Healthcare in the U.S. -- Final Version.pptx - HEALTHCARE IN THE U.S CPH 1400 15 October 2019 Hannah Rochford MPH – [email protected] LEARNING

Healthcare in the U.S. -- Final Version.pptx - HEALTHCARE...

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HEALTHCARE IN THE U.S. CPH: 1400 15 October 2019 Hannah Rochford, MPH – [email protected]
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LEARNING OBJECTIVES What are the trademark components of the US healthcare system? What are some areas of strength and what are some areas of concern within the historic and current versions of the U.S. healthcare system? What are the factors that influence passage and effectiveness of health policies? What are the factors that influence healthcare utilization? How can health policies advance equity or exacerbate disparities?
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HOW DOES IT WORK? Hopefully you won’t be sorry you asked.
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INTERNATIONAL HEALTH SYSTEM ALTERNATIVES Model Bismarck NHI Beverage Out-of- Pocket Country Examples Germany, Netherland s Canada UK, France, Cuba Many Low- Income Nations Care Financing Private, multi-payer (Funded through employees’ paychecks) Public, single payer Public, single payer Private, self-funded Care Delivery Private Private Public Private Description Tight governmen t regulation to control costs Similar to Medicare Physicians are salaried by the government; Similar to the No core system or major programs **Note: Every country has the option to opt-out of their program
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HISTORIC DISCUSSIONS Theodore Roosevelt explored National Health Insurance when many European countries were establishing systems to quell their social unrest  Failed per Anti- German sentiment around WWI and lack of AMA support Resurfaced again with the in the 1930’s under Franklin D. Roosevelt but seen as politically unfeasible Proposed again in Harry Truman’s 1948 campaign and failed for the same reasons Lyndon B. Johnson pass the then unpopular Medicare & Medicaid policies in 1965 giving our nation’s system its trademark ‘Demographic Incrementalism’  Hoped that by expanding coverage to Older Adults, Pregnant women and Children a foundation for expanding coverage to other groups would be laid In the early 1970’s Richard Nixon proposed a comprehensive health system based on the Health Management Organizations he was familiar with as a Californian  This failed for political reasons again In the early 1980’s Reagan shifts Medicare to a prospective payment system Conversations attempting to achieve a true system have been circulating in the U.S. since 1912.
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RECENT DISCUSSIONS Bill Clinton pushed a national health care agenda forward in 1992 proposing a fixed federal budget with managed competition among private insurance plans (similar to Germany’s model)  failed per strong opposition by the Health Insurance Industry Obama’s approach was informed by many of the political missteps of the Clinton attempt. He moved swiftly, gathered interest group support early on, gave Congress authority over policy details Obama’s approach was also based on the successful state-level reform attempts of Oregon and Massachusetts Obama’s enacted policy had the following key features: o Individual mandate, with penalties o Employer mandate, with tax penalties o
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