The cost of healthcare, and consequently of health insurance, continues to increase dramatically. A growing chorus calls for replacing the fundamental method by which people purchase insurance today--through their employers--with a system of individually acquired insurance. This article argues that changing how Americans purchase health insurance could change the dynamics between insurers and healthcare providers in a way that could favorably impact costs, primarily through reliance on highly limited provider networks. It examines the bases of legal obstacles to limited provider networks embedded in both statutory and case law and urges re-examination of those bases in light of changes in the distribution system of health insurance.
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Am J Trop Med Hyg
January 2025
Department of Pediatrics, National School of Tropical Medicine, Section of Tropical Medicine, Baylor College of Medicine, Houston, Texas.
The burden of pathogenic enteric protozoa and soil-transmitted helminths among impoverished populations living on the Texas-Mexico border is unclear. We conducted a cross-sectional study on an ongoing longitudinal cohort of 616 adults residing in Starr County, Texas. A total of 359 adults were screened for four protozoa and five soil-transmitted helminths by using real-time polymerase chain reaction.
View Article and Find Full Text PDFJMIR Res Protoc
January 2025
Psychiatry Department, Weill Cornell Medicine, New York, NY, United States.
Background: Mental illness is one of the top causes of preventable pregnancy-related deaths in the United States. There are many barriers that interfere with the ability of perinatal individuals to access traditional mental health care. Digital health interventions, including app-based programs, have the potential to increase access to useful tools for these individuals.
View Article and Find Full Text PDFIr J Med Sci
January 2025
Rotunda Hospital, Dublin, Ireland.
Background: Medical indemnity (MI) has become an important topic in the era of increasing number of medico-legal cases in Ireland. However, there is a sensible difference in understanding and usage of medical indemnity between Irish and international medical graduates.
Aim: This study aimed to investigate the knowledge and awareness of medical indemnity among international medical graduates in Ireland.
Health Econ Rev
January 2025
Finnish Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland.
Background: Healthcare expenditures have risen in middle- and high-income countries. One of the potential contributors is the overuse of diagnostics. I explore whether medical imaging is overused when privately owned clinics in Finland treat patients with voluntary private health insurance (VPHI).
View Article and Find Full Text PDFJ Manag Care Spec Pharm
January 2025
Academy of Managed Care Pharmacy Foundation, Alexandria, VA.
Background: Over the past 5 years, managed care pharmacy has been shaped by a global pandemic, advancements in generative artificial intelligence (AI), Medicare drug price negotiation policies, and significant therapeutic developments. Collective intelligence methods can be used to anticipate future developments in practice to help organizations plan and develop new strategies around those changes.
Objective: To identify emerging trends in managed care pharmacy.
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