The site is very large but comprehensive and easily maneuverable.
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Insure.com provides valuable information to consumers and insurance professionals with the most current comprehensive information about insurance. Insure.com hosts two services: The Consumer Insurance Guide and the Insurance Professional’s Guide. Through these programs information about several advertisements, syndications, and insurance quotations are provided for the consumer and the professional. The site claims to produce over 20,000 pages of context for the consumer making decisions about insurance. It also presents latest news in the insurance industry as well as recent premium research for the professional. The site is extensively comprehensive and presents the latest news about the insurance industry as well as events concerning health care coverage. Insurance.com includes a toolbar that helps with navigation through several sections the site. The reason I picked this site is because it provides an average uninsured individual with some information on how to pick an insurance that is suitable for him or her.
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According to current census, there are more than 7 million uninsured children that are eligible for coverage through Medicaid or other programs. Such a atrocity has lead to Covering Kids a program funded by Robert Wood Johnson Foundation where the primary goals are: to design and conduct outreach programs that are geared towards identifying and enrolling eligible children into Medicaid and other programs; simplify enrollment process; and coordinating existing coverage programs for low-income children. The site goes through a detailed description of plans and initiatives on how the outreach will be achieved. In that process several useful information on children’s health coverage is provided. Grantees of this program are classified by state and the projects undertaken by the states are described. For families interested in gaining information about their children’s coverage eligibility, this is a recommended site.
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Insure USA with its slogan “Coverage is the Cure” provides facts about the uninsured and the direction that they are heading. The organizations initiative is the increase in health care coverage to all. Today there are about 44 million uninsured individuals in the US and the number is likely to grow to 55 million by the end of this decade. As a result the organization proposes a plan to reduce the number of individuals uninsured by expanding coverage to all. It proposes to achieve this goal by providing safety net for the neediest as well as providing private coverage for the working poor. Tax initiatives and subsides are also mentioned as ways of lowering overall health care costs to make health coverage available to all. The site also provides fact sheets and testimonials as well as a well-organized PowerPoint presentation about the proposal. Take note of the counter on the home page that keeps track of current number of uninsured individuals.
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http://www.americashealth.org/
The National Coalition on Health Care is on of the nations largest alliances (compromising of 96 groups) dedicated to achieving better more affordable health care for all Americans. This non-profit, non-partisan coalition was founded in 1990 and represents nearly 100 million Americans. To achieve this mission, the coalition brings together large and small businesses, labor unions, consumer groups, religious groups, and primary care providers. The site presents relatively current news events covering wide aspects of health care in the US. There is also a section solely dedicated to coverage on health policies and their impact on health care as well as the general public. The “Did You Know” section is particularly interesting since it presents facts and myth about the uninsured in the U.S. Several health care terms are also defined in this section.
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Documents
Update on the Characteristics of the Uninsured
http://www.cacvoices.org/warehouse
In this article, Marcus Cheatham has organized several statistical data about the uninsured in an attempt to summarize the effects of Medicaid and welfare reform on the uninsured in the 90s. He noted that the economic success from 1993 to 1997 has lead to a decrease in the number of uninsured individuals in the US (although that trend is not true any more). He has presented sufficient data on the household composition of the uninsured as well as their employment and educational status. Age and gender distribution of the uninsured is also provided with a graphical analysis of the changes between 1993 and 1997. Although this site might have comprehensive data the information is not current.
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The Uninsured Phenomenon ñ Myths and Realities
http://www.americashealth.org/know/uninsured_myths.html
This document was prepared for the lay in an attempt to clarify the myths and realities about the composition of the uninsured population and how the problem can be addressed. The document is formatted where a myth is presented and the realities about the myth are discussed afterwards. Questions regarding the future of uninsured individuals as well as the effects of our economy on the uninsured are answered in these discussions. For example there is a strong standing myth that most of the uninsured are also unemployed. Yet in fact, most of the uninsured are employed or are dependents of an employed individual. The actual number of the employed yet uninsured individuals is ~ 25 million (60%) of the total uninsured population (Note: questions on how current these numbers are). This document is self-explanatory and easy to understand for most. It also does a good job in clarifying some of the misconceptions and stigmas associated with uninsured individuals.
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Is Immigration Responsible for the Growing Number of the Uninsured?
http://www.kff.org/content/2001/2221/2221.pdf
John Holahan, Leighton Lu, and Mary Pohl conducted an extensive study to determine if indeed the number of the uninsured increased due to recent surges in large number of immigrants into the United States. Their study was stemmed from the desire to identify and reduce any factors that are responsible for the increase in the number of uninsured people. It was important to identify if immigrants are indeed relevant to this question. Contrary to wide belief, they discovered that recent immigrants only make up for a small portion of the uninsured. In 1998 non-citizen immigrants made up only 20% of the total uninsured individuals in the country. During the span of 1994 to 1998 the number of immigrants has actually declined while the number of uninsured has dramatically increased, furthermore supporting the claim that they are not solely responsible for the increase. The researchers also documented that the largest growth in the uninsured was exhibited in the native-bourns during the same time and the trend is continuing till this date. There are several charts and tables within the report showing the statistical significance of their study in light of providing evidence to their conclusion: Immigrants are not responsible for the growing number of the uninsured.
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The Uninsured and Their Access to Health Care
http://www.kff.org/content/2001/1420b/1420b.pdf
Here is a short and concise document prepared by the Kaiser Commission on Medicaid and the Uninsured where most facts about the uninsured and their access to health care are acknowledged. The commission starts out by discussing the importance of insurance on access to quality care. Since Medicare covers most of the elderly, individuals under the age of 65 overly saturate the uninsured population. The document mainly sets out to answer four critical questions: Who are the uninsured? How many are uninsured? Why are so many Americans uninsured? And, what difference does health insurance make? Briefly, the uninsured were discovered to be low-income families that earned less that 200% of the federal poverty level. In 1999 42 Americans nearly 18% of the non-elderly population were uninsured and that number is now rising. This number is a 10 million increase over that last decade. The major reason as to why so many are not covered is simply the expense of private insurance. Many low-wage workers are not able to afford health coverage for themselves or their families. Medicaid does fill in the gaps but that is still not sufficient. Finally it was shown that health insurance not only affects access to quality care but also the financial well being of families. This site is very interesting, easy to read and above all SHORT for a quick reference.
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The Administrations responses to questions about the State Children’s Health Insurance Program
http://www.hcfa.gov/init/q&aintro.htm
Through the SCHIP many children of low-income families have now become eligible for health insurance coverage. Individual states have been given federal support to institute such program in an attempt to protect the greatest investment of our future: our children. As a result the Health Care Financing and Administration (HCFA) has prepared this document to answer any questions raised by states, providers and consumers regarding the SCHIP program.
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| Note: The information below may contain additional relevant materials and documents. Some of the information may be duplicate. The evaluations depend on both the student doing the review and the information contained at the time of the review. Sites are subject to change! |