health

U.S. health care is in the midst of a major transformation. With the implementation of the Affordable Care Act, tens of millions of Americans are getting health insurance coverage for the first time. Expanded coverage will bring a tsunami of new demand, and current transformations underline the truth that insurance is not the same thing as access to appropriate health care. Across the nation, front-line providers of primary care – safety net providers – risk becoming overwhelmed by the arrival of millions of people newly insured or enrolled in Medicaid, including many vulnerable people with special needs. As happened after the start of Medicare in 1965, the United States faces the prospect of tremendous strain on the vital primary care infrastructure – with the risk that many people could still go without adequate care.

Bolstering safety net services will be essential to meet the needs of the newly insured – as well as the needs of millions who will still remain uninsured (either because Affordable Care does not include them or because they live in conservative states that refuse to expand Medicaid). more...

The Patient Protection and Affordable Care Act of 2010 – popularly called ObamaCare – was designed to increase access to health insurance. The law does this in several ways, including by setting up exchange marketplaces where uninsured Americans can comparison shop for private health plans and (if they have low or moderate incomes) get subsidies to help pay the premiums. Medicaid expansion is another, equally important, method by which the Affordable Care Act will enlarge health insurance coverage. more...

Are there magic bullets that will insure that every person can grow old gracefully – live out the final years with soundness in mind and body? Of course not. Illnesses or accidents can strike unexpectedly, and no one has the capacity to alter completely the influence of genetic destiny or avoid the inevitable decline of bodily systems. Yet there is much that each person can do – along with family members, friends, and caregivers – to maximize the likelihood of completing the final stages of life in strong, active, and satisfying fashion.

Professionally-vetted research, including studies I have completed with my colleague Edward Thompson, Jr., reveal that lifestyles can have a powerful effect on extending both the quality and quantity of the years available to each person as he or she grows older. Optimal choices require people to be well-informed and exercise good judgment about everything from eating habits and physical activity, to keeping in touch with other people and making regular visits to the doctor. more...

Most Americans would be surprised to learn that the nation’s largest health care provider is not a private hospital network or an insurance company—it is the government-run Veterans Health Administration, popularly known as “the VA.” Every year more than 8.3 million veterans receive free or low-cost health care at hundreds of VA medical centers and outpatient clinics, parts of the most extensive integrated health care system in the country. The number of patients served has nearly doubled over the past fifteen years. Although VA patients are, on average, sicker and poorer than the average American, the system successfully delivers high-quality health care, even as it reins in costs. more...

Health reform has many popular parts—rules against insurance company abuses; subsidies and tax credits to make health coverage affordable for millions; improvements in Medicare. But controversy persists about the “individual mandate” rule—which says that everyone must either have health insurance coverage or pay a fine.

Attacks have intensified since the Supreme Court decision to uphold the Affordable Care Act, because the mandate fine was declared a valid exercise of the taxing power assigned by the Constitution to the federal government. Opponents of health reform denounce the mandate as “tyranny” and say that it amounts to a big “middle class tax increase.”

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