The Affordable Care Act (ACA), the sweeping health care reform enacted by the Obama Administration in 2010, continues to be a contentious policy at the center of highly polarized political debates. Both before and after the law’s passage, political elites on both sides of the issue attempted to sway public opinion through two traditional approaches: messaging and policymaking itself. They operated under the assumption that the public’s personal experiences toward the law would make them more favorable. Yet these tried-and-true methods have had limited influence on public attitudes toward the ACA. Public opinion towards the ACA remained stable from 2010 to 2016, with more Americans opposing the law than supporting it. It was only after Donald Trump was elected in 2016 and the prospect of the law being repealed became a reality that public opinion swung in favor of the ACA. If traditional methods of influencing public opinion had little impact on attitudes towards the ACA, what did? In Stable Condition, political scientist Daniel J. Hopkins draws on survey data from 2009 to 2020 to assess how a variety of factors such as personal experience, political messaging, and partisanship did or did not affect public opinion on the ACA. Hopkins finds that although personal experience with the ACA’s Medicaid expansion increased favorability among low-income Americans, it did not have a broader overall impact on public opinion. Personal experience with the Health Insurance Marketplace did not increase wider support for the ACA either. Due to the complex nature of the law, users of the Marketplace often did not realize they were benefiting from the ACA. Therefore, perceptions of the Marketplace were shaped by high-profile issues with the enrollment website and opposition to the individual mandate. These experiences ultimately offset one another, resulting in little discernable change in public opinion overall. Hopkins argues that political polarization was also responsible for elite’s limited influence and that public opinion on the ACA was largely determined by partisanship and political affiliation. Americans quickly aligned with their party’s stance on the law and were resistant to changing their beliefs despite the efforts of political elites. Stable Condition is an illuminating examination of the limits of elites’ influence and the forces that shaped public opinion about the Affordable Care Act.

In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance for the management of critically ill patients with acute renal failure, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice.

I sat in my interview intending to make decorative iron work after I left school and my future boss said; 'we also do one or two horses are you interested!' That was the beginning of my working life of fifty two years as a farrier instead of blacksmithing. I have amassed many amusing stories from the stables. I met some wonderful clients with one or two exceptions. A long the way I had the pleasure of meeting some amazing characters both animal and human. my life wasn't without its trials and tribulations but my love of my work carried me through.

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.