MULTIMEDIA LIBRARY
Below are selected reports and articles that discuss the issue of health care reform in the United States and Oregon. This list will continue to grow, so check back frequently. Also, if you know of a resource or publication that should be added, please contact us at shareit@ohsu.edu
AUDIO: Robert Lowe, MD, MPH, director of OHSU Center for Policy and Research in Emergency Medicine testifies at Senate Commission on Health Care Access and Affordability. Dr. Lowe's testimony begins at hour 3:18:00. Click here to play the audio (Real Media required).
VIDEO: Dr. Peter Kohler recently spoke to a class of medical students about the history and future of health care financing in the United States. Click here to play the video (Real Media required).
AUDIO: On the Road to Revolution: Fear and Loathing In the U.S. Health Care System, with Dr. John Kitzhaber; a presentation and "call-to-action" to fundamentally change the way the public funds are allocated for health care in Oregon. This speech was originally presented at the City Club of Portland on October 14, 2005. Click here to play the MP3 file.
AUDIO: OHSU President Kohler talks about solutions. Dr Kohler talked to the Washington County Public Affairs forum on January 30 about the link between rising health care costs, the aging population and the number of uninsured/underinsured people. Dr. Kohler describes a new delivery model that focuses on prevention, lower cost encounters and the need for decision-supporting software development. Click here to play the MP3 file.
A Crisis in Health Care Access: This paper by OHSU presents a broad overview of how Oregon's health care crisis has evolved so quickly and discusses its impact on patients, health care and hospitals.
A Medicaid Primer: (Kaiser Family Foundation - July 2005)
Since Congress established the Medicaid program in 1965, it has become a linchpin in our health care system, covering health and long-term care services for many of the sickest and poorest Americans. In 2003, over 52 million people were covered by Medicaid. In the absence of the program, the vast majority of its enrollees would join the ranks of the 45 million uninsured. However, Medicaid is not well understood by most people. This primer provides basic information and dispels misperceptions.
Building a Better Health Care System: This report from the National Coalition on Health Care (2004) concludes that system-wide health care reform would save much more money than it would cost. In four scenarios, the investment needed to achieve universal health coverage would be more than offset by savings. In each case, the cost of a reformed system would be much less than the cost of continuing with the same system.
Characteristics of the Uninsured: A View From the States: This report from the Robert Wood Johnson Foundation, 2005, reviews state-level data about adults who work but do not have health insurance coverage. More than 20 million working adults do not have health care coverage, according to an analysis of 2003 data from the Centers for Disease Control and Prevention. In eight states, at least 1 in 5 working adults is uninsured. In 39 other states, at least 1 working adult in every 10 does not have health care coverage.
Charity Care on the Rise as Uninsured Patients Flood Hospitals: This Pricewaterhouse Coopers Survey, discussed by Oregon Association of Hospitals and Health Systems (OAHHS), shows that hospitals may be providing more charity care than is even reported, and that these uncompensated costs are being shifted to other patients.
Do We Really Want Broad Access to Health Care?: "Americans may say they believe that instituting broader coverage is the right thing to do, yet everyone prefers to change the subject when the discussion turns to how to pay for it," write authors James Mongan, M.D., and Thomas H. Lee, M.D., of this article published by The New England Journal of Medicine, March 24, 2005.
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Examining the Health Care Safety Net in the Portland Area: Portland's health care safety net for people without insurance does not meet the health care needs of more than half of this medically underserved population, according to this December 2004 Portland City Club report.
Federal Spending on the Health Care Safety Net from 2001-2004: Has Spending Kept Pace with the Growth in the Uninsured? This analysis by the Kaiser Commission on Medicaid and the Uninsured found that, as the number of uninsured Americans increased by 4.6 million from 2001 to 2004, federal safety net spending per uninsured person fell from $546 to $498 during the same period. After adjusting for inflation, says the report authors, total federal spending for care for the uninsured increased by 1.3 percent from 2001-2004 while the number of uninsured increased by 11.2 percent. These trends resulted in an 8.9 percent decline in spending by the federal government per uninsured person.
A Growing Hole in the Safety Net: Physician Charity Care Declines Again: Continuing a decade-long trend, the proportion of U.S. physicians providing charity care dropped to 68 percent in 2004-05 from 76 percent in 1996-97, according to a national study from the Center for Studying Health System Change (HSC).
Health benefit costs rise 6.1% in 2005: Rise in insurance costs nationwide will be 6.7 percent in 2006, average total annual cost per employee for health benefits is now $7,089, according to the Mercer Human Resources Consulting Survey.
The Health Care Crisis and What to Do About It: Paul Krugman and Robin Wells review three new about about the health care crisis and possible solutions in the New York Review of Books:
Can We Say No? The Challenge of Rationing Health Care
by Henry J. Aaron and William B. Schwartz, with Melissa Cox
Brookings Institution, 199 pp., $44.95; $18.95 (paper)
The Health Care Mess: How We Got into It and What It Will Take to Get Out
by Julius Richmond and Rashi Fein
Harvard University Press, 320 pp., $26.95
Healthy, Wealthy, and Wise: Five Steps to a Better Health Care System
by John F. Cogan, R. Glenn Hubbard, and Daniel P. Kessler
American Enterprise Institute/Hoover Institution, 130 pp., $18.00
Health Care Vouchers: A Proposal for Universal Coverage: Dissatisfaction with the financing of the U.S. health care system is widespread. The system is inefficient, inequitable, and increasingly perceived to be unaffordable," write authors Ezekiel J. Emanuel, M.D., Ph.D., and Victor R. Fuchs, Ph.D, of this article published in the New England Journal of Medicine, March 24, 2005. "As an alternative, we propose a voucher system for universal health care that might elicit broad support."
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Health Insurance Cost: Fact Sheet: This report presents statistics about nationwide coverage trends for health insurance over time; compiled by the National Coalition on Health Care, 2004.
Health Insurance Coverage: Fact Sheet: This report presents statistics about the cost of health insurance over time; compiled by the National Coalition on Health Care, 2004.
Health Insurance Coverage of Women Ages 18-64, by State, 2003-2004: This Kaiser Family Foundation fact sheet provides state-by-state data on the uninsured rate, as well as rates of private insurance coverage and Medicaid coverage, among women nationally, in the 50 states and the District of Columbia.
Home Sick: How Medical Debt Undermines Housing Security
In an analysis of the financial consequences that can strike those in the U.S. with health care bills they cannot pay, the Boston-based Access Project conducted a report showing that medical debt is becoming a threat to home ownership or housing stability for many American families, including those with health insurance (November 2005).
Impact of Changes to Premiums, Cost-Sharing, and Benefits on Adult Medicaid Beneficiaries: Results from An Ongoing Study of the Oregon Health Plan: As states around the country grapple with rising Medicaid budgets, this study shows that Oregon's 2003 Medicaid redesign has left former Medicaid recipients with no coverage for extended periods.
Income, Poverty and Health Insurance Coverage in the United States: Data from the U.S. Census Bureau compiling trends in 2004 for these factors.
Insured but Not Protected: How Many Adults Are Underinsured?: In addition to the 45 million uninsured adults in the United States, another 16 million were underinsured in 2003, according to this report published by Health Affairs journal and discussed on The Commonwealth Fund Web site.
Paying a Premium: The Added Cost of Care for the Uninsured: This report by Families USA (June 2005) quantifies, for the first time, the dollar impact on private health insurance premiums when doctors and hospitals provide health care to uninsured people. In 2005, premium costs for family health insurance coverage provided by private employers will include an extra $922 in premiums due to the cost of care for the uninsured; premiums for individual coverage will cost an extra $341.
Record Number of Oregonians - Mostly Working-Age Adults - Lacked Health Insurance, While Oregon Leads Nation in Growth in Uninsured: Recent statistics compiled by the Oregon Center for Public Policy.
Reaching out to Enhance Well-Being: A summary of the community benefits provided by OHSU to the state of Oregon. OHSU's investment in its more than 200 community programs is worth more than $150 million annually. These programs all work toward a common goal: to improve the well-being of people in Oregon today and tomorrow.
The Science of Caring for the Underserved: This OHSU publication describes the research under way by the School of Nursing to better the health and well-being of medically underserved populations.
Threadbare: Holes in America's Safety Net
This Kaiser Commission on Medicaid and the Uninsured report describes the impact of coverage gaps in our safety net through the perspectives of those who provide care to the uninsured and first-hand accounts of the uninsured who are seeking care (November 2005).
Trends in Oregon's Health Care Market and The Oregon Health Plan: This Oregon Health Policy and Research authored report to the 73rd Oregon Legislative Assembly provides background information on the uninsured and undersinsured in Oregon.
The Trouble With Uncompensated Hospital Care: This article by Joel S. Weissman, Ph.D., tackles the "implicit assumption of the U.S. health care system that poor, uninsured persons who become ill can obtain free or discounted care. Although many individual physicians provide such services, uncompensated hospital care represents our safety net of last resort - but uncompensated care is not free," he writes. He also notes that while hospitals and doctors strive to do their best to serve uninsured people, "serving as a safety net while still functioning as a business is a challenge." The article was published in the New England Journal of Medicine, March 24, 2005.
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The Uninsured: A Primer: This Kaiser Family Foundaiton primer, updated with 2004 data, reviews the basic profile of the uninsured population, how they receive care, and what the are options for increasing coverage.
Women's Health Insurance Coverage Fact Sheet:As the cost of health insurance continues to increase, women in particular face difficult challenges because they are less likely to have employer based coverage and are more likely to be the health decision maker for their families. This s Kaiser Family Foundation fact sheet describes the major sources of health insurance coverage for women ages 18-64, including employer-sponsored insurance and Medicaid. It provides information on the more than 17 million women who are uninsured and summarizes the major policy challenges facing women in the health insurance sector.
