BCycle is a public bicycle sharing company owned by Trek Bicycle and is based in Waterloo , Wisconsin , United States . It has 34 local systems operating in cities across the United States. However, in several cities it operates under a name other than BCycle (i.e., CAT Bike, Red Bike, GREENbike, etc.)
95-403: The BCycle system consists of bicycles and solar-powered stations positioned throughout a city or region. The result is a slight variation in the system, depending on the city of operation. Such variations can include differences in pricing and operating under a name other than BCycle. Notwithstanding, even though they may operate under different names, their stations will still include the logo with
190-542: A child born in the US in 2015 is 81.2 (females) or 76.3 (males) years. According to the WHO, life expectancy in the US is 31st in the world (out of 183 countries) as of 2015 . The US's average life expectancy (both sexes) is just over 79. Japan ranks first with an average life expectancy of nearly 84 years. The US ranks lower (36th) when considering health-adjusted life expectancy (HALE) at just over 69 years. Another source,
285-456: A circled "B" (but perhaps with a different color outer circle). Variations are also affected by the primary sponsors of the local system. Users of the system can purchase annual memberships or just a day or week pass. The system is intended for short trips rather than using an automobile or bike rentals. They can then check out and return bikes at any station in their city. Depending on the local system and type of membership or pass, users can keep
380-447: A combination of private insurance and various federal and state programs. As of 2017 , health insurance was most commonly acquired through a group plan tied to an employer, covering 150 million people. Other major sources include Medicaid, covering 70 million, Medicare, 50 million, and health insurance marketplaces created by the ACA covering around 17 million. In 2017,
475-469: A letter to the insurance industry, threatened that bad actors may be excluded from new health insurance markets that were to open in 2014. Senate Republicans pointed out in a letter to Sebelius that a 1997 directive from the Centers for Medicare and Medicaid Services explicitly allowed HMOs to tell members about legislation and urge them to express opinions. American health care system Healthcare in
570-558: A major driver for healthcare reform in the US . As of 2016 , the US spent $ 3.3 trillion (equivalent to $ 4.11 trillion in 2023; 17.9% of GDP), or $ 10,438 (equivalent to $ 13,252 in 2023 ) per person; major categories included 32% on hospital care, 20% on physician and clinical services, and 10% on prescription drugs. In comparison, the United Kingdom spent $ 3,749 (equivalent to $ 4,760 in 2023 ) per person. In 2018, an analysis concluded that prices and administrative costs were largely
665-475: A nationalized healthcare system. A 1978 study argued that “Today every government in the world-including Red China with its squadrons of semi-trained “barefoot doctors”-realizes it has a responsibility to keep its citizens in good physical and mental health. Unlike the U.S., nations like Scandinavia, the U.K., Ireland, Japan and others have opted for a universal health care system in which the state pays everyone's medical bills.” Instead, most citizens are covered by
760-429: A part in US's international ranking as having the highest healthcare expenditures despite significant patient cost-sharing. Those who are insured may be underinsured such that they cannot afford adequate medical care. A 2003 study estimated that 16 million US adults were underinsured, disproportionately affecting those with lower incomes—73% of the underinsured in the study population had annual incomes below 200% of
855-402: A percentage of GDP; however, this expenditure does not necessarily translate into better overall health outcomes compared to other developed nations. Coverage varies widely across the population, with certain groups, such as the elderly and low-income individuals, receiving more comprehensive care through government programs such as Medicaid and Medicare . The U.S. healthcare system has been
950-398: A professional medical degree . In the US, the vast majority of physicians have a Doctor of Medicine (M.D.) degree. Those with Doctor of Osteopathic Medicine (D.O.) degrees get similar training and go through the same MLE steps as MD's and so are also allowed to use the title "physician". As in most other countries, the manufacture and production of pharmaceuticals and medical devices
1045-491: A relatively more cost effective rate of a societal cost of $ 327,000 to $ 867,000 (equivalent to $ 415,143 to $ 1.1 million in 2023 ) per life saved compared to other public policies which cost an average of $ 7.6 million (equivalent to $ 9.65 million in 2023 ) per life. A 2009 study in five states found that medical debt contributed to 46.2% of all personal bankruptcies , and 62.1% of bankruptcy filers claimed high medical expenses in 2007. Since then, health costs and
SECTION 10
#17330857747831140-587: A shift in healthcare. The American Medical Association (AMA) worked to standardize medical education, and the introduction of employer-sponsored insurance plans marked the beginning of the modern health insurance system. More people were starting to get involved in healthcare like state actors, other professionals/practitioners, patients and clients, the judiciary, and business interests and employers. They had interest in medical regulations of professionals to ensure that services were provided by trained and educated people to minimize harm. The post–World War II era saw
1235-532: A significant expansion in healthcare where more opportunities were offered to increase accessibility of services. The passage of the Hill–Burton Act in 1946 provided federal funding for hospital construction, and Medicare and Medicaid were established in 1965 to provide healthcare coverage to the elderly and low-income populations, respectively. The healthcare system in the United States can be traced back to
1330-501: A statistical brief by the Healthcare Cost and Utilization Project (HCUP), there were 35.7 million hospitalizations in 2016, a significant decrease from the 38.6 million in 2011. For every 1,000 in the population, there was an average of 104.2 stays and each stay averaged $ 11,700 (equivalent to $ 14,854 in 2023 ), an increase from the $ 10,400 (equivalent to $ 13,802 in 2023 ) cost per stay in 2012. Approximately 7.6% of
1425-412: A study estimated that nearly half of hospital-associated care resulted from emergency department visits. As of 2017 , data from 2009–2011 showed that end-of-life care in the last year of life accounted for about 8.5%, and the last three years of life about 16.7%. As of 2013 , administration of healthcare constituted 30% of US healthcare costs. Free-market advocates claim that the healthcare system
1520-483: A study found that 73% of plans on ACA marketplaces had narrow networks, limiting access and choice in providers. Healthcare coverage is provided through a combination of private health insurance and public health coverage (e.g., Medicare, Medicaid). In 2013, 64% of health spending was paid for by the government, and funded via programs such as Medicare , Medicaid , the Children's Health Insurance Program , Tricare , and
1615-487: A study reported obesity-related deaths have surged in the United States in recent years, particularly among men, according to new data published in The American Journal of Cardiology. The study noted that while the age-adjusted mortality rate has increased due to obesity, deaths related to cardiovascular disease, including ischemic heart disease and heart failure, have actually decreased. Healthcare providers in
1710-508: A trend of high rates of underinsurance and wage stagnation contributed to a healthcare consumption decline for low-income Americans. This trend was reversed after the implementation of the major provisions of the ACA in 2014. As of 2017 , the possibility that the ACA may be repealed or replaced has intensified interest in the questions of whether and how health insurance coverage affects health and mortality. Several studies have indicated that there
1805-573: A usual source of medical care, visiting the dentist yearly, rates of preventable hospitalizations, reported difficulty seeing a specialist, delaying care due to cost, and rates of health insurance coverage. In 2004, an OECD report noted that "all OECD countries [except Mexico, Turkey, and the US] had achieved universal or near-universal (at least 98.4% insured) coverage of their populations by 1990". The 2004 IOM report also observed that "lack of health insurance causes roughly 18,000 unnecessary deaths every year in
1900-498: A wholly owned subsidiary. They were awarded their first TRICARE contract in 1995, and began serving military beneficiaries in 1996. From 2004 to 2009, HMHS was the managed care contractor for the Department of Defense Military Health System TRICARE South Region. In 2009, HMHS' Managed Care Support Contract was awarded to United Military and Veterans Services, a subsidiary of UnitedHealth Group . HMHS protested that decision and
1995-451: Is "dysfunctional" because the system of third-party payments from insurers removes the patient as a major participant in the financial and medical choices that affect costs. The Cato Institute claims that because government intervention has expanded insurance availability through programs such as Medicare and Medicaid, this has exacerbated the problem. According to a study paid for by America's Health Insurance Plans (a Washington lobbyist for
SECTION 20
#17330857747832090-442: Is a common way for individuals to obtain coverage. The complex nature of the system, as well as its high costs, has led to ongoing discussions about the future of healthcare in the United States. At the same time, the United States is a global leader in medical innovation, measured either in terms of revenue or the number of new drugs and medical devices introduced. The Foundation for Research on Equal Opportunity concluded that
2185-533: Is an association with expansion of the ACA and factors associated with better health outcomes such as having a regular source of care and the ability to afford care. A 2016 study concluded that an approximately 60% increased ability to afford care can be attributed to Medicaid expansion provisions enacted by the Patient Protection and Affordable Care Act. Additionally, an analysis of changes in mortality post Medicaid expansion suggests that Medicaid saves lives at
2280-529: Is carried out by private companies. The research and development of medical devices and pharmaceuticals is supported by both public and private sources of funding. In 2003, research and development expenditures were approximately $ 95 billion (equivalent to $ 151 billion in 2023 ) with $ 40 billion (equivalent to $ 63.5 billion in 2023 ) coming from public sources and $ 55 billion (equivalent to $ 87.3 billion in 2023 ) coming from private sources. These investments into medical research have made
2375-433: Is designed to test whether medical students can apply their medical skills and knowledge to actual clinical practice during students' fourth year of medical school. The third step is done after the first year of residency. It tests whether students can apply medical knowledge to the unsupervised practice of medicine. The American College of Physicians , uses the term "physician" to describe all medical practitioners holding
2470-474: Is in the shorter lifespan of men, but, even after adjustment for age (assuming men live as long as women), there still is a 20% difference in lifetime healthcare expenditures. Unlike most developed nations , the US health system does not provide healthcare to the country's entire population. In 1977, the United States was said to be the only industrialized country not to have some form of national health insurance or direct healthcare provision to citizens through
2565-605: Is no nationwide system of government-owned medical facilities open to the general public but there are local government-owned medical facilities open to the general public. The US Department of Defense operates field hospitals as well as permanent hospitals via the Military Health System to provide military-funded care to active military personnel. The federal Veterans Health Administration operates VA hospitals open only to veterans, though veterans who seek medical care for conditions they did not receive while serving in
2660-455: Is the official health benefits provider of the PGA Tour and Champions Tour . The Humana Distaff Handicap is a Grade 1 race for thoroughbred fillies and mares , four-years-old and up. The race is run each spring on Kentucky Derby day at Churchill Downs and set at a distance of 7 furlongs for a purse of $ 250,000. In 1993, Humana founded Humana Military Healthcare Services (HMHS) as
2755-746: Is the presenting sponsor of the Grand Ole Opry and the National Senior Games . Since 1979, Humana has been a principal sponsor of the annual Humana Festival of New American Plays in Louisville, Kentucky. LPGA player Nancy Scranton was a spokesperson for Humana. In the past, PGA Tour player David Toms ' David Toms Foundation has partnered with the Humana Foundation to provide grants to several children's charities in New Orleans. Humana
2850-534: The COVID-19 pandemic . In 2019, the under-five child mortality rate was 6.5 deaths per 1000 live births, placing the US 33rd of 37 OECD countries. While not as high in 2015 (14) as in 2013 (18.5), maternal deaths related to childbirth have shown recent increases; in 1987, the mortality ratio was 7.2 per 100,000. As of 2015 , the US rate is double the maternal mortality rate in Belgium or Canada, and more than triple
2945-469: The Colonial Era . Community-oriented care was typical, with families and neighbors providing assistance to the sick. During the 19th century, the practice of medicine began to professionalize, following the “Anglo-American model” where these new medical professionals were empowered by the state to govern their own affairs, leading to various collaborations to acquire status and win legislation granting them
BCycle - Misplaced Pages Continue
3040-633: The Government Accountability Office upheld the protest in late 2009. In 2011, HMHS regained the five-year contract to administer medical benefits to military members and families in the South region, a contract worth $ 23.5 billion. In 2018, this was moved to the new TRICARE East region during the TRICARE regional realignment. On December 22, 2022, the Department of Defense announced the award of
3135-715: The Obama administration 's healthcare reform, a claim refuted by John Rother, AARP 's executive vice president. Douglas Elmendorf, the head of the Congressional Budget Office (CBO), supported the claim that Medicare benefits could be cut, but his comments were in reference to just one of several congressional bills. CBO estimates of another healthcare reform bill found that changes to premiums would vary. The Centers for Medicare and Medicaid Services instructed Humana to cease all such mailings to Medicare plan members pending an investigation. HHS Secretary Kathleen Sebelius, in
3230-702: The Veterans Health Administration . People aged under 65 acquire insurance via their or a family member's employer, by purchasing health insurance on their own, getting government and/or other assistance based on income or another condition, or are uninsured. Health insurance for public sector employees is primarily provided by the government in its role as employer. Managed care , where payers use various techniques intended to improve quality and limit cost, has become ubiquitous. Measures of accessibility and affordability tracked by national health surveys include: percent of population with insurance, having
3325-716: The WHO , total healthcare spending in the US was 18% of its GDP in 2011, the highest in the world. The Health and Human Services Department expects that the health share of GDP will continue its historical upward trend, reaching 19% of GDP by 2017. Of each dollar spent on healthcare in the US, 31% goes to hospital care, 21% goes to physician/clinical services, 10% to pharmaceuticals, 4% to dental, 6% to nursing homes and 3% to home healthcare, 3% for other retail products, 3% for government public health activities, 7% to administrative costs, 7% to investment, and 6% to other professional services (physical therapists, optometrists, etc.). In 2017,
3420-541: The 1980s. During this period, Humana developed the double corridor model for hospital construction. This design minimized the distance between patients and nurses by placing nursing support services in the interior of the building with patient rooms surrounding the perimeter. As the American health care system changed in the 1980s, "one of its hospitals in Arizona lost a contract with the largest health-maintenance organization in
3515-448: The 1990s. In 2015, the total number of deaths by heart disease was 633,842, by cancer it was 595,930, and from chronic lower respiratory disease it was 155,041. In 2015, 267.18 deaths per 100,000 people were caused by cardiovascular diseases, 204.63 by neoplasms and 100.66 by neurological disorders. Diarrhea, lower respiratory, and other common infections were ranked sixth overall, but had the highest rate of infectious disease mortality in
3610-462: The 20th century saw continued evolution in healthcare policy, technology, and delivery. Following the Stabilization Act of 1942 , employers, unable to provide higher salaries to attract or retain employees, began to offer insurance plans, including healthcare packages , as a benefit in kind , thereby beginning the practice of employer-sponsored health insurance, a practice that is cemented into
3705-535: The COVID-19 pandemic, but still trails behind peer and rival countries including Canada, China and Germany. Death certificate data from the CDC reveals that mortality rates among children and adolescents increased by 11% for the years 2019 and 2020 and a further 8% for 2020 and 2021, with injuries being a driving factor, along with homicide, suicide, drug overdoses and motor vehicle accidents impacting those aged 10 to 19. In 2024
3800-591: The Central Intelligence Agency, indicates life expectancy at birth in the US is 79.8, ranking it 42nd in the world. Monaco is first on this list of 224, with an average life expectancy of 89.5. A 2013 National Research Council study stated that, when considered as one of 17 high-income countries , the US was at or near the top in infant mortality, heart and lung disease, sexually transmitted infections , adolescent pregnancies , injuries, homicides, and rates of disability . Together, such issues place
3895-606: The European Union, and four times as many as the United Kingdom. A major impending demographic shift in the US will require the healthcare system to provide more care, as the older population is predicted to increase medical expenses by 5% or more in North America due to the "baby boomers" reaching retirement age. The overall spending on healthcare has increased since the late 1990s, and not just due to general price raises as
BCycle - Misplaced Pages Continue
3990-470: The Humana building, and three days later Humana changed its policy and authorized the man's treatment. Michael Moore 's 2007 documentary Sicko used the video of Linda Peeno's testimony. On June 28, 2007, Humana declared that Peeno was never a Humana "associate" (permanent, full-time employee), but rather a "part-time contractor." Humana disputed portions of her Congressional testimony by saying that because
4085-405: The U.S. Healthcare System. Government-funded healthcare facilities especially have a large reliance on these NPs due to the amount of services they are required to provide. Services, particularly urgent-care services, may also be delivered remotely via telemedicine by providers such as Teladoc . Besides government and private healthcare facilities, there are also 355 registered free clinics in
4180-615: The U.S. have died by suicide. Cumulative poverty of ten years or more is the fourth leading risk factor for mortality in the United States annually. Since 2020, the Centers for Disease Control and Prevention (CDC) reports that the life expectancy for the US population was 77.0 years, a decrease of 1.8 years from 2019. Life expectancy fell again in 2021 to 76.4 years, which has been attributed to COVID-19 and rising death rates from suicide, drug overdoses and liver disease. As of 2023, U.S. life expectancy has increased slightly following
4275-419: The US at 31.65 deaths per 100,000 people. There is evidence, however, that a large proportion of health outcomes and early mortality can be attributed to factors other than communicable or non-communicable disease. As a 2013 National Research Council study concluded, more than half the men who die before the age of 50 die due to murder (19%), traffic accidents (18%), and other accidents (16%). For women,
4370-578: The US at the bottom of the list for life expectancy in high-income countries. Females born in the US in 2015 have a life expectancy of 81.6 years, and males 76.9 years; more than three years less and as much as over five years less than people born in Switzerland (85.3 F, 81.3 M) or Japan (86.8 F, 80.5 M) in 2015. The top three causes of death among both sexes and all ages in the US have consistently remained cardiovascular diseases (ranked 1st), neoplasms (2nd) and neurological disorders (3rd), since
4465-724: The US encompass individual healthcare personnel, healthcare facilities, and medical products. In the US, ownership of the healthcare system is now mainly in private hands, though federal, state, county, and city governments also own certain facilities. As of 2018 , there were 5,534 registered hospitals in the US. There were 4,840 community hospitals, which are defined as nonfederal, short-term general, or specialty hospitals. The nonprofit hospitals share of total hospital capacity has remained relatively stable (about 70%) for decades. There are also privately owned for-profit hospitals as well as government hospitals in some locations, mainly owned by county and city governments. The Hill–Burton Act
4560-507: The US that provide limited medical services. They are considered to be part of the social safety net for those who lack health insurance. Their services may range from more acute care (i.e., STIs, injuries, respiratory diseases) to long term care (i.e. dentistry, counseling). Another component of the healthcare safety net would be federally funded community health centers . Other healthcare facilities include long-term housing facilities which, as of 2019 , there were 15,600 nursing homes across
4655-508: The US the leader in medical innovation, measured either in terms of revenue or the number of new drugs and devices introduced. In 2016, the research and development spending by pharmaceutical companies in the US was estimated to be around $ 59 billion (equivalent to $ 73.5 billion in 2023 ). In 2006, the US accounted for three quarters of the world's biotechnology revenues and 82% of world R&D spending in biotechnology. According to multiple international pharmaceutical trade groups,
4750-462: The US". A 2009 study done at Harvard Medical School with Cambridge Health Alliance by cofounders of Physicians for a National Health Program , a pro-single payer lobbying group, showed that nearly 45,000 annual deaths are associated with a lack of patient health insurance. The study also found that uninsured, working Americans have an approximately 40% higher mortality risk compared to privately insured working Americans. The Gallup organization tracks
4845-470: The US, with a large portion of that number being for-profit (69.3%) In 2022, 19 hospitals filed for bankruptcy, closed, or announced plans to close. Physicians in the US include those trained by the US medical education system, and those that are international medical graduates who have progressed through the necessary steps to acquire a medical license to practice in a state. This includes going through
SECTION 50
#17330857747834940-401: The US. Common reasons for seeking these alternative approaches included improving their well-being, engaging in a transformational experience, gaining more control over their own health, or finding a better way to relieve symptoms caused by chronic disease. They aim to treat not just physical illness but fix its underlying nutritional, social, emotional, and spiritual causes. In a 2008 survey, it
5035-442: The United States is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance , and out-of-pocket payments . The U.S. is the only developed country without a system of universal healthcare , and a significant proportion of its population lacks health insurance . The United States spends more on healthcare than any other country, both in absolute terms and as
5130-426: The United States dominates science and technology, which "was on full display during the COVID-19 pandemic , as the U.S. government [delivered] coronavirus vaccines far faster than anyone had ever done before", but lags behind in fiscal sustainability, with "[government] spending ... growing at an unsustainable rate". In the early 20th century, advances in medical technology and a focus on public health contributed to
5225-838: The acquisition after United stock dropped $ 2.9 billion in value. In 2001, Humana was a cofounder of Avality. In 2005, Humana entered into a business partnership with Virgin Group , offering financial incentives to members for healthy behavior, such as regular exercise. On November 16, 2006, the Centers for Disease Control and Prevention (CDC) and Humana Inc. partnered to expand on traditional private-sector approaches to population health management. In 2010, Humana bought Texas-based Concentra Inc., which owns urgent-care and physical therapy centers, for $ 790 million, effectively returning to healthcare services. In May 2011, Humana announced it would be using mobileStorm to transmit protected health information to patients. In March 2015, Humana announced
5320-571: The area [and] Humana created its own health insurance plan." In 1993, Humana had become the largest hospital operator in the country, owning 77 hospitals. Humana executives spun off hospital operations from health insurance operations to create Galen Health Care. The following year they sold the 73 hospitals of Galen Health Care Inc. to Nashville-based Columbia Hospital Corporation of America for $ 3.4 billion. In 1998, one year after Jones had stepped aside as CEO, United Healthcare made an unsuccessful attempt to acquire Humana. Humana pulled out of
5415-410: The bicycles for 30–60 minutes without any additional charge for an unlimited number of times. Bicycles can be used longer for a nominal hourly assessment. However, if a bicycle is returned to any station, it can usually be immediately checked back out for an additional 30-60 free minutes. Another variation is dates and hours of operations. Some systems do not operate at night and some do not operate during
5510-1055: The cause of the high costs, including prices for labor, pharmaceuticals, and diagnostics. The combination of high prices and high volume can cause particular expense; in the US, high-margin high-volume procedures include angioplasties , C-sections , knee replacements , and CT and MRI scans; CT and MRI scans also showed higher utilization in the US. Aggregate US hospital costs were $ 387.3 billion in 2011—a 63% increase since 1997 (inflation adjusted). Costs per stay increased 47% since 1997, averaging $ 10,000 in 2011 (equivalent to $ 13,544 in 2023 ). As of 2008 , public spending accounts for between 45% and 56% of US healthcare spending. Surgical, injury, and maternal and neonatal health hospital visit costs increased by more than 2% each year from 2003–2011. Further, while average hospital discharges remained stable, hospital costs rose from $ 9,100 in 2003 (equivalent to $ 15,072 in 2023 ) to $ 10,600 in 2011 (equivalent to $ 14,357 in 2023 ) and were projected to be $ 11,000 by 2013 (equivalent to $ 14,388 in 2023 ). According to
5605-555: The city announced the end of the B-cycle operation, with 700 bikes and all stations to be removed by the end of January 2020. As of January 2024, B-cycle has bicycle sharing systems in the following areas: Humana Humana Inc. is a for-profit American health insurance company based in Louisville , Kentucky . In 2023, the company ranked 42 on the Fortune 500 list, which made it
5700-635: The country's first smart bike sharing system. Following the Democratic National Convention, Trek, Humana and advertising agency Crispin Porter + Bogusky formed B-Cycle, LLC to develop a technologically and visually appealing bike share system. The joint venture worked with a non-profit created to operate the system, Denver Bike Sharing, operating as Denver B-cycle, to launch with 500 bikes and 40 stations in Denver on Earth Day , April 22, 2010. In 2018,
5795-409: The creation of a digital health and analytics division called Humana Studio H. In December 2019, the company announced it would acquire Enclara Healthcare from Consonance Capital Partners and Enclara management. In 2021, Susan Diamond, formerly occupying an interim position, was announced to be the new permanent CFO. Her appointment to the position comes with the company's focus being turned towards
SECTION 60
#17330857747835890-416: The drama had no connection whatsoever with Humana. On May 30, 1996, Linda Peeno , a physician who was contracted to work for Humana for nine months, testified before Congress as to the downside of managed care . Peeno said she was effectively rewarded by her employer for causing the death of a patient, because it saved the company a half-million dollars. Peeno stated that she felt the "managed care" model
5985-672: The eighth year of Denver B-cycle, it received a US$ 400,000 subsidy from the City of Denver government. In 2018, controversy emerged on the Denver City Council , with criticism that "B-cycle is mainly in areas where it's white and wealthy and not in neighborhoods of color and working-class neighborhoods where transit is a need." Substantial competition to dockable bicycle transportation has emerged from unsubsidized "[d]ockless bike and scooter companies have flocked to Denver," including Jump bicycles and Lime scooters . In mid-November 2019,
6080-429: The federal poverty level. Lack of insurance or higher cost sharing (user fees for the patient with insurance) create barriers to accessing healthcare: use of care declines with increasing patient cost-sharing obligation. Before the ACA passed in 2014, 39% of below-average income Americans reported forgoing seeing a doctor for a medical issue (whereas 7% of low-income Canadians and 1% of low-income British citizens reported
6175-664: The health insurance industry) and carried out by PriceWaterhouseCoopers, increased utilization is the primary driver of rising healthcare costs in the US The study cites numerous causes of increased utilization, including rising consumer demand, new treatments, more intensive diagnostic testing, lifestyle factors, the movement to broader-access plans, and higher-priced technologies. The study also mentions cost-shifting from government programs to private payers. Low reimbursement rates for Medicare and Medicaid have increased cost-shifting pressures on hospitals and doctors, who charge higher rates for
6270-411: The high cost of patented drugs in the US has encouraged substantial reinvestment in such research and development. Though, the ACA will force industry to sell medicine at a cheaper price. Due to this, it is possible budget cuts will be made on research and development of human health and medicine in the US. In 2022, the United States had 10,265 drugs in the works, more than twice as many as China and
6365-469: The highest ranked (by revenues) company based in Kentucky . It is the fourth largest health insurance provider in the U.S. Lawyers David A. Jones Sr. and Wendell Cherry founded a nursing home company in 1961. The company, known in 1968 as Extendicare Inc., became the largest nursing home company in the United States. In 1972, Jones and Cherry sold the nursing home chain to purchase hospitals . In 1974,
6460-543: The home healthcare business, acquiring in April of the same year a 60% stake in Kindred at Home, an in-home care and hospice business. In April 2022, it was announced Humana would sell a 60% interest of its Kindred at Home division to the private investment company, Clayton, Dubilier & Rice , for US$ 2.8 billion. In February 2023, Humana announced they were exiting the employer-based commercial group insurance market. Humana
6555-475: The hospital was to be sold to a for-profit medical corporation and renamed "Ecumena", with subsequent changes to the hospital, both positive and negative, emanating from that change. The company claimed that the program infringed on the Humana trademark. Humana failed to block the airing of the show, but was successful at forcing NBC into showing a disclaimer at the beginning of the September 30 episode saying that
6650-516: The managed care support contract for the TRICARE East Region to Humana Military. Humana filed a lawsuit in August 2019, alleging that 37 defendants engaged in a “far-reaching conspiracy” to “blatantly fix the price” of generic drugs. This follows a similar smaller lawsuit from October 2018. In 1987, Humana sued NBC over a story line in the television medical drama St. Elsewhere in which
6745-717: The military are charged for services. The Indian Health Service (IHS) operates facilities open only to Native Americans from recognized tribes. These facilities, plus tribal facilities and privately contracted services funded by IHS to increase system capacity and capabilities, provide medical care to tribespeople beyond what can be paid for by any private insurance or other government programs. Hospitals provide some outpatient care in their emergency rooms and specialty clinics, but primarily exist to provide inpatient care. Hospital emergency departments and urgent care centers are sources of sporadic problem-focused care. Surgicenters are examples of specialty clinics. Hospice services for
6840-517: The nation's largest ever temporary bike sharing program at the 2008 Democratic National Convention in Denver , Colorado . Called Freewheelin, this program made 1,000 bikes available to the delegates at both the Democratic and Republican National Conventions . The programs proved so successful that the Democratic host committee selected bike sharing as a special legacy program to receive a donation to launch
6935-593: The new combined company, however the merger was blocked by a federal judge in January 2017. In February 2017, Aetna Inc. and Humana Inc. quashed a $ 34 billion merger agreement after judges ruled against the merger for a second time. In July 2018, Humana joined two private equity firms in the acquisition of Kindred Healthcare . The deal provided Humana with a 40% stake in the company's home health, hospice and community care businesses, called "Kindred at Home," for approximately $ 800 million. In August 2018, Humana announced
7030-421: The numbers of uninsured and underinsured have increased. A 2013 study found that about 25% of all senior citizens declare bankruptcy due to medical expenses. In practice, the uninsured are often treated, but the cost is covered through taxes and other fees which shift the cost. Forgone medical care due to extensive cost sharing may ultimately increase costs due to downstream medical issues; this dynamic may play
7125-432: The partners changed the corporate name to Humana Inc. The name was meant to change public perception from 'warehousing' or indifferently treating people to providing a higher level of human care and, by extension, more humane care. It grew in the following years, both by business and in 1978 through the takeover of American Medicorp Inc., which doubled the company's size, and grew into the world's largest hospital company in
7220-529: The patient's healthcare plan did not cover heart transplants, denial of coverage was valid. On September 21, 2009, the U.S. Dept. of Health and Human Services opened an investigation into Humana for sending flyers to Medicare recipients that the AARP characterized as deceptive. The mail was made to appear to contain official information about Medicare Advantage and prescription drug benefit information, but instead alleged that core Medicare benefits could be cut by
7315-565: The percent of adult Americans who are uninsured for healthcare, beginning in 2008. The rate of uninsured peaked at 18.0% in 2013 prior to the ACA mandate, fell to 10.9% in the third quarter of 2016, and stood at 13.7% in the fourth quarter of 2018. "The 2.8-percentage-point increase since that low represents a net increase of about seven million adults without health insurance." The US Census Bureau reported that 28.5 million people (8.8%) did not have health insurance in 2017, down from 49.9 million (16.3%) in 2010. Between 2004 and 2013,
7410-465: The percentages are different: 53% of women who die before the age of 50 die due to disease, whereas 38% die due to accidents, homicide, and suicide. Diseases of despair (drug overdoses, alcoholic liver disease, and suicide), which started increasing in the early 1990s, kill roughly 158,000 Americans a year as of 2018 . Suicides reached record levels in the United States in 2022, with nearly 49,500 suicide deaths. Since 2011, around 540,000 people in
7505-496: The population had overnight stays in 2017, each stay lasting an average of 4.6 days. A study by the National Institutes of Health reported that the lifetime per capita expenditure at birth, using the year 2000 dollars, showed a large difference between the healthcare costs of females ($ 361,192, equivalent to $ 639,048 in 2023 ) and males ($ 268,679, equivalent to $ 475,367 in 2023 ). A large portion of this cost difference
7600-437: The power to self-regulate. The establishment of medical schools and professional organizations led to standardized training and certification processes for doctors. Despite this progress, healthcare services remained disparate, particularly between urban and rural areas. The concept of hospitals as institutions for the sick began to take root, leading to the foundation of many public and private hospitals. The latter part of
7695-625: The rate in the Finland as well as several other Western European countries. In 2019, Black maternal health advocate and Parents writer Christine Michel Carter interviewed Vice President Kamala Harris . As a senator, in 2019 Harris reintroduced the Maternal Care Access and Reducing Emergencies (CARE) Act which aimed to address the maternal mortality disparity faced by women of color by training providers on recognizing implicit racial bias and its impact on care. Harris stated: We need to speak
7790-752: The rate of spending is growing faster than the rate of inflation. Moreover, the expenditure on health services for people over 45 years old is 8.3 times the maximum of that of those under 45 years old. Other methods of medical treatment are being practiced more frequently than before. This field is labeled Complementary and Alternative Medicine (CAM) and are defined as therapies generally not taught in medical school nor available in hospitals. They include herbs , massages, energy healing, homeopathy , faith healing , and, more recently popularized, cryotherapy , cupping , and Transcranial Magnetic Stimulation or TMS. Providers of these CAM treatments are sometimes legally considered healthcare providers in
7885-490: The risk in an attempt to provide value-based healthcare , have grown in popularity. Regional areas have separate healthcare markets, and in some markets competition is limited as the demand from the local population cannot support multiple hospitals. About two-thirds of doctors practice in small offices with less than seven physicians, with over 80% owned by physicians; these sometimes join groups such as independent practice associations to increase bargaining power. There
7980-431: The sale of Concentra to private equity firm Welsh, Carson, Anderson & Stowe and Select Medical Holdings Corporation for about $ 1 billion, with proceeds to fund a "$ 2 billion share buyback program and other corporate spending." In July 2015, Aetna announced that it would acquire Humana for $ 37 billion in cash and stock (approximately $ 230 a share at that time). Aetna and Humana shareholders would own 74% and 26% of
8075-404: The same). The US life expectancy in 2010 was 78.6 years at birth, up from 75.2 years in 1990; this ranks 42nd among 224 nations, and 22nd out of the 35 OECD countries, down from 20th in 1990. In 2021, US life expectancy fell to 76.4 years, the shortest in roughly two decades. Drivers for this drop in life expectancy include accidents, drug overdoses , heart and liver disease, suicides and
8170-570: The subject of significant political debate and reform efforts, particularly in the areas of healthcare costs, insurance coverage, and the quality of care. Legislation such as the Affordable Care Act of 2010 has sought to address some of these issues, though challenges remain. Uninsured rates have fluctuated over time, and disparities in access to care exist based on factors such as income, race , and geographical location. The private insurance model predominates, and employer-sponsored insurance
8265-412: The terminally ill who are expected to live six months or less are most commonly subsidized by charities and government. Prenatal, family planning , and dysplasia clinics are government-funded obstetric and gynecologic specialty clinics respectively, and are usually staffed by nurse practitioners. Because of the robust skills credited to nurse practitioners (NPs) they are able to address disparities in
8360-546: The three steps of the US Medical Licensing Examination (USMLE). The first step of the USMLE tests whether medical students both understand and are capable of applying the basic scientific foundations to medicine after the second year of medical school. The topics include: anatomy, biochemistry, microbiology , pathology, pharmacology, physiology, behavioral sciences , nutrition, genetics , and aging. The second step
8455-580: The uncomfortable truth that women—and especially Black women—are too often not listened to or taken seriously by the health care system, and therefore they are denied the dignity that they deserve. And we need to speak this truth because today, the United States is 1 of only 13 countries in the world where the rate of maternal mortality is worse than it was 25 years ago. That risk is even higher for Black women, who are three to four times more likely than white women to die from pregnancy-related causes. These numbers are simply outrageous. Life expectancy at birth for
8550-437: The winter months. Notwithstanding the variations, annual memberships are recognized in most BCycle cities in a reciprocity program called " B-connected ." The cost of annual memberships vary from US$ 50 to US$ 80. The bicycles used by BCycle were designed specifically for bike sharing by Trek Bicycle. In 2007, the founding partners of BCycle, Trek and health care insurance company Humana , launched their bike sharing venture with
8645-410: The work culture of today. The Health Maintenance Organization Act of 1973 encouraged the development of managed care, while advances in medical technology revolutionized treatment. In the 21st century, the Affordable Care Act (ACA) was passed in 2010, extending healthcare coverage to millions of uninsured Americans and implementing reforms aimed at improving quality and reducing costs. According to
8740-416: Was found that 37% of hospitals in the US offer at least one form of CAM treatment, the main reason being patient demand (84% of hospitals). Costs for CAM treatments average $ 33.9 (equivalent to $ 49.81 in 2023 ) with two-thirds being out-of-pocket, according to a 2007 statistical analysis. Moreover, CAM treatments covered 11.2% of total out-of-pocket payments on healthcare. During 2002 to 2008, spending on CAM
8835-413: Was inherently unethical. In 1999, season one of Michael Moore's TV series The Awful Truth reported on Humana refusing to pay for a diabetic patient with pancreatic failure needing a transplant. The man's policy stated it covered all of his diabetes -related expenses, but another section of the policy stated that it did not cover organ transplants. Moore conducted a fake funeral on the front steps of
8930-458: Was on the rise, but usage has since plateaued to about 40% of adults in the US The US spends more as a percentage of GDP than similar countries, and this can be explained either through higher prices for services themselves, higher costs to administer the system, or more utilization of these services, or to a combination of these elements. Healthcare costs rising far faster than inflation have been
9025-399: Was passed in 1946, which provided federal funding for hospitals in exchange for treating poor patients. The largest hospital system in 2016 by revenue was HCA Healthcare ; in 2019, Dignity Health and Catholic Health Initiatives merged into CommonSpirit Health to create the largest by revenue, spanning 21 states. Integrated delivery systems , where the provider and the insurer share
#782217