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I do not think that conservatives are convinced that affordable health care for all is not feasible. I think they want to maintain a big business for profit at the expense of the American people’s health . There is a vast network of very rich corporations , pharmaceuticals , hospitals and doctors who profit enormously from the present system of healthcare in the US. I will use a summary of the study done at Yale University and Published in the Lancet medical journal to emphasize my point.SummaryAlthough health care expenditure per capita is higher in the USA than in any other country, more than 37 million Americans do not have health insurance, and 41 million more have inadequate access to care. Efforts are ongoing to repeal the Affordable Care Act which would exacerbate health-care inequities. By contrast, a universal system, such as that proposed in the Medicare for All Act, has the potential to transform the availability and efficiency of American health-care services. Taking into account both the costs of coverage expansion and the savings that would be achieved through the Medicare for All Act, we calculate that a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than US$450 billion annually (based on the value of the US$ in 2017). The entire system could be funded with less financial outlay than is incurred by employers and households paying for health-care premiums combined with existing government allocations. This shift to single-payer health care would provide the greatest relief to lower-income households. Furthermore, we estimate that ensuring health-care access for all Americans would save more than 68 000 lives and 1·73 million life-years every year compared with the status quo.• View related content for this articleThis article is available free of charge.Simply log in to access the full article, or register for free if you do not yet have a username and password.1.Collins SR Gunja MZ Doty MMHow well does health coverage protect consumers from costs? Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016.http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2017/oct/collins_underinsured_biennial_ib.pdfDate: Oct 11, 2017Date accessed: March 27, 2019View in ArticleGoogle Scholar2.United States Census BureauAnnual estimates of the resident population for selected age groups by sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2017 2017 population estimates.https://factfinder.census.gov/bkmk/table/1.0/en/PEP/2017/PEPAGESEXWe're sorry but this website doesn't work properly without JavaScript enabled. Please enable it to continue.https://factfinder.census.gov/bkmk/table/1.0/en/PEP/2017/PEPAGESEXDate: Feb 18, 2018Date accessed: July 3, 2018View in ArticleGoogle Scholar3.Auter ZU.S. uninsured rate steady at 12·2% in fourth quarter of 2017.U.S. Uninsured Rate Steady at 12.2% in Fourth Quarter of 2017The uninsured rate among U.S. adults held steady at 12.2% in the fourth quarter of 2017, but is up 1.3 points since the end of 2016.https://news.gallup.com/poll/225383/uninsured-rate-steady-fourth-quarter-2017.aspxDate: Jan 16, 2018Date accessed: July 3, 2018View in ArticleGoogle Scholar4.Fiedler M Adler LHow will the Graham-Cassidy proposal affect the number of people with health insurance coverage?.How will the Graham-Cassidy proposal affect the number of people with health insurance coverage?Matthew Fiedler and Loren Adler estimate that the Graham-Cassidy legislation would reduce the number of people with insurance coverage by around 22 million each year during the 2020 through 2026 period.https://www.brookings.edu/research/how-will-the-graham-cassidy-proposal-affect-the-number-of-people-with-health-insurance-coverage/Date: Sept 22, 2017Date accessed: March 27, 2019View in ArticleGoogle Scholar5.Organisation for Economic Co-operation DevelopmentOECD Health Statistics 2015.OECD Health StatisticsThis dataset includes comparative tables analysing various health care resources such as total health and social employment, physicians by age, gender, categories, midwives, nurses, caring personnel, personal care workers, dentists, pharmacists, physiotherapists, hospital employment, graduates, remuneration of health professionals, hospitals, health equipment, hospital beds, medical technology with their respective subsets. The statistics are expressed in different units of measure such as number of persons, salaried, self-employed, per population.https://www.oecd-ilibrary.org/social-issues-migration-health/data/oecd-health-statistics_health-data-enDate: 2015Date accessed: March 27, 2019View in ArticleGoogle Scholar6.Centers for Medicare and Medicaid ServicesNHE Fact Sheet.NHE Fact Sheet | CMSHistorical NHE, 2019: NHE grew 4.6% to $3.8 trillion in 2019, or $11,582 per person, and accounted for 17.7% of Gross Domestic Product (GDP). Medicare spending grew 6.7% to $799.4 billion in 2019, or 21 percent of total NHE. Medicaid spending grew 2.9% to $613.5 billion in 2019, or 16 percent of total NHE. Private health insurance spending grew 3.7% to $1,195.1 billion in 2019, or 31 percent of total NHE. Out of pocket spending grew 4.6% to $406.5 billion in 2019, or 11 percent of total NHE. Hospital expenditures grew 6.2% to $1,192.0 billion in 2019, faster than the 4.2% growth in 2018. Physician and clinical services expenditures grew 4.6% to $772.1 billion in 2019, a faster growth than the 4.0% in 2018. Prescription drug spending increased 5.7% to $369.7 billion in 2019, faster than the 3.8% growth in 2018. The largest shares of total health spending were sponsored by the federal government (29.0 percent) and the households (28.4 percent).   The private business share of health spending accounted for 19.1 percent of total health care spending, state and local governments accounted for 16.1 percent, and other private revenues accounted for 7.5 percent. For further detail see NHE Tables in downloads below. Projected NHE, 2019-2028: National health spending is projected to grow at an average annual rate of 5.4 percent for 2019-28 and to reach $6.2 trillion by 2028. Because national health expenditures are projected to grow 1.1 percentage points faster than gross domestic product per year on average over 2019–28, the health share of the economy is projected to rise from 17.7 percent in 2018 to 19.7 percent in 2028. Price growth for medical goods and services (as measured by the personal health care deflator) is projected to accelerate, averaging 2.4 percent per year for 2019–28, partly reflecting faster expected growth in health sector wages. Among major payers, Medicare is expected to experience the fastest spending growth (7.6 percent per year over 2019-28), largely as a result of having the highest projected enrollment growth. The insured share of the population is expected to fall from 90.6 percent in 2018 to 89.4 percent by 2028. For further detail see NHE projections 2019-2028 in downloads below. NHE by Age Group and Gender, Selected Years 2002, 2004, 2006, 2008, 2010, 2012, and 2014: Per person personal health care spending for the 65 and older population was $19,098 in 2014, over 5 times higher than spending per child ($3,749) and almost 3 times the spending per working-age person ($7,153). In 2014, children accounted for approximately 24 percent of the population and about 11 percent of all PHC spending. The working-age group comprised the majority of spending and population in 2014, almost 54 percent and over 61 percent respectively. The elderly were the smallest population group, nearly 15 percent of the population, and accounted for approximately 34 percent of all spending in 2014. 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While this is a small change in national spending, the federal government's health spending would increase substantially, rising by an estimated 221 percent.https://www.rand.org/pubs/research_reports/RR3106.htmlDate: Aug 1, 2018Date accessed: December 1, 2019View in ArticleGoogle Scholar23.Pollin R Heintz J Arno P Wicks-Lim J Ash MEconomic analysis of medicare for all.PERI - Economic Analysis of Medicare for AllThis study by PERI researchers Robert Pollin, James Heintz, Peter Arno, Jeannette Wicks-Lim and Michael Ash presents a comprehensive analysis of the p...https://www.peri.umass.edu/publication/item/1127-economic-analysis-of-medicare-for-allDate: Nov 30, 2018Date accessed: December 5, 2019View in ArticleGoogle Scholar24.Berwick DM Johnson SMedicare for all cost letter. 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The report estimates the amount of uncompensated…https://www.kff.org/uninsured/report/uncompensated-care-for-the-uninsured-in-2013-a-detailed-examination/Date: May 30, 2014Date accessed: March 27, 2019View in ArticleGoogle Scholar40.Centers for Medicare and Medicaid ServicesHistorical National Expenditure Accounts.Historical | CMSThe National Health Expenditure Accounts (NHEA) are the official estimates of total health care spending in the United States. Dating back to 1960, the NHEA measures annual U.S. expenditures for health care goods and services, public health activities, government administration, the net cost of health insurance, and investment related to health care. The data are presented by type of service, sources of funding, and type of sponsor. U.S. health care spending grew 4.6 percent in 2019, reaching $3.8 trillion or $11,582 per person.  As a share of the nation's Gross Domestic Product, health spending accounted for 17.7 percent. 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Between 2016 and 2017, the number of people with health insurance coverage increased by 2.3 million, up to 294.6 million. • In 2017, private health insurance coverage continued to be more prevalent than government coverage, at 67.2 percent and 37.7 percent, respectively. Of the subtypes of health insurance coverage, employer-based insurance was the most common, covering 56.0 percent of the population for some or all of the calendar year, followed by Medicaid (19.3 percent), Medicare (17.2 percent), direct-purchase coverage (16.0 percent), and military coverage (4.8 percent). • Between 2016 and 2017, the rate of Medicare coverage increased by 0.6 percentage points to cover 17.2 percent of people for part or all of 2017 (up from 16.7 percent in 2016). • The military coverage rate increased by 0.2 percentage points to 4.8 percent during this time. 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Hispanics had the highest uninsured rate (16.1 percent). • Between 2016 and 2017, the percentage of people without health insurance coverage at the time of interview decreased in three states and increased in 14 states.https://www.census.gov/library/publications/2018/demo/p60-264.htmlDate: Sept 12, 2018Date accessed: January 14, 2020View in ArticleGoogle Scholar56.Duron VP Monaghan SF Connolly MD et al.Undiagnosed medical comorbidities in the uninsured: a significant predictor of mortality following trauma.J Trauma Acute Care Surg. 2012; 73: 1093-1098View in ArticleScopus (31)PubMedCrossrefGoogle Scholar57.Lopez-Gonzalez L Pickens GT Washington R Weiss AJCharacteristics of medicaid and uninsured hospitalizations, 2012.Characteristics of Medicaid and Uninsured Hospitalizations, 2012 #182Location of patients' residence Place of residence is based on the urban-rural classification scheme for U.S. counties developed by the National Center for Health Statistics (NCHS). For this Statistical Brief, we collapsed the NCHS categories into either urban or rural according to the following: Urban: Large Central Metropolitan: includes metropolitan areas with 1 million or more residents Large Fringe Metropolitan: includes counties of metropolitan areas with 1 million or more residents Medium and Small Metropolitan: includes areas with 50,000 to 999,999 residents. Rural: Micropolitan and Noncore: includes nonmetropolitan counties (i.e., counties with no town greater than 50,000 residents). Median community-level income Median community-level income is the median household income of the patient's ZIP Code of residence. The cut-offs for the quartile designation are determined using ZIP Code demographic data obtained from the Nielsen Company. The income quartile is missing for patients who are homeless or foreign. Payer Payer is the expected primary payer for the hospital stay. To make coding uniform across all HCUP data sources, payer combines detailed categories into general groups: Medicare: includes patients covered by fee-for-service and managed care Medicare Medicaid: includes patients covered by fee-for-service and managed care Medicaid Private Insurance: includes Blue Cross, commercial carriers, and private health maintenance organizations (HMOs) and preferred provider organizations (PPOs) Uninsured: includes an insurance status of self-pay and no charge Other: includes Worker's Compensation, TRICARE/CHAMPUS, CHAMPVA, Title V, and other government programs Hospital stays billed to the State Children's Health Insurance Program (SCHIP) may be classified as Medicaid, Private Insurance, or Other, depending on the structure of the State program. Because most State data do not identify patients in SCHIP specifically, it is not possible to present this information separately. 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It considers how countries have used available health care resources to reduce the overall burden of CVD and diabetes, and it focuses on the variation in OECD health systems’ ability to convert health care inputs (such as expenditure) into health gains.https://read.oecd-ilibrary.org/social-issues-migration-health/cardiovascular-disease-and-diabetes-policies-for-better-health-and-quality-of-care_9789264233010-enDate: June 17, 2015Date accessed: July 2, 2019View in ArticleGoogle Scholar75.Thomas K Ornstein CAmid opioid crisis, insurers restrict pricey, less addictive painkillers.Amid Opioid Crisis, Insurers Restrict Pricey, Less Addictive Painkillers (Published 2017)Drug companies and doctors have been accused of fueling the opioid crisis, but some question whether insurers have played a role, too.https://www.nytimes.com/2017/09/17/health/opioid-painkillers-insurance-companies.htmlDate: Sept 17, 2017Date accessed: December 1, 2019View in ArticleGoogle Scholar76.Amos OWhy opioids are such an American problem.BBC, Oct 25, 2017Why opioids are such an American problemPeople in America take more opioids - such as morphine and codeine - than in any other country. 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Most of the original guidance remains the same, but limited changes have been made as a result of: (1) the Supreme Court's decision in US Airways, Inc. v. Barnett, 535 U.S., 122 S. Ct. 1516 (2002), and (2) the Commission's issuance of new regulations under section 501 of the Rehabilitation Act. The major changes in response to the Barnett decision are found on pages 4-5, 44-45, and 61-62. In addition, minor changes were made to certain footnotes and the Instructions for Investigators as a result of the Barnett decision and the new section 501 regulations. EFFECTIVE DATE: Upon receipt. EXPIRATION DATE: As an exception to EEOC Order 205.001, Appendix B, Attachment 4, . a(5), this Notice will remain in effect until rescinded or superseded. ORIGINATOR: ADA Division, Office of Legal Counsel. INSTRUCTIONS: File after Section 902 of Volume II of the Compliance Manual. Enforcement Guidance: Reasonable Accommodation and Undue Hardship Under the Americans with Disabilities Act Table of Contents INTRODUCTION GENERAL PRINCIPLES REQUESTING REASONABLE ACCOMMODATION REASONABLE ACCOMMODATION AND JOB APPLICANTS REASONABLE ACCOMMODATION RELATED TO THE BENEFITS AND PRIVILEGES OF EMPLOYMENT TYPES OF REASONABLE ACCOMMODATIONS RELATED TO JOB PERFORMANCE JOB RESTRUCTURING LEAVE MODIFIED OR PART-TIME SCHEDULE MODIFIED WORKPLACE POLICIES REASSIGNMENT OTHER REASONABLE ACCOMMODATION ISSUES UNDUE HARDSHIP ISSUES BURDENS OF PROOF INSTRUCTIONS FOR INVESTIGATORS APPENDIX: RESOURCES FOR LOCATING REASONABLE ACCOMMODATIONS INDEX This Enforcement Guidance clarifies the rights and responsibilities of employers and individuals with disabilities regarding reasonable accommodation and undue hardship. Title I of the ADA requires an employer to provide reasonable accommodation to qualified individuals with disabilities who are employees or applicants for employment, except when such accommodation would cause an undue hardship. This Guidance sets forth an employer's legal obligations regarding reasonable accommodation; however, employers may provide more than the law requires. This Guidance examines what "reasonable accommodation" means and who is entitled to receive it. The Guidance addresses what constitutes a request for reasonable accommodation, the form and substance of the request, and an employer's ability to ask questions and seek documentation after a request has been made. The Guidance discusses reasonable accommodations applicable to the hiring process and to the benefits and privileges of employment. The Guidance also covers different types of reasonable accommodations related to job performance, including job restructuring, leave, modified or part-time schedules, modified workplace policies, and reassighttps://www.eeoc.gov/policy/docs/accommodation.html#leaveDate: 2002Date accessed: January 6, 2020View in ArticleGoogle Scholar82.Blinder V Eberle C Patil S Gany FM Bradley CJWomen with breast cancer who work for accommodating employers more likely to retain jobs after treatment.Health Aff. 2017; 36: 274-281View in ArticleScopus (41)CrossrefGoogle Scholar83.Aizer AA Falit B Mendu ML et al.Cancer-specific outcomes among young adults without health insurance.J Clin Oncol. 2014; 32: 2025-2030View in ArticleScopus (83)PubMedCrossrefGoogle Scholar84.Substance Abuse and Mental Health Services AdministrationBehavioral health trends in the United States: results from the 2014 national survey on drug use and health.https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdfDate: Sept 10, 2015Date accessed: March 27, 2019View in ArticleGoogle Scholar85.National Institute of Mental HealthMental Illness.NIMH " Mental IllnessMental Illness Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (51.5 million in 2019). Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe. Two broad categories can be used to describe these conditions: Any Mental Illness (AMI) and Serious Mental Illness (SMI). AMI encompasses all recognized mental illnesses. SMI is a smaller and more severe subset of AMI. Additional information on mental illnesses can be found on the NIMH Health Topics Pages . Definitions The data presented here are from the 2019 National Survey on Drug Use and Health (NSDUH) by the Substance Abuse and Mental Health Services Administration (SAMHSA). For inclusion in NSDUH prevalence estimates, mental illnesses include those that are diagnosable currently or within the past year; of sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); and, exclude developmental and substance use disorders. Any Mental Illness Any mental illness (AMI) is defined as a mental, behavioral, or emotional disorder. AMI can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment (e.g., individuals with serious mental illness as defined below). Serious Mental Illness Serious mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI. Prevalence of Any Mental Illness (AMI) Figure 1 shows the past year prevalence of AMI among U.S. adults. In 2019, there were an estimated 51.5 million adults aged 18 or older in the United States with AMI. This number represented 20.6% of all U.S. adults. The prevalence of AMI was higher among females (24.5%) than males (16.3%). Young adults aged 18-25 years had the highest prevalence of AMI (29.4%) compared to adults aged 26-49 years (25.0%) and aged 50 and older (14.1%). The prevalence of AMI was highest among the adults reporting two or more races (31.7%), followed by White adults (22.2%). The prevalence of AMI was lowest among Asian adults (14.4%). Figure 1 Past Year Prevalence of Any Mental Illness Among U.S. Adults (2019) Demographic Percent Overall 20.6 Sex Female 24.5 Male 16.3 Age 18-25 29.4 26-49 25.0 50+ 14.0 Race/Ethnicity Hispanic or Latino* 18.0 White 22.2 Black or African American 17.3 Asian 14.4 NH/OPI 16.6 AI/AN 18.7 2 or More 31.7 *Persons of Hispanic origin may be of any race; all other racial/ethnic groups are non-Hispanic. NH/OPI = Native Hawaiian / Other Pacific Islander | AI/AN = American Indian / Alaskan Native Mental Health Services — AMI Figure 2 presents data on mental health services received within the past year by U.S. adults aged 18 or olhttps://www.nimh.nih.gov/health/statistics/mental-illness.shtmlDate: Nov, 2017Date accessed: June 8, 2018View in ArticleGoogle Scholar86.Firth J Kirzinger A Brodie MKaiser Health Tracking Poll: April 2016.Kaiser Health Tracking Poll: April 2016 - Substance Abuse and Mental HealthThe April Kaiser Health Tracking Poll examines public opinion on the severity of health problems in the U.S. and takes a closer look at attitudes towards current health problems; including access t…https://www.kff.org/report-section/kaiser-health-tracking-poll-april-2016-substance-abuse-and-mental-health/Date: April 28, 2016Date accessed: March 27, 2019View in ArticleGoogle Scholar87.National Alliance on Mental Illness (NAMI)A Long Road Ahead: Achieving True Parity in Mental Health and Substance Use Care.NAMI, 2015https://www.nami.org/about-nami/publications-reports/public-policy-reports/a-long-road-ahead/2015-alongroadahead.pdfDate accessed: January 6, 2020View in ArticleGoogle ScholarUncited References64.Sommers BD Long SK Baicker KChanges in mortality after Massachusetts health care reform: a quasi-experimental study.Ann Intern Med. 2014; 160: 585-593Scopus (128)PubMedCrossrefGoogle Scholar65.Sommers BDState medicaid expansions and mortality, revisited: a cost-benefit analysis.Am J Health Econ. 2017; 3: 392-421Scopus (30)CrossrefGoogle Scholar66.Kronick RHealth insurance coverage and mortality revisited.Health Serv Res. 2009; 44: 1211-1231Scopus (38)PubMedCrossrefGoogle Scholar67.Franks PHealth insurance and mortality. 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