Technology and the Future of Health Care

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Author :
Publisher : Jossey-Bass
ISBN 13 :
Total Pages : 296 pages
Book Rating : 4.:/5 ( download)

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Book Synopsis Technology and the Future of Health Care by : David Ellis

Download or read book Technology and the Future of Health Care written by David Ellis and published by Jossey-Bass. This book was released on 2001-03-06 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most experts believe that innovation in every aspect of patient care will be nothing less than astonishing as we move into the next century. Technology and the Future of Health Care brings together a remarkable group of health care visionaries who have identified and begun to analyze which trends and technological advances will likely shape and inform the next generation of medicine. From fundamental advances in computing and administration, research, nursing, and patient care delivery to noninvasive surgery, biomolecular therapies, bionics, and beyond, this ground-breaking book offers professional, executive-level insight into topics that until recently existed only in the realm of science fiction.

The Future of the Public's Health in the 21st Century

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Author :
Publisher : National Academies Press
ISBN 13 : 0309133181
Total Pages : 536 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Future of the Public's Health in the 21st Century by : Institute of Medicine

Download or read book The Future of the Public's Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

The Future of Healthcare: It's Health, Then Care

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Author :
Publisher : Lulu.com
ISBN 13 : 0578075989
Total Pages : 64 pages
Book Rating : 4.5/5 (78 download)

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Book Synopsis The Future of Healthcare: It's Health, Then Care by : Frances J. Turisco

Download or read book The Future of Healthcare: It's Health, Then Care written by Frances J. Turisco and published by Lulu.com. This book was released on 2011-06-01 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare is ripe for disruptive innovation. CSC takes a holistic view of healthcare, with the patient at the center, and identifies 5 trends that will re-shape the industry. Healthcare is moving from a care-first to a wellness-first perspective via the efforts and technologies in these trends: E-Power to the Patient - Patients take on a larger, more active role in managing their wellness and health. Earlier Detection - Earlier detection maximizes options for successful treatment, leading to a speedier return to good health. High-Tech Healing - New technologies can significantly boost outcomes and quality of life. Resources: More, but Different - Solving the healthcare resource puzzle requires new players and new care models. Global Healthcare Ecosystem Emerges - More information, more connected, leads to better care and better research. This report targets patients, providers, healthcare businesses, technology companies and industry gurus. Learn how you can be part of the change.

The Role of Telehealth in an Evolving Health Care Environment

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Publisher : National Academies Press
ISBN 13 : 0309262011
Total Pages : 159 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis The Role of Telehealth in an Evolving Health Care Environment by : Institute of Medicine

Download or read book The Role of Telehealth in an Evolving Health Care Environment written by Institute of Medicine and published by National Academies Press. This book was released on 2012-12-20 with total page 159 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.

The Future of Public Health

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Publisher : National Academies Press
ISBN 13 : 0309581907
Total Pages : 240 pages
Book Rating : 4.3/5 (95 download)

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Book Synopsis The Future of Public Health by : Committee for the Study of the Future of Public Health

Download or read book The Future of Public Health written by Committee for the Study of the Future of Public Health and published by National Academies Press. This book was released on 1988-01-15 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.

Evidence-Based Medicine and the Changing Nature of Health Care

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Author :
Publisher : National Academies Press
ISBN 13 : 0309113695
Total Pages : 202 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Evidence-Based Medicine and the Changing Nature of Health Care by : Institute of Medicine

Download or read book Evidence-Based Medicine and the Changing Nature of Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2008-09-06 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

The Future of Health-care Delivery

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Publisher : Potomac Books, Inc.
ISBN 13 : 1612341578
Total Pages : 400 pages
Book Rating : 4.6/5 (123 download)

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Book Synopsis The Future of Health-care Delivery by : Stephen C. Schimpff

Download or read book The Future of Health-care Delivery written by Stephen C. Schimpff and published by Potomac Books, Inc.. This book was released on 2012 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately 100,000 deaths per year in the United States result from preventable medical errors. This figure is about twice the number of people who die in car accidents and five times the number of murder victims annually, and twenty times the number of servicemen and women killed in Iraq and Afghanistan since the start of hostilities in 2001. If you think Americans have the best health-care system in the world, think again. In this deeply researched and controversial book, Dr. Stephen Schimpff explains why our health-care delivery system serves us so poorly, why it costs so much, and why government policy over many decades has not only failed to improve care delivery but has actually made it worse. In the process, he dispels common misconceptions about medicine and health care. The Future of Health-Care Delivery provides timely information and a road map to achieve world-class care delivery, putting health care where it belongs--in the hands of the patient and medical professionals instead of the insurance companies and government.

The Future of Nursing 2020-2030

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Publisher :
ISBN 13 : 9780309685061
Total Pages : pages
Book Rating : 4.6/5 (85 download)

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Book Synopsis The Future of Nursing 2020-2030 by : National Academies of Sciences Engineering and Medicine

Download or read book The Future of Nursing 2020-2030 written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2021-09-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.

The Future of Nursing

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Author :
Publisher : National Academies Press
ISBN 13 : 0309208955
Total Pages : 700 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis The Future of Nursing by : Institute of Medicine

Download or read book The Future of Nursing written by Institute of Medicine and published by National Academies Press. This book was released on 2011-02-08 with total page 700 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

Care Without Coverage

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Publisher : National Academies Press
ISBN 13 : 0309083435
Total Pages : 213 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Care Without Coverage by : Institute of Medicine

Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

The Future of Healthcare

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Author :
Publisher : Emmanuel Fombu
ISBN 13 : 9780692122969
Total Pages : 296 pages
Book Rating : 4.1/5 (229 download)

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Book Synopsis The Future of Healthcare by : Emmanuel Fombu

Download or read book The Future of Healthcare written by Emmanuel Fombu and published by Emmanuel Fombu. This book was released on 2018-05-19 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt: Our healthcare system is prohibitively expensive. Fortunately, artificial intelligence, big data, machine learning, blockchain, the internet of things and wearable technologies are revolutionizing the way that we look at healthcare. The future of healthcare is coming. This is what it looks like.

The Future of Health

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Author :
Publisher : John Wiley & Sons
ISBN 13 : 1119797314
Total Pages : 215 pages
Book Rating : 4.1/5 (197 download)

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Book Synopsis The Future of Health by : Roberto Ascione

Download or read book The Future of Health written by Roberto Ascione and published by John Wiley & Sons. This book was released on 2021-10-26 with total page 215 pages. Available in PDF, EPUB and Kindle. Book excerpt: Learn how the future of medicine is being unlocked—one digital innovation at a time The Future of Health is an insightful and comprehensive overview of the past, present, and future of digital health. Accomplished health innovation leader Roberto Ascione delivers a practical exploration of how the latest digital technologies are transforming the practice of medicine and redefining health itself by making it more accessible, sustainable, and human. The book includes practical, real-world examples from the United States, Asia, and Europe of technology applications, companies, and start-up that have changed—or will change—our relationship with our health and the healthcare system. Readers will also find: How our health is becoming increasingly consumer and connected while technology is empowering patients in completely new ways and deeply transforming the doctor-patient relationship Discussions of how the training of medical professionals, particularly doctors, has changed—or needs to change—to meet the new digital reality Examinations of how new technologies will allow doctors to dodge many of the administrative and regulatory burdens they currently face each day Treatments of the ability of new technologies to unlock new, holistic ways of practicing medicine, with a focus on latest developments such as Digital Therapeutics and Virtual Reality Reflections on how digital health is fostering a shift “from cure to care” and will unleash a human-sized future for a more accessible, ubiquitous, and sustainable healthcare The Future of Health is required reading for medical practitioners and the managers of pharmaceutical companies. It will also earn a place in the libraries of medical device companies and healthcare entrepreneurs seeking an incisive treatment of the impact of digital technology on all aspects of healthcare. Also, the general public, interested in understanding how to take better control of their own health through digital technologies, will find this book insightful and easy to comprehend.

Healthcare Systems

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Publisher : CRC Press
ISBN 13 : 1351683713
Total Pages : 456 pages
Book Rating : 4.3/5 (516 download)

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Book Synopsis Healthcare Systems by : Jeffrey Braithwaite

Download or read book Healthcare Systems written by Jeffrey Braithwaite and published by CRC Press. This book was released on 2018-05-11 with total page 456 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book, we invited 146 authors with expertise in health policy, systems design, management, research, or practice, from each of the countries included, to consider health reforms or systems improvements in their country or region. The resulting case studies, of 52 individual countries and five regional groupings, cover 152 countries or territories, or three-quarters of the world’s nations. Each chapter author was asked to think 5–15 years into the future and make a prediction on how their health system could be strengthened as a result of the successful unfolding of their case study. The types of projects our authors have chosen to explicate into the future are wide-ranging. They vary from e-consultation services in Estonia, achieving universal health coverage in Argentina and Mexico, reforming long-term care in the Netherlands, reassessing care for the aging population and the frail elderly in Australia, streamlining the health system through Lean Thinking in Nigeria, using regulation to improve care in South Africa, developing a new accreditation model in Turkey, through to a critique of physician specialization in Russia and applying IT initiatives to improve care in China, Lebanon, Taiwan, Papua New Guinea, the United Arab Emirates, Venezuela and Wales. Chapter writers recognized that the improvement work they were doing was part of a moving target. There was general agreement that the effective use of limited resources and overcoming hurdles and constraints were crucial to enhancing health systems in order to deliver better care over the medium term. While some initiatives required considerable funding, many were relatively inexpensive. These case studies demonstrate ways in which fruitful application of partnerships and creativity can make considerable gains in strengthening healthcare delivery systems. Features The third book in a series on international health reform Involves 146 contributing authors, five regional editors, a series editor and a highly skilled support team to explore sustainable improvement in health systems in the future Encompasses a time horizon of the next 5–15 years Covers 152 countries or territories, with 52 individual countries and an analysis of five regional groupings comprising 100 countries

Health Care Comes Home

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Publisher : National Academies Press
ISBN 13 : 0309212405
Total Pages : 202 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis Health Care Comes Home by : National Research Council

Download or read book Health Care Comes Home written by National Research Council and published by National Academies Press. This book was released on 2011-06-22 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, health care devices, technologies, and practices are rapidly moving into the home. The factors driving this migration include the costs of health care, the growing numbers of older adults, the increasing prevalence of chronic conditions and diseases and improved survival rates for people with those conditions and diseases, and a wide range of technological innovations. The health care that results varies considerably in its safety, effectiveness, and efficiency, as well as in its quality and cost. Health Care Comes Home reviews the state of current knowledge and practice about many aspects of health care in residential settings and explores the short- and long-term effects of emerging trends and technologies. By evaluating existing systems, the book identifies design problems and imbalances between technological system demands and the capabilities of users. Health Care Comes Home recommends critical steps to improve health care in the home. The book's recommendations cover the regulation of health care technologies, proper training and preparation for people who provide in-home care, and how existing housing can be modified and new accessible housing can be better designed for residential health care. The book also identifies knowledge gaps in the field and how these can be addressed through research and development initiatives. Health Care Comes Home lays the foundation for the integration of human health factors with the design and implementation of home health care devices, technologies, and practices. The book describes ways in which the Agency for Healthcare Research and Quality (AHRQ), the U.S. Food and Drug Administration (FDA), and federal housing agencies can collaborate to improve the quality of health care at home. It is also a valuable resource for residential health care providers and caregivers.

First, Do Less Harm

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Publisher : Cornell University Press
ISBN 13 : 0801464072
Total Pages : 304 pages
Book Rating : 4.8/5 (14 download)

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Book Synopsis First, Do Less Harm by : Ross Koppel

Download or read book First, Do Less Harm written by Ross Koppel and published by Cornell University Press. This book was released on 2012-04-23 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each year, hospital-acquired infections, prescribing and treatment errors, lost documents and test reports, communication failures, and other problems have caused thousands of deaths in the United States, added millions of days to patients' hospital stays, and cost Americans tens of billions of dollars. Despite (and sometimes because of) new medical information technology and numerous well-intentioned initiatives to address these problems, threats to patient safety remain, and in some areas are on the rise. In First, Do Less Harm, twelve health care professionals and researchers plus two former patients look at patient safety from a variety of perspectives, finding many of the proposed solutions to be inadequate or impractical. Several contributors to this book attribute the failure to confront patient safety concerns to the influence of the "market model" on medicine and emphasize the need for hospital-wide teamwork and greater involvement from frontline workers (from janitors and aides to nurses and physicians) in planning, implementing, and evaluating effective safety initiatives. Several chapters in First, Do Less Harm focus on the critical role of interprofessional and occupational practice in patient safety. Rather than focusing on the usual suspects-physicians, safety champions, or high level management-these chapters expand the list of "stakeholders" and patient safety advocates to include nurses, patient care assistants, and other staff, as well as the health care unions that may represent them. First, Do Less Harm also highlights workplace issues that negatively affect safety: including sleeplessness, excessive workloads, outsourcing of hospital cleaning, and lack of teamwork between physicians and other health care staff. In two chapters, experts explain why the promise of health care information technology to fix safety problems remains unrealized, with examples that are at once humorous and frightening. A book that will be required reading for physicians, nurses, hospital administrators, public health officers, quality and risk managers, healthcare educators, economists, and policymakers, First, Do Less Harm concludes with a list of twenty-seven paradoxes and challenges facing everyone interested in making care safe for both patients and those who care for them.

The Changing Economics of Medical Technology

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Author :
Publisher : National Academies Press
ISBN 13 : 030904491X
Total Pages : 225 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis The Changing Economics of Medical Technology by : Institute of Medicine

Download or read book The Changing Economics of Medical Technology written by Institute of Medicine and published by National Academies Press. This book was released on 1991-02-01 with total page 225 pages. Available in PDF, EPUB and Kindle. Book excerpt: Americans praise medical technology for saving lives and improving health. Yet, new technology is often cited as a key factor in skyrocketing medical costs. This volume, second in the Medical Innovation at the Crossroads series, examines how economic incentives for innovation are changing and what that means for the future of health care. Up-to-date with a wide variety of examples and case studies, this book explores how payment, patent, and regulatory policiesâ€"as well as the involvement of numerous government agenciesâ€"affect the introduction and use of new pharmaceuticals, medical devices, and surgical procedures. The volume also includes detailed comparisons of policies and patterns of technological innovation in Western Europe and Japan. This fact-filled and practical book will be of interest to economists, policymakers, health administrators, health care practitioners, and the concerned public.

The Future of Healthcare Reform in the United States

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Author :
Publisher : University of Chicago Press
ISBN 13 : 022625495X
Total Pages : 365 pages
Book Rating : 4.2/5 (262 download)

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Book Synopsis The Future of Healthcare Reform in the United States by : Anup Malani

Download or read book The Future of Healthcare Reform in the United States written by Anup Malani and published by University of Chicago Press. This book was released on 2015-10-15 with total page 365 pages. Available in PDF, EPUB and Kindle. Book excerpt: When the Supreme Court's majority ruling in NFIB v. Sebelius upheld the Patient Protection and Affordable Care Act (the PPACA, or Obamacare), it was clear that this major shift in American health care provision was here to stay. For better or worse, the PPACA is now both a target for, and a constraint on, the next wave of reformist ideas. Driven by curiosity about how the American health care regime will continue to evolve in the near and medium term, Dean Michael Schill and Professor Anup Malani of the University of Chicago Law School commissioned fourteen essays from leading scholars of law, economics, medicine, and public health that offer predictions for the most important issues and debates in health-care reform over the next five to seven years. Essays are arranged in five sections. Part I, ACA and the Law, sets the stage with three essays on legal challenges and justifications for the Act. Part II, ACA and the Federal Budget, explores the variety of potential fiscal consequences resulting from Obamacare. Part III, ACA and Health Care Delivery, offers competing viewpoints on what the Act will ultimately mean for consumers of health care. Part IV, Health Care Costs, Innovation, and the ACA speculates about what the altered financial structure of health care will mean for the pace of development of new medical technologies. Part V, ACA and Health Insurance Markets, concludes the volume with a pair of contrasting assessments of the prospects for the new insurance "exchange" markets.