Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care and health system expenses, among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity. According to the Health Insurance Association of America, health insurance is defined as "coverage that provides for the payments of benefits as a result of sickness or injury. Includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment" (pg. 225).
Robert Greenstein is founder and executive director of the Center on Budget and Policy Priorities (CBPP), a Washington, DC think tank that focuses on federal and state fiscal policy and public programs that affect low- and moderate-income families and individuals. According to his CBPP bio, Greenstein is "an expert on the federal budget and in particular, the impact of tax and budget proposals on low-income people".
Greenstein was awarded a MacArthur Fellowship in 1996, and the 14th Annual Heinz Award in Public Policy in 2008. In 1994, he was appointed by President Bill Clinton to serve on the Bipartisan Commission on Entitlement and Tax Reform. Prior to founding the Center, Greenstein was Administrator of the Food and Nutrition Service at the United States Department of Agriculture under President Jimmy Carter. In November of 2011, Greenstein was included on The New Republic's list of Washington's most powerful, least famous people.
Health care reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes enacted in 2010: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010 (H.R. 4872), which amended the PPACA and became law on March 30, 2010.
The number of persons without health insurance coverage in the United States is one of the primary concerns raised by advocates of health care reform. A person without health insurance is commonly termed uninsured (regardless of insurance of objects unrelated to health), and this article uses the term in this sense as well. According to the United States Census Bureau, in 2009 there were 48.6 million people in the US (15.7% of the population) who were without health insurance. The percentage of the non-elderly population who are uninsured has been generally increasing since the year 2000.
The causes of this rate of uninsurance remain a matter of political debate. Rising insurance costs have contributed to a trend in which fewer employers are offering health insurance, and many employers are managing costs by requiring higher employee contributions. Many of the uninsured are the working poor or are unemployed. Others are healthy and choose to go without it. Some have been rejected by insurance companies and are considered "uninsurable". Some are without health insurance only temporarily. Some choose faith-based alternatives to health insurance.
The Center on Budget and Policy Priorities (CBPP) is an American non-profit think tank that analyzes the impacts of budget policies and promotes effective approaches to reducing poverty. It was founded in 1981, and is based in Washington, D.C. The Center describes itself as a "policy organization...working at the federal and state levels on fiscal policy and public programs that affect low- and moderate-income families and individuals".
The Center examines the short- and long-term impacts of proposed budget and tax policies on the economy, on federal and state budgets, and on households in different income groups. It also examines whether federal and state governments are addressing critical priorities, both for low- and moderate-income Americans and for the population as a whole, and whether they have sufficient revenues to do so.
Health care in the United States is provided by many distinct organizations. Health care facilities are largely owned and operated by private sector businesses. 62% of the hospitals are non-profit, 20% are government owned, 18% are for-profit.
60–65% of healthcare provision and spending comes from programs such as Medicare, Medicaid, TRICARE, the Children's Health Insurance Program, and the Veterans Health Administration. Most of the population under 67 is insured by their or a family member's employer, some buy health insurance on their own, and the remainder are uninsured. Health insurance for public sector employees is primarily provided by the government.
The term health insurance is commonly used in the United States to describe any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance or a social welfare program funded by the government. Synonyms for this usage include "health coverage," "health care coverage" and "health benefits."
In a more technical sense, the term is used to describe any form of insurance that provides protection against the costs of medical services. This usage includes private insurance and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs such as Medicaid and the State Children's Health Insurance Program, which provide assistance to people who cannot afford health coverage.
Executive director is a term sometimes applied to the chief executive officer (CEO) or managing director of an organization, company, or corporation. It is widely used in North American non-profit organizations, though in recent decades many U.S. nonprofits have adopted the title President or CEO.
Confusion can arise because the words "executive" and "director" occur both in this title and in those of various members of some organizations' Board of directors. The precise meanings of these terms are discussed in the Board of Directors section of the article on Board of Directors.