The March Supreme Court hearings on the Affordable Care Act have reinvigorated the debate about health care in the United States. RAND Health has used its COMPARE microsimulation model to estimate the effects of major health policy changes, such as the ACA with and without the individual mandate, using data from multiple, nationally representative sources. RAND Health offers answers on how health care and health insurance will change in the future in response to financial pressures and legal changes, as well as assessments of the current system's performance.
The Real Cost of Healthcare
While some downplay the burden of growing health care costs in the United States, RAND Health Director Art Kellermann contends that the U.S. health care system fails too many, too often, and at too high of a price.
The rapid growth of health care costs has had far-reaching economic effects. Among these are decreased availability of employer-based insurance, reduced enrollment in such plans, and declines in the financial protection that employer-based coverage provides, especially for middle-class families.
An analysis of the effects of implementing the Affordable Care Act without an individual mandate found that over 12 million people who would have otherwise signed up for coverage will be uninsured, and premium prices will increase by 2.4 percent.
As of 2008, 17% of 2- to-19-year-olds in the U.S. were obese. Youth obesity has become a major concern for local and national policymakers, and many of their efforts have looked at the food environment as an area for intervention. Fast food, snacks and soda are available inside and outside school, and the common thinking is that the ease of access to unhealthy foods makes it easier for children and teens to make unhealthy food choices. However, two new studies by RAND Health researchers indicate that the relationship between obesity and the food environment may not be so straightforward.
Use of anesthesia providers to monitor sedation during screening colonoscopies and other outpatient gastroenterology procedures more than doubled from 2003 to 2009 in the United States, with most of the increase among low-risk patients who may not need this service.
Researchers from RAND and other institutions have begun pilot-testing a web-based tool designed to help parents and adult caregivers determine whether to seek urgent medical attention for a sick child with flu-like symptoms. The study is being conducted by RAND Health in two hospital emergency rooms in the Washington, D.C., area—Children's National Medical Center in the District of Columbia and Inova Fairfax Hospital in Falls Church, Va.
The nurse practitioner (NP) workforce has been growing rapidly in recent years, but future projections have been varied. A new study forecasts dramatic growth by 2025, easing concerns about a potential looming nursing shortage and suggesting that NPs will meet a substantial amount of future demand for care.
Electronic prescribing is looked to as a cost-saving and error-preventing tool for health care. In offices where e-prescribing was implemented, prescribers used information about formularies and drug benefits, but missing information reduced confidence in these resources and led to paper-based workarounds.
Many school-based programs to prevent adolescent alcohol and drug use exist, but most are mandatory and scheduled during class time. A voluntary after-school program focused specifically on alcohol and drug use may be effective in deterring alcohol use among early adolescents.