Perspective
The Effects of the Affordable Care Act on Workers’ Health Insurance Coverage
Christine Eibner, Ph.D., Peter S. Hussey, Ph.D., and Federico Girosi, Ph.D.
Employer-sponsored health insurance is the cornerstone of the U.S. health insurance system. David Blumenthal, among others, has described this system as an “accident of history,” and he quotes Uwe Reinhardt, a leading authority on health care economics, as asserting that “If we had to do it over again, no policy analyst would recommend this model.”1 Nonetheless, the Patient Protection and Affordable Care Act of 2010 (the ACA) builds on, rather than eliminates, employer-sponsored insurance. However, because the ACA makes substantial changes to the employer-based system, some wonder whether the employers’ role in providing insurance will diminish or disappear over time.
Perspective
Walking the Tightrope of Health Insurance Reform between 2010 and 2014
Christopher C. Jennings, and Katherine J. Hayes, J.D.
Both political parties wax poetic about the need for popular insurance reforms, but legislating what is necessary and implementing it properly has always been the trick. In the aftermath of the enactment of the Affordable Care Act, President Barack Obama and his administration are walking a policy tightrope: they must implement meaningful reforms in the transition to a stable insurance market without unduly disrupting existing insurance arrangements by means of excessive increases in premiums or declines in coverage.
Perspective
Truth and Consequences — Insurance-Premium Rate Regulation and the ACA
Ann Mills, M.Sc., M.B.A., Carolyn L. Engelhard, M.P.A., and Patricia M. Tereskerz, J.D., Ph.D.
Over the past decade, the largest health insurance companies have seen a disproportionate increase in profits of 250%, or 10 times the rate of inflation. During the past year alone, there has been a double-digit increase in health insurance premiums.1
Health Law, Ethics, and Human Rights
The Disclosure Dilemma — Large-Scale Adverse Events
Denise M. Dudzinski, Ph.D., Philip C. Hébert, M.D., Ph.D., Mary Beth Foglia, R.N., Ph.D., and Thomas H. Gallagher, M.D.
In 2003, the infection-control staff of a Toronto teaching hospital realized that the sterility of prostate-biopsy equipment had been inadvertently compromised by incomplete cleaning.1 Although the risk of infectious transmission was considered very low, hospital officials could not be certain that hundreds of men had not been exposed to harmful pathogens. The hospital faced a dilemma: should they disclose this adverse event that may have harmed many patients (a large-scale adverse event)? Or should they not disclose the event if the risk of harm was remote and if the disclosure would primarily cause anxiety to patients who would ultimately not be physically harmed by the event?
Perspective
Indoor Tanning — Science, Behavior, and Policy
David E. Fisher, M.D., Ph.D., and William D. James, M.D.
An estimated 1 million times per day, someone in the United States uses ultraviolet (UV) radiation for skin tanning. According to the indoor tanning industry, tanning beds are used by 30 million Americans, or about 10% of the U.S. population, each year (www.theita.com/indoor). These users include minors, who often have ready access to tanning beds. In response to considerable grassroots and political opposition to indoor tanning, in late March the Food and Drug Administration (FDA) convened an advisory panel to review the safety of the procedure. The FDA is expected to announce a decision soon on whether and how to reclassify tanning lamps and possibly to address minors’ access to them.
Data Watch
Health Care Reform Is Ranked Third Most Important Voting Issue
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Video
Ways and Means Committee Hearing on Efforts to Promote the Adoption and Meaningful Use of Health Information Technology
View David Blumenthal's Testimony on Ways and Means Committee Website
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