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Biomedical subjects

Karen Davis

Publications and source records attributed to Karen Davis.

42 records · Page 3Linked to original sources

Medicare versus private insurance: rhetoric and reality.

Many policymakers have called for the remodeling of Medicare to more closely resemble private insurance, which is often assumed to work better than public programs do. However, evidence from this 2001 survey demonstrates that Medicare beneficiaries are generally more satisfied with their health care than are persons under age sixty-five who are covered by private insurance. Medicare beneficiaries report fewer problems getting access to care, greater confidence about their access, and fewer instances of financial hardship as a result of medical bills. Making the program more like private insurance runs the risk of undermining a program that is working well from the perspective of beneficiaries.

Adult↗

Creating consensus on coverage choices.

The framework for reaching near-universal coverage outlined in this paper combines tax credits for private insurance and public program expansions. It illustrates how a series of incremental steps could be phased in to achieve near-universal coverage. Hallmarks include creation of a Congressional Health Plan; use of the income tax system to provide tax credits and enroll uninsured people; creation of a state Family Health Insurance Program open to everyone below 150 percent of poverty; and creation of a Medicare Part E, open to the disabled and uninsured older adults. The paper provides coverage and cost estimates and identifies potential sources of revenue to finance coverage.

Financing, Government↗

Primary care and health system performance: adults' experiences in five countries.

This paper reports on a 2004 survey of primary care experiences among adults in Australia, Canada, New Zealand, the United Kingdom, and the United States. The survey finds shortfalls in delivery of safe, effective, timely, or patient-centered care, with variations among countries. Delays in lab test results and test errors raise safety concerns. Failures to communicate, to engage patients, or to promote health are widespread. Aside from clinical preventive care, the United States performs poorly on most care dimensions in the study, with notable cost-related access concerns and short-term physician relationships. Contrasts across countries point to the potential to improve performance and to learn from international initiatives.

Adolescent↗

Medicare extra: a comprehensive benefit option for Medicare beneficiaries.

The proposed Part E, Medicare Extra, outlined in this paper adds a comprehensive benefit option to Medicare, eliminating the need for beneficiaries to purchase a private drug plan and Medigap supplemental coverage. Financed by a budget-neutral beneficiary premium, it has the advantages of greater simplicity, efficiency, and value without adding to federal costs. Beneficiaries now enrolled in Medigap plans would save money, as could employers by choosing a lower-cost alternative to current retiree health plans. Eliminating some of the excess payments to Medicare Advantage plans would yield savings that could be used to help finance premium subsidies for low-income beneficiaries.

Aged↗

Taking the pulse of health care systems: experiences of patients with health problems in six countries.

This paper reports on a 2005 survey of sicker adults in Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States. Sizable shares of patients in all six countries report safety risks, poor care coordination, and deficiencies in care for chronic conditions. Majorities in all countries report that mistakes occurred outside the hospital. The United States often stands out for inefficient care and errors and is an outlier on access/cost barriers. Yet no country consistently leads or lags across survey domains. Deficiencies in transition care during hospital discharge and coordination failures among patients seeing multiple physicians underscore shared challenges of improving performance across sites of care.

Delivery of Health Care↗