Lecture 10 Notes Health Reform in the States

Lecture 10 Notes Health Reform in the States - Lecture 10...

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Lecture 10 Notes: Health Reform in the States S tate s have and w ill keep having a r ole in US health s y s tem and the r e f o r e in health s y s tem r e f o r m. US a f ede r al s y s tem/ con s titutional divi s ion o f po w e r . G R and C ANADA al s o f ede r al s y s tem s a s w e w ill s ee. Cont r a s t w ith UK , F R, JP . But each f ede r al s y s tem i s unique. US r e s e rv e s po w e rs to s tate s , limited f ede r al gove r nment. Evolved becau s e w a r , economy --- u s e o f comme r ce clau s e, eme r gencie s . A living thing. I . W h y st a t e s i n h eal th: 1. LE GA C Y A R GUM E N T: s t u ck w ith it; can ' t avoid s o don ' t t r y. S tate s al r eady the r e --- licen s e MDs monito r f acilitie s r un f acilitie s public health manage M edicaid and pay s ha r e Re f o r m w ill not exclude tho s e al r eady in in s u r ance companie s and s tate s 2. PO L I T I C A L A R GUM E N T: be s t to decent r alize politically N eed to decent r alize to avoid attack that building a national bu r eauc r acy. F ede r al gov ' t not popula r . Local i s democ r atic, r e s pon s ive, hone s t? Each pa r ty ha s r ea s on s to f avo r s tate s . D em s have s tate s that w ant NHI ; Rep s have s tate s that w ill neve r ag r ee. 3. F E D ER A L IS T A R GUM E N T: Belie f in bene f it s o f decent r alization Expe r iment; innovation --- geniu s o f f ede r ali s m
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D ive rs ity --- US big cou n ty; C A =Canada; NY = N ethe r land s ; C A + FA + MI = G R; no one s y s tem be s t, have to allo w f lexibility o f local condition s , t r adition s . But --- i s n ' t the one o f big complaint s the lack uni f o r mity mo s t vi s ible in M edicaid you a r e OK in M a ss achu s ett s but not M i ss i ss ippi > F amily o f th r ee in C A $11,708 but A L $1,488 > NY pay s $120 pe r day f o r N u rs ing H ome ca r e; C A pay s only $65.
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