The Parliamentary Support Programme is funded by the European Commission under the European Programm e for Reconstruction and Development The opinions expressed in this research study do not necessarily represent the official views of the Parliamentary Support Programme, the Speakers' Forum, individual legislatures or the European Commission. I got excited in the sense that it would be my first time to fly and also my first visi t to Cape Town and to Parliament as well as to the sea. Our flight to Cape Town was scheduled for 18h On board the flight I was relaxed because I was sitting next to Adele and she comforted me.
Overview[ edit ] Chart showing life expectancy at birth and health care spending per capita for OECD countries as of These range from increased use of health care technology through changing the anti-trust rules governing health insurance companies and tort-reform to rationing of care.
Different overall strategies have been suggested as well. He mentioned electronic record-keeping, preventing expensive conditions, reducing obesity, refocusing doctor incentives from quantity of care to quality, bundling payments for treatment of conditions rather than specific services, better identifying and communicating the most cost-effective treatments, and reducing defensive medicine.
He argued that the U. He articulated four "pillars" of such a strategy: Writing in The New Yorkersurgeon Atul Gawande further distinguished between the delivery system, which refers to how medical services are provided to patients, and the payment system, which refers to how payments for services are processed.
He argued that reform of the delivery system is critical to getting costs under control, but that payment system reform e. Gawande argued that dramatic improvements and savings in the delivery system will take "at least a decade. He argued this would be an iterative, empirical process and should be administered by a "national institute for healthcare delivery" to analyze and communicate improvement opportunities.
These options included increased use of health information technology, research and incentives to improve medical decision making, reduced tobacco use and obesity, reforming the payment of providers to encourage efficiency, limiting the tax federal exemption for health insurance premiums, and reforming several market changes such as resetting the benchmark rates for Medicare Advantage plans and allowing the Department of Health and Human Services to negotiate drug prices.
The authors based their modeling on the effect of combining these changes with the implementation of universal coverage. The authors concluded that there are no magic bullets for controlling health care costs, and that a multifaceted approach will be needed to achieve meaningful progress.
Health insurance premiums for employer-provided family coverage Health spending accounted for Following the United States were the Netherlands at Americans spent more than twice as much as relatively rich European countries such as France, Sweden and the United Kingdom.
The causes are disputed, ranging from recession-related delays in visiting doctors to more long-term trends in moderating insurance premiums and reduced spending on structures and equipment.
However, costs per capita continue to rise. Per capita cost increases have averaged 5. Costs relative to GDP have risen from Reasons include, among others: Higher unemployment due to the recession, which has limited the ability of consumers to purchase healthcare; Rising out-of-pocket payments; Deductibles the amount a person pays before insurance begins to cover claims have risen sharply.
Workers must pay a larger share of their own health costs, and generally forces them to spend less; and The proportion of workers with employer-sponsored health insurance enrolled in a plan that required a deductible climbed to about three-quarters in from about half in Bloomberg reported in January If health insurance were cheaper, or the marketplace were structured so that most people bought health coverage for themselves rather than getting it with their jobs, people would be paid more and raises would be higher.
Comparative effectiveness research would be one of many tools used by the IMAC. And ultimately, without a structure in place to help contain health care costs over the long term as the health market evolves, nothing else we do in fiscal policy will matter much, because eventually rising health care costs will overwhelm the federal budget.
Washington Post columnist David Ignatius has also recommended that President Obama engage someone like Cortese to have a more active role in driving reform efforts. Several treatment alternatives may be available for a given medical condition, with significantly different costs yet no statistical difference in outcome.
Such scenarios offer the opportunity to maintain or improve the quality of care, while significantly reducing costs, through comparative effectiveness research.
According to economist Peter A. He described how the U. With a central oversight panel the U. Medicare and Medicaid currently pay clinicians the same amount regardless of results. But there is a pilot program to increase payments for doctors who deliver high-quality care at lower cost, while reducing payments for those who deliver low-quality care at higher cost.
Still another would test a system of penalties and rewards scaled to the quality of home health and rehabilitation care. Other experiments try moving medicine away from fee-for-service payment altogether.
A bundled-payment provision would pay medical teams just one thirty-day fee for all the outpatient and inpatient services related to, say, an operation.
This would give clinicians an incentive to work together to smooth care and reduce complications.
These groups would be permitted to keep part of the savings they generate, as long as they meet quality and service thresholds. The bill has ideas for changes in other parts of the system, too.
Some provisions attempt to improve efficiency through administrative reforms, by, for example, requiring insurance companies to create a single standardized form for insurance reimbursement, to alleviate the clerical burden on clinicians.For nearly years, a federal law known as the Jones Act has restricted water transportation of cargo between U.S.
ports to ships that are U.S.-owned, U.S.-crewed, U.S.-registered, and U.S.-built. FLORIDA STATE'S COURT SYSTEM. Diagram of the State Courts System (PDF) - This file provides a condensed review of the structure of the Florida Court System from trial courts to appellate courts, their jurisdiction and types of cases heard at each level.
Overview Until , Florida had more different kinds of trial courts than any state except New York. A movement developed in the late s to reform this confusing system. BibMe Free Bibliography & Citation Maker - MLA, APA, Chicago, Harvard.
ABSTRACT. A nearly universal consensus has developed in the United States that the current health care financing system is a failure.
The system has been unable to control the continuing rapid rise in health care costs (by far, the highest in the world), and it has been unable to stem the growing population that has no health insurance coverage (at least 36 million people).
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