Fertility-a human right worthy of mandated insurance coverage: the evolution, limitations, and future of access to care.

We review the history, current status, and potential future of state infertility mandates and focus on the business implications of mandates and on the inadequacies and reproductive injustice resulting from gaps between legislative intent and practical implementation. Nineteen states have passed laws that require insurers to either cover or offer coverage for infertility diagnoses and treatment. The qualifications for coverage, extent of coverage, and exemptions vary drastically from one state to another, resulting in deficiencies in access to care even within mandated states for certain groups, such as single individuals, patients in same-sex relationships, and patients pursuing fertility preservation. Although insurance coverage of fertility services in the United States has expanded as an increasing number of states have enacted infertility mandates, significant gaps in implementation and access remain even among states with existing mandates. Provider, patient, and legislative advocacy is warranted in the name of reproductive justice to expand insurance coverage and, in turn, maximize reproductive outcomes, which have been shown to improve as financial barriers are lifted.

Political Accommodations in Multipayer Health Care Systems: Implications for the United States.

Current interest in a single-payer approach to universal health care coverage in the United States has also triggered interest in alternative multipayer approaches to the same goal.An analysis of experiences in Germany, the Netherlands, Switzerland, and Israel shows how the founding of each system required a distinctive political settlement and how the subsequent timing, content, and course of the reforms were shaped by political circumstances and adjustments to the founding bargain in each nation.Although none of these systems is directly transferable to the United States, certain parallels with the American context suggest that a multipayer approach might offer a model for universal coverage that is more politically feasible than a single-payer scheme but also that issues associated with risk selection and other potential inequities would remain.

Legal and policy requirements of basic health insurance package to achieve universal health coverage in a developing country.

OBJECTIVES: This study has analyzed the policy-making requirements related to basic health insurance package at the national level with a systematic view. RESULTS: All the documents presented since the enactment of universal health insurance in Iran from 1994 to 2017 were included applying Scott method for assuring meaningfulness, authenticity, credibility and representativeness. Then, content analysis was conducted applying MAXQDA10. The legal and policy requirements related to basic health insurance package were summarized into three main themes and 11 subthemes. The main themes include three kinds of requirements at three level of third party insurer, health care provider and citizen/population that contains 5 (financing insurance package, organizational structure, tariffing and purchasing the benefit packages and integration of policies and precedents), 4 (determining the necessities, provision of services, rules relating to implementation and covered services) and 2 (expanded coverage of population and insurance premiums) sub themes respectively. According to the results, Iranian policy makers should notice three axes of third party insurers, health providers and population of the country to prepare an appropriate basic benefit package based on local needs for all the people that can access with no financial barriers in order to be sure of achieving UHC.

California's Efforts To Cover The Uninsured: Successes, Building Blocks, And Challenges.

During the last century, California policy makers tried multiple approaches to achieve the goal of affordable health coverage for all: employer and individual requirements, single payer, and hybrids. All failed, primarily because of the amount of financing needed to cover the large numbers of uninsured Californians and the supermajority vote requirements for tax increases. These failures, however, provided important lessons for state and national reform efforts. More immediate success was achieved with incremental reforms, such as child health insurance, Medicaid section 1115 waivers, and the creation of purchasing pools. These reforms, as well as the experience derived from the broader coverage expansion efforts, contributed to the intellectual and policy frameworks that underlay major national reforms and created building blocks for the state's successful implementation of the Affordable Care Act. That act allowed California to meet its greatest need: the financing required to make a truly sizable dent in the numbers of uninsured Californians.

Impact of tobacco industry and other corporations in the defeat of the 1994 Clinton health care plan.

BACKGROUND: The primary reason cited by many scholars for the defeat of the Clinton Administration's 1994 health care reform bill has long been identified as Health Insurance Association of America and National Federation of Independent Businesses opposition to the bill. Given this predominant consensus combined with sizeable proposed funding for the bill by a large tobacco product tax, this manuscript examined what the tobacco industry's role was in whole or part in defeating the Clinton health care bill. METHODS: This research occurred through crosschecking internal tobacco industry documents and Clinton White House documents. RESULTS: Prior to the passage of the bill, the tobacco industry accepted a compromise of 45 cents per pack increase phased in over five years. Due to this compromise, the industry or third party allies had no role in the ultimate defeat in the bill. CONCLUSIONS: The primary reason for the bill's ultimate defeat was general business (but not tobacco industry and third party ally) opposition, the bill running out of time, and conflicting bills. Secondary reasons for the bill's defeat included issues with: employer mandates, high taxes on insurance plans, impacts on medical research and education, Congressional attention to other issues, election year politics, and possible future excise tax possibilities.

Comprehensive Legislative Reform to Protect the Integrity of the 340B Drug Discount Program.

The 40B Drug Discount Program (340B Program) is a federally facilitated program that requires drug manufacturers to provide steep discounts on outpatient prescription drugs to qualifying safety net health care providers. The federal program is intended as a safeguard to ensure access to affordable drugs to the indigeut. However, over the last two decades safety net health care providers have exploited financial incentives under the 340B Program at the expense of drug manufacturers and patients, including the most needy and vulnerable populations-they are committed to serve. Although the federal government has been applauded for increasing effortsto combat health care fraud and abuse including recovering $3.3 billion in 2014, federal officials and the general public have paid markedly less attention to pervasive abuse of the 340B Program. In 2014, drug purchases of 340B-designated drugs totaled $7 billion and are expected to increase to $12 billion: by 2016 as a result of the expansion of the program under the Affordable Care Act. The 340B Program has completely lost its way, and comprehensive legislation is necessary to realign the program with its intent.

Marking time in the land of plenty: reflections on mental health in the United States.

This reprinted article originally appeared in American Journal of Orthopsychiatry, 1981, Vol. 51, No. 3, 391-402. (The following abstract of the original article appeared in record 2013-42918-004.) This article focuses on reflections on mental health in the United States. This accumulation of wisdom and knowledge from experts inside and outside government has for the most part been ignored or shelved over the years because of revisions, deferrals, impoundments, vetoes, threatened vetoes, reorganizations, budget cuts, inflation, and military demands. Programs such as Head Start, which have been proven successful, have been fighting for survival, and community mental health centers, which in many ways represented a bold, new approach with much creative promise, were threatened with the loss of federal funding in the early 1970s. The humanist tradition in mental health and social services is best exemplified by Pinel's unchaining of psychotic patients: Itards infinite patience in working with Victor, the wild child: and Jane Addams's extraordinary development of community programs. On an international level a recent report of the WHO European Regional Office also has called for a wide ranging, independent group that would cut across national governments and exercise influence at high political levels to insure that important mental health policies are implemented. Perhaps the day will even come when an American President will feel responsible and accountable to the nation in an annual report to Congress and the people on the progress made in health and social welfare areas in his or her administration.

[A refined institution was created: which serves to all of the members of insurance in the case of illness: foundation and development of Merkur's sanatorium in Zagreb until 1945]. / Stvorena je jedna veoma lijepa ustanova, koja sluzi svim osiguranicima u slucaju bolesti: osnutak i razvoj merkurova sanatorija u zagrebu do 1945. godine.

The historiography of Zagreb sanatorium Merkur, founded by Merkur Insurance Society in 1930 is presented. The research is based on archival sources kept in the State's archives as well as in the National library in Zagreb aiming to identify the opening, building and governing the hospital until 1945. The analysis of the hospital historiography allowed the insight into social insurance development on our territory as well as of Zagreb's population receptivity towards the health institution and the quality of health service in the first half of the 20th century. The paper is dedicated to the 140th anniversary of Merkur Insurance Society foundation.