The Bridge
Public Health Newsletter
Spring 2014, Volume 4
The Bridge is a public health newsletter written and produced by Hofstra University students and faculty devoted to bridging the gaps in our health care system and improving the health of our communities.
Recap: “Health Care Reform 2014 and Beyond The Impact of Obamacare” By Ronald Sanchez, MPH, ’14 John McDonough, DrPH, MPA, director of the Center for Public Health Leadership at Harvard University School of Public Health and a former advisor to the U.S. Senate on health care reform, presented a special public lecture at the Leo A. Guthart Cultural Center Theater on “Health Care Reform 2014 and Beyond: The Impact of Obamacare.” Dr. McDonough offered incredible insight into the planning, execution and the future of the health reform law.
Why Health Reform? “Obamacare” is the common term used for the Patient Protection and Affordable Care Act (ACA), the federal law enacted in 2010. The need for reform to the U.S. health system has been in contention for decades. In 2009 there were more than 50 million uninsured or underinsured non-elderly residents, with a U.S. health care bill of $3 trillion – approximately $8,000 per person, representing 17.4 percent of the country’s gross domestic product. Health care expenditures have been steadily increasing globally, but in the U.S. there has been a substantial spike in costs since the 1980s. Compared to highly developed health systems in other countries, the U.S. spends much more. For example, the next most expensive per capita health system is Norway, at about $5,300 per person. In other words, for every dollar the U.S. spends, Norway spends only $0.67. Dr. McDonough made clear that greater health care spending does not equate to better health outcomes or improved quality of care. We spend twice as much as France ($3,978 per capita), and they rank No. 1 globally. The U.S. ranks No. 37 worldwide. A variety of health disparities and inequalities has been pushing the nation’s health system into disaster – enter the Affordable Care Act.
The ACA The Public Health Care and Education Act amended the Patient Protection and Affordable Care Act to formalize the Affordable Care Act (ACA). The ACA is a robust law with 10 titles that focuses on all sectors of health care – consumers, providers, security systems, payers, hospitals, pharmaceuticals, biomedicine, payment and revenue systems, delivery systems, prevention and wellness, technology, the workforce and education. Currently, the provisions of the law that have garnered the most attention and have had the greatest impact thus far are the first two
titles: (1) Affordable and Available Coverage and (2) Medicaid and Child Health Insurance Plan (CHIP). Title I passed immediate reforms, such as coverage for children under 26; ban on lifetime and annual limits; medical loss ratios (in which insurance companies must spend at least 80 percent of their revenue on health care or provide rebates to enrollees); and closing of the Medicare Part D prescription drug “donut hole.” Dr. McDonough described these changes as “the most substantive changes to health care in the U.S. since the passing of Medicare and Medicaid.” Title I also establishes consumers guaranteed issues of coverage, removal of the possibility of being denied for pre-existing conditions, individual responsibilities in the form of tax penalties, and insurance premium and cost sharing subsidies. Title II establishes the option to expand the Medicaid and Child Health Plus programs for low-income individuals and families. continued on page 8
Inside From the Director................................................................2 Health Care Reform 2014 and Beyond............ front cover Love Shouldn’t Hurt......................................................... 3 Campus-Wide Health Promotion Campaign.................. 4 Dental Public Health........................................................ 5 Public Health Film Festival.............................................. 5 Progress on Millennium Development Goals................. 6 Nassau County Minority Health Conference.................. 7 Interdisciplinary Student Case Competition on Childhood Obesity........................................................... 8 Industry Leaders Discuss Changes in Health Care................................................................ 10 How Nurses Can Help Save Health Reform.................. 10 Radiation Safety............................................................. 11 Run or Dye 5K................................................................ 12 Shouldn’t Everyone Have a Right to a Healthy Life?................................................................ 12 Women’s Health Fair...................................................... 13 Health Equity Symposium............................................. 14 For More Information.................................................... 14
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