This item contains the agenda, minutes, and attachments for the Faculty Senate meeting on this date. There may be additional materials from the meeting available at the Faculty Center. / Minutes originally posted on Dec. 3rd, 2013; correction made to minutes and reposted on Feb. 3rd, 2014.

Essay in Political Science, C-level, by Camila Alvarez Cea, spring semester 2010.   Tutor: Alf Sundin “Reality or a Political Mirage? – A Study of the Swedish Press Views on the Health Insurance Reform in the USA”   The purpose of this essay is partly to examine whether the picture that Swedish press presents of the health insurance reform in the US, which is part of the Patient Protection and Affordable Act bill, will be of crucial importance to the possibilities that the American population has to receive health insurance. The main research question is accordingly: “Does the picture that Swedish press presents of the health insurance reform in the USA, seem like something that will be of radical importance to the possibilities of the population to receive healthcare?” The purpose is also to examine in which model (demand or market) the opinions of the Swedish press fits. This purpose will be answered by using three specific questions asking whether their opinions differ when it comes to three criterions: organization, financing/resources and delivery systems. These criterions come from a model from Milton I. Roemer’s book “National health systems of the world,” which also is the theoretical foundation of this essay.   The methodological approach of this essay is a qualitative text analysis along with an analysis chart, where the three criterions have been examined from the reporting of the four Swedish newspapers chosen for this essay. The conclusions that have been reached from the analysis chart are that the opinions differ greatly within Swedish press, and that the picture that Swedish press presents of the health insurance reform is that it will become easier for the American population to receive health care.

BACKGROUND: The barriers in accessing healthcare for gay, lesbian and bisexuals individuals are not well explored. These challenges as well as a lack of knowledge concerning this understudied group has prompted the Institute of Medicine to create a research agenda to build a foundational understanding of gay, lesbian and bisexual health and the barriers they encounter.1 the primary aim of this study will be to compare the differences in health care access and utilization between gay/lesbian, bisexual and heterosexual individuals using a large, nationally representative dataset of the U.S. population. METHODS: Data from 2001 to 2012 from the National Health and Nutrition Examination Survey was pooled. Using logistic regression, we calculated the unadjusted and adjusted odds ratios of having health insurance, having a routine place and seeing a provider at least one in the past year. RESULTS: We found that gay men were more likely to have health insurance coverage (ORadj:2.13 95%CI: 1.15,3.92), while bisexual men were at a small disadvantage in having health insurance coverage (ORadj:0.82 95%CI: 0.46,1.46). Bisexual men were more likely to have received health care in the past 12 months (ORadj:3.11 95%CI: 1.74,5.55). Lesbian women were less likely to have health insurance coverage (ORadj-lesbian:0.58 95%CI: 0.34,0.97). CONCLUSION: This study contributed to the limited knowledge on understanding the health care access and utilization among gay, lesbian and bisexual individuals, which was classified as a high priority by the Institute of Medicine. Expanding health insurance coverage through the Affordable Care Act and Universal Partnership Coverage may reduce the disparities among gay, lesbian and bisexual individuals.

Americans spent nearly $2.6 trillion, or $8,000 per person for medical and administrative costs in 2010. By 2015, healthcare spending in the United States increased to 5.8% reaching $3.2 trillion or $9,990 per individual. By tackling healthcare administrative costs, it is estimated that healthcare providers could reduce these costs by $20 billion yearly. This case study explored strategies for streamlining hospital administrative procedures to reduce costs. The business process reengineering model formed the conceptual framework for this study. Data were gathered through semistructured face-to-face interviews guided by open-ended questions with a purposeful sample of 4 hospital managers in Atlanta, Georgia. This study identifies important themes regarding cost reduction and hospital administration based on participant interviews. Themes included participants' unfavorable perspectives of the Spell out PPACA (PPACA) legislation, employment of physicians, PPACA reimbursement method, follow-up services, hospital administrative governance, and lack of business education. The themes comprised steps hospital managers could take to streamline administrative procedures to reduce costs. The implications for positive social change included the potential to provide strategies for streamlined processes that could lead to savings passed on to patients from low socio-economic backgrounds through accessibility to affordable healthcare services.

Colorectal cancer is the second leading cause of cancer-related deaths worldwide as of 2020. Early detection and diagnosis of colorectal cancer can greatly increase the chances of successful treatment and can also reduce the cost of care including treatment. It’s shown in recent years that the colorectal cancer screening rates have slowed nationwide which impacts the new diagnoses of colorectal cancer (CRC) and the ability to treat it at an early stage to avoid increase in mortality rate. The purpose of this research is to examine the impact of the Affordable Care Act 2010 ‘s policy to remove colorectal cancer screening fee for adults aged 50-75 on screening, incidence, and mortality rate of colorectal cancer using panel data model and employing sequential recursive system of equations method. Since a decision to get screened is an individual’s choice, this study explores methods to increase colorectal cancer screening rate with the help of behavioral economics theories. Results of the study show that Affordable Care Act’s policy to remove colorectal cancer screening fee has a significant impact on both colorectal cancer screening and incidence rates. The ACA’s policy is associated with an increase in colorectal cancer screening rate while associating with a decrease in cancer incidence rate. Relating to the colorectal cancer mortality rate, an effort was made to examine the effect of the Affordable Care Act's policy to remove colorectal cancer screening fee on the overall cost savings resulting from lives saved. However, since this study found no significant impact of the ACA's policy on the mortality rate of colorectal cancer, further exploration in this regard was not pursued. On the other hand, studies conducted to increase colorectal cancer screening rate by applying behavioral economics methods have shown that default method with an opt-out choice and financial incentive with a loss-framed messaging methods are proven effective. Therefore, these methods can be investigated to design and implement a nationwide initiative.

No description available.

Amid the global pandemic, it becomes more apparent that diabetes is a pressing health concern because racial/ethnic minorities with underlying diabetes conditions have been disproportionately affected. The study proposes a multiyear examination to document the role of the Affordable Care Act (ACA) in racial/ethnic disparities in diabetes health. Using the Behavioral Risk Factor Surveillance System from 2011 to 2019, the study with a pre-post design investigated changes in access to care and diabetes health among non-White minorities compared with Whites before and after the ACA by conducting multivariable linear regression, with state-fixed effects and robust standard errors. Compared with Whites, racial/ethnic minorities showed significant improvements in health insurance coverage, having a personal doctor, and not seeing a doctor because of cost. Blacks (3.2% points,  ≤ 0.000), Hispanics (1.6% points,  = 0.001), and "other" racial/ethnic group (1.5% points,  = 0.003) experienced a greater increase in diagnosed prediabetes than Whites, whereas no and small differences were found in diagnosed diabetes and obesity, respectively. The yearly comparisons of changes in diagnosed prediabetes showed that Blacks compared with Whites had a growing increase from 1.2% points ( = 0.001) in 2014 to 3.3% points ( = 0.001) in 2019. Insurance coverage has declined after 2016, and obesity had an increasing trend across race/ethnicity. The ACA had a positive role in improving access to care and identifying those at risk for diabetes to a larger extent among racial/ethnic minorities. However, the policy impacts have been diminishing in recent years. Continued efforts are needed for sustained policy effects.

The three branches of government rely on public engagement for the prosperity of the nation. Moreover, informed public opinion is a fundamental tenant of democracy. With that in mind, this paper aims to explore the relationship between the Judicial Branch and the public. Specifically, this paper examines and questions the Supreme Court’s efficacy communicating with the public. American constituents are inundated on a daily basis by the clamor of D.C. politics. The twenty four hour news cycle has given way to politicized headlines and exaggerated pundit commentary on contentious national issues. In a technological age where information is instant and the public has become accustomed to soundbites for education, the Supreme Court is left out of place. Both the Executive Branch and Legislative Branch converse directly with the public when necessary. Politicians frequently address their constituents or discuss complicated issues with voters first hand. However, the Supreme Court has rejected this strategy and instead relies almost exclusively on the press to relay their decisions. The judicial branch is the only third of our government without constant communication to the American people. As a result, the judiciary is relatively ignored by its citizens. By discussing a number of landmark cases since the turn of the century, this paper aims to analyze how those decisions were both announced to the public by the media and how the public received them. The Court has certainly adopted the press as an agent of communication. But is the media truly the proper outlet for the Court’s rulings?

This item contains the agenda, minutes, and attachments for the Faculty Senate meeting on this date. There may be additional materials from the meeting available at the Faculty Center.

美國前總統歐巴馬於2010年簽署之法案「病人保護暨可負擔醫療法」（Patient Protection and Affordable Care Act, PPACA）又稱「歐巴馬醫療法」（Obamacare），主要目的之一在於提升對人民醫療照顧的保障，擴大人民的醫療照顧覆蓋面，並讓醫療保險成為可負擔的，具體改革面向主要在公共醫療照顧的範圍擴大、對人民強制納保規定，與對於商業醫療保險之各種規制，而從歐巴馬醫療法內容中，得以探討美國如何在維持既有醫療照顧體系架構、商業醫療保險為主導的模式中，透過對商業醫療保險的規制來成就相當於社會保險所實現的社會安全，並與我國作比較，雖然主要採取之醫療照顧模式不同，但同樣在促成全民納保的社會國目的之達成，兩國背後的立法背景、操作上有何異同，以及會遇到之爭議與困境何在，並且進一步思考是否有讓我國在處理目前制度問題的值得參考之處。 本文先論述美國傳統對於醫療照顧的心態與背景，並介紹美國的醫療照顧制度與衍生的問題，並從中了解醫療照顧之相關權利、全民納保觀念在美國的發展狀況，接著介紹歐巴馬醫療法的發展過程與實際內容，聚焦在擴大醫療照顧覆蓋面與令醫療保險成為可負擔之相關規定，並了解幾個重要的聯邦最高法院對歐巴馬醫療法之違憲審查判決中對爭議的處理，之後觀察歐巴馬醫療法如何透過對商業醫療保險的規制來讓其能成就社會安全功能，並追蹤後續歐巴馬醫療法實施後之成效與未來可能變化。對照我國，在介紹我國全民健康保險之發展與內容後，比較兩國在促成全民納保的背景、立法與釋憲過程中的爭議為何且如何處理、全民納保的操作內容，以及醫療照顧相關權利的承認與否、商業醫療保險的角色等，也從中討論是否有我國在解決現今全民健保之問題上可參考之面向。