Health-Law-Sylvia.Law-Sp05 - I H EALTH L AW II I...

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Unformatted text preview: I. H EALTH L AW II. I NTRODUCTION A. Access B. Costs in 2002, we spend 14.9% of GNP on health care! Through the 1990s, health expenditures as a share remained fairly constant, since then, they have gone up again 1. We spent over $5,000 per person on health care in the US. In recent decades, health care costs increase faster than consumer price index 2. What do we spend all that money on? 1/3 – hospital. services, 1/5 – physician services, 10% - prescription drugs (have doubled recently, services have gone down) 3. Who pays? In 2002, it was 36% private health insurance, 19% Medicare, 17% Medicaid, 16% out of pocket 4. In recent decades, Medicare has been bigger than Medicaid, but it’s expanding 5. We spend a lot more than any other country (Germany – 59% of what we spend per capita, Britain – 39% and they provide universal health care!) 6. Costs create huge problems! For individuals, for businesses, for state gov’ts – can be the largest budget line, for fed, gov’t 7. Financing is incredibly complex, but also key to understanding the issues C. Quality sometimes magnificent, but often the quality of care provided is poor. Focus on alternative ways of defining and influencing quality D. Managed care claims review. Even if you are insured, sometimes you don’t get the $$! E. Access, Cost, and Quality in relation to services at the beginning of life and at the end of life III. A CCESS TO H EALTH C ARE A. B ARRIERS TO A CCESS 1. The Rise and Crisis of Provider-Dominated Health Care a) The pre-modern period (1) Lower class work (2) In patients’ homes (a) Hospitals were associated with almshouses or mental institutions (3) Private charitable hospitals (a) Enhanced doctors’ education b) 1887 – 1910 – The turn of the century (1) Physicians (a) Prior to the 19 th century, healers were low status and low paid, often women (herbalists, midwives, abortionists) (b) Paid like barbers – service providers, not professionals (2) What happened to change that? (a) Stunning developments in technology and science and the understanding of germ theory (b) Allopath (germ guys) believed that their theories about treating people were so superior to the herbalists – they enlisted the power of the state to: (c) Prohibit practice by anyone not licensed by the state – confined the practice of medicine (d) Persuaded legislatures to put control in the hands of the allopath themselves (e) State should provide for general rather than specialized licensing (3) What kinds of problems were we trying to address?...
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This note was uploaded on 04/04/2008 for the course LAW ALL taught by Professor Multiple during the Fall '06 term at NYU.

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Health-Law-Sylvia.Law-Sp05 - I H EALTH L AW II I...

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