This detailed look at the individual insurance market in the United States explains how it works, offers approaches to improvement that build on what currently works well, and provides a realistic assessment of how much improvement we can demand and expect.

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

This book establishes a framework for assessing health care reform proposals and their implementation. It helps clarify objectives, identifies issues to be addressed in proposals, distinguishes between short- and long-term expectations and achievements, and directs attention to important but sometimes neglected questions about the organization and provision of health care services. In addition, the volume presents a discussion and analysis of issues essential to achieving fundamental goals of health care reform: to maintain and improve health and well-being, to make basic health coverage universal, and to encourage the efficient use of limited resources. The book is a useful resource for anyone developing or assessing options for reform.

The Affordable Care Act will have a dangerous effect on the American economy. That may sound like a political stance, but it’s a conclusion directly borne out by economic forecasts. In Side Effects and Complications, preeminent labor economist Casey B. Mulligan brings to light the dire economic realities that have been lost in the ideological debate over the ACA, and he offers an eye-opening, accessible look at the price American citizens will pay because of it. Looking specifically at the labor market, Mulligan reveals how the costs of health care under the ACA actually create implicit taxes on individuals, and how increased costs to employers will be passed on to their employees. Mulligan shows how, as a result, millions of workers will find themselves in a situation in which full-time work, adjusted for the expense of health care, will actually pay less than part-time work or even not working at all. Analyzing the incentives—or lack thereof—for people to earn more by working more, Mulligan offers projections on how many hours people will work and how productively they will work, as well as how much they will spend in general. Using the powerful tools of economics, he then illustrates the detrimental consequences on overall employment in the near future. Drawing on extensive knowledge of the labor market and the economic theories at its foundation, Side Effects and Complications offers a crucial wake-up call about the risks the ACA poses for the economy. Plainly laying out the true costs of the ACA, Mulligan’s grounded and thorough predictions are something that workers and policy makers cannot afford to ignore.

Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

Provides divergent views on issues involving mental health reform in the United States.

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.