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At least 127 records · Page 7Linked to original sources
PubMed2004

Life insurance, living benefits, and physician-assisted death.

One of the most significant concerns about the legalization of physician-assisted death in the United States relates to the possibility that a chronically or terminally ill person would choose to end her or his life for financial reasons. Because we believe that the life insurance industry is uniquely poised to help minimize any such incentive, we submit that it has a moral obligation to do so. In particular, we propose that the industry encourage greater flexibility in the payout of policy benefits in the event an insured should be diagnosed with a terminal illness or suffer from intractable pain.

Euthanasia↗
PubMed1988

Postwar changes in the income position of the aged.

Since the war the relative number of aged persons with income from employment has declined, while the proportion with income from social insurance benefits has increased. Despite the fact that social insurance benefits yield a lower average income than do earnings, the averaged aged person's income in 1952 was higher in both current dollars and dollars of stable purchasing power than it was in 1945. The improvement is the result of several factors, including larger earnings by aged workers, increased benefits paid retired workers and their aged survivors under social insurance and related programs higher old-age assistance payments and the rise in the relative number of persons with money income. The growth in the average aged person's income, however, has been at a rate lower than that of the average income of the population as a whole. As a result the average person has had a smaller share in total consumer income in each of the years since 1945 that he had in that year.

Aged↗
PubMed2006

Assessing the public health impact of state health benefit mandates.

OBJECTIVE: To document the process used in assessing the public health impact of proposed health insurance benefit mandates in California as part of the California Health Benefits Review Program (CHBRP) to serve as a guide for other states interested in incorporating a public health impact analysis into their state mandated benefit review process. BACKGROUND: As of September 2004, of the 26 states that require reviews of mandated benefit legislation, 25 required an assessment of the cost impact, 12 required an assessment of the medical efficacy, and only 6 had language requiring an assessment of the public health impact. METHODOLOGY: This paper presents the methodology used to calculate the overall public health impact of each mandate. This includes a discussion of data sources, required data elements, and the methods used to quantify the impact of a mandated health insurance benefit on: overall public health, on gender and racial disparities in health outcomes, on premature death, and on the economic loss associated with disease. In addition we identify the limitations of this type of analysis. CONCLUSIONS: The approach that California has adopted to review proposed health benefit mandates represents a leap forward in its consideration of the impact of such mandates on the health of the population. the approach is unique in its specific requirements to address public health impacts as well as the attempt to quantify these impacts by the CHBRP team. The requirement to make available this information to the state government has the potential, ultimately, to increase the availability of health insurance products in California that will maximize public health.

California↗
PubMed1982

Why do people retire from work early?

This article examines the validity of a mortality study of early retirees by Dr. Eric Kingson. The Kingson study supports the hypothesis that men who retired early were very prone to have work-limiting conditions even though they were not awarded Disability Insurance benefits. This article maintains that Kingson's study is analytically faulty because of the procedure used to categorize the sample. In comparing groups of early retirees, Kingson combined two groups--(1) severely disabled persons who died before becoming eligible to receive Disability Insurance benefits and (2) early retirees who alleged work-limiting disability. He found that their combined mortality was higher than that of those who received Disability Insurance benefits. He then concluded that, for this reason, early retirees who alleged work-limiting disability really had such disabilities. However, this article contends that the mortality effects of the first group are so great as to mask any conclusions relevant to the two groups combined. The analysis here does not conclude that persons generally do not retire early because of poor health, but rather that the findings of Kingson's study, being based on faulty mortality analysis, are not conclusive.

Adult↗
PubMed1991

Benefit flexibility, cost shifting and mandated mental health coverage.

This paper presents a policy analysis of options for making a state's mandated mental health benefit more flexible while maintaining insurance premiums at a constant level. The analysis illustrates the difficult choices facing legislatures that attempt to balance improved coverage for mental health care with concerns about rising health care costs. A sophisticated simulation model is used to assess the costs of four alternative insurance benefit design options.

Ambulatory Care↗
PubMed2006

Evaluating medical effectiveness for the california health benefits review program.

An important aspect of the mandate assessments requested by the California legislature is a review of the scientific and medical literature on the medical effectiveness of the proposed health insurance benefit mandate. Although such a review bears many similarities to effectiveness reviews that might be undertaken for publication as research studies, several important differences arise from the requirements of the California legislation. Our reviews are intended to assist the legislators in deciding whether to support a specific mandate to modify health insurance benefits in a particular way. Thus, our assessments focus on how the scientific literature bears on the proposed mandate, which may involve a complicated chain of potential effects leading from altered coverage to ultimate impact on health. Evidence may be available for only some of the links in the chain. Furthermore, not all the evidence may be directly applicable to the diverse population of California or the subpopulation affected by the mandate. The mandate reviews, including the medical effectiveness analyses, may be used in a potentially contentious decision making setting. The legislative calendar requires that they need to be timely, yet they must be as valid, credible, and based on the best information available as possible. The focus on applicability also implies the need for informed, technical decisions concerning the relevance of the articles for the report, and these decisions need to be made as transparent as possible. These goals and constraints yield an approach that differs somewhat from an investigator-initiated review of the literature.

California↗
PubMed1995

Self-insuring employee health benefits.

Self-insurance is a popular way to fund employee health benefits, but it presents a potential barrier to state health insurance reform initiatives because self-insured health plans are able to avoid state regulation. Thus it is important to understand why employers self-insure. This study tests an explanatory model of self-insurance, using data from the 1989 Survey of Health Insurance Plans. Models predicting self-insurance are estimated for private employers and for all health plan sponsors, including public employers, unions, and trade associations. The author found a threshold for self-insuring among private employers at about 100 employees and another at about 200 workers when all health plan sponsors were considered. Plans with union members are more likely to be self-insured. Self-insurance is more likely in the presence of alcohol treatment mandates but less likely with mental health mandates.

Decision Making, Organizational↗
PubMed2003

Employee input and health care cost-containment strategies.

Health insurance premiums have risen steadily in recent years, and many employers are coping by increasing employee premium contributions. The danger with cost shifting is that a substantial number of employees will refuse offered insurance because of the escalating contribution required of them. The authors surveyed employees regarding what aspects of their insurance benefits they would be willing to give up if their policies were to be substantially trimmed. The responses were varied and influenced by income, education, current contribution to premium, and health status. Interestingly, few employees outside of unions strategize with their employers about how best to structure health insurance benefits to keep them affordable.

Adolescent↗
PubMed1990

Benign moral hazard and the cost-effectiveness analysis of insurance coverage.

When a medical intervention is found to be cost effective, what level of insurance coverage should apply to it? The optimal level of coverage may be less than or greater than full coverage of medical care costs; a finding of cost effectiveness for a service does not necessarily imply v full coverage or coverage at the same rate as other services. If there is some imperfection in the ability to translate higher insurance benefits into higher insurer revenues, the optimal level of coverage will be greater the higher the degree of moral hazard applying to the service.

Aged↗
PubMedDate not supplied

Medicare's ESRD Program, Part 1: Dialysis.

The federal End State Renal Disease (ESRD) program was created by statute in 1972 as a general population entitlement to be administered by Medicare. The program extends all Medicare benefits to patients, regardless of age, who are diagnosed as having ESRD, as long as they are fully insured for old age and survivor insurance benefits (Social Security), are entitled to monthly insurance benefits under the Social Security Act, or are spouses or dependent children of individuals with the foregoing Social Security benefits. About 7 percent of all ESRD patients are excluded from this entitlement by these criteria. The two major therapies embraced by the ESRD program are renal dialysis and kidney transplantation. In this first part of a two-part article, dialysis is the focal point. Kidney transplants will be covered in the May-June issue of Physician Executive.

Humans↗