Jonas' Introduction to the U.S. Health Care System, Ninth Edition by unknow

Author:unknow
Language: eng
Format: epub
ISBN: 9780826174048
Publisher: Springer Publishing Company, Inc.
Published: 2020-04-18T00:00:00+00:00

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Children’s Health Insurance Program

Created as the State Children’s Health Insurance Program by the Clinton administration’s Balanced Budget Act (BBA) of 1997, CHIP provides health coverage for uninsured children who are not eligible for Medicaid. It is jointly financed by the federal and state governments and administered by the states. Within broad federal guidelines, each state determines the design of its program, eligibility groups, benefit packages, payment levels for coverage, and administrative and operating procedures. Federal payments to states are based on state expenditures under approved plans. CHIP provided a capped amount of funds to states on a matching basis for federal fiscal years (FYs) 1998 to 2007. The expansion continued under the ACA, and 9.5 million children were enrolled in CHIP at some point since it began through federal FY 2017 (CMS, 2017), and 6.8 million were still enrolled during calendar year 2017 (Medicaid.gov, 2019). The estimated average insurance cost per enrollee was under US$2,700 in 2017 (see Table 6.5) and the program total was US$18.2 billion.

Other Government Programs

Among other major government health programs are, at the federal level, those offered through the Department of Defense (DOD) and the Veterans Affairs (VA). At the state level, they include the state public health and mental hospital services and, at the local level, the local public general hospitals and local public health services.

These government programs are paid primarily with broad-based tax levy funds. Together, they consume a relatively small proportion of the NHE. For example, in 2017, Other Health Insurance Programs—which include the DOD and VA health programs—were 4% of national HCE. Moreover, they had accounted for 4% of HCE every year since 2008, and before that for 3% since 1990. Their highest level was in 1960, when they accounted for 7% of HCE (see Table 6.3).

GoFundMe Campaigns

One curious artifact of the modern U.S. health care system is the rise of GoFundMe campaigns to pay for individuals’ health care needs. As Kaiser Health Network noted in its interview with GoFundMe’s CEO Rob Solomon, the “prominence of the medical category is the symptom of a broken system” (Bluth, 2019). And summarizes the author of a New Yorker article, the “advantages in crowdfunding still go to the people who arrive with the most powerful connections and the best networks. After that, there is competition, with perverse incentives: whoever has the most heartrending story wins” (Heller, 2019).

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