Description: An essay discussing universal access to high quality, low cost health care.

Description: Essay stating Americans need to invent, implement, and evaluate sustainable health care policies, divert cash-flow streams away from projects which feed the beast and focus on projects and policies which enhance value. It will require a combination of thoughtful, coordinated policies and a change in our cultural expectations of infinite resources and unlimited choice.

Description: Brief discussion of future anticipated health reform and information on papers discussing these reforms. Topics include Medicare, individual insurnace, tax credits & subsidies, pre-Medicare retirees and Medicaid

Description: The Health Section Council Chairperson looks back at a historic year for the health care industry, and what it means for health actuaries.

Description: This article describes the Health Insurance Providers Fee implemented through Section 9010 of the Affordable Care Act (ACA) and discusses how the fee will creates challenges in Managed Medicaid Rate development. It also offers some suggested ways to include the fee in Managed Medicaid rates.

Description: Rhode Island’s unique “global Medicaid waiver” pursues a potentially dangerous national policy trend: long-term care LTC rebalancing without strong eligibility controls. Resulting cost overruns could seriously damage the state’s social safety net. To maximize the global waiver’s opportunity, minimize its danger, and become a LTC financing model for the country, policy makers need to recognize the issues discussed in this report and pursue the recommended additional research and analysis.

Description: Article on the history of the Long Term Care Discussion Group, a Washington DC-based venue for discussing long-term care and related issues for over 20 years.

Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: Feature article discussing the impact of health care reform on the direct insurance market and the reinsurance market.

Description: Health care reform will require health insurers to change the way they make decisions on what to sell while remaining financially sound. The new regulatory reality of expanded access to coverage leaves insurers with fewer options for managing costs and business risk. With the introduction of risk adjustment mechanisms in the exchanges, the most profitable members will not necessarily be the lowest cost ones, but rather, the members which the health plan is relatively more effective at servicing. While Patient Protection and Affordable Care Act 'PPACA' prohibits underwriting and using any health status information for denying coverage or varying the premium rates, this article describes how the use of consumer data will affect the way health insurers make decisions on what products to sell.