McKenzie_6e_PPT_CH14

McKenzie_6e_PPT_CH14 - Health Care System Function Chapter...

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Health Care System: Function Chapter 14 KIN 4601 Fall 2010 Deborah S. Dailey, MS
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Health care services not accessible to all Even when accessible there are racial & ethnic disparities – often receive a lower quality of care than do their white counterpart, especially for more complicated procedures Major problems of system represented in Kissick’s (1994) cost containment, access, triangle
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Access to Health Care - 1 In 2005, 46.6 million Americans were uninsured; millions more lacked or have gap coverage for shorter periods Likelihood of being uninsured greater for those who: younger people (18-24), those with less education(types of jobs), those with lower income, those who are not U.S. citizens and males (due to personality) 8 in 10 uninsured persons were members of working families (able to afford it, access)
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Health Insurance Coverage among people < 65 years
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Access to Health Care - 2 Medically indigent: Those who are unable to receive medical care because they cannot afford it; Working poor: Those who have a job but are still unable to afford health insurance around 30 million ppl Most Americans pay for health care 3 or 4 times
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Access to Health Care - 2 Why People Do Not Have Health Insurance? © Adams, P. F., and P. M. Barnes (2006). Vital and Health Statistics, 10(229).
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Paying for Health Care - 1 Personal Health Care Expenditure by Source of Funds © National Center for Health Care Statistics
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Paying for Health Care - 2 Arrangements for payment: fee-for-service (fee schedule) Fee-for-service: The patient is “first party” the provider “second party” and the insurance or government “third party. paying for health care in which after the service is rendered, a fee is paid Prepaid health care found mostly in managed care plans: Set price per member, may only pay certain months at a time or set amount of visit, after you go over the allotted money then you have to pay
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Health Insurance - 1 Like other insurance– risk & cost spreading process, you are not guaranteed the services when they are needed. Paid for in “equitable fashion;” some pay more if at high risk (e.g., smoking) The greater the risk the greater the premium 1911: First health insurance, policy premium
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Health Insurance - 2 State Children’s Health Insurance Program (SCHIP) Enacted in 1997 & authorized in 1997 for $40 billion To cover uninsured children: 11.3 million Voluntary grants to states that apply for it; can be part of Medicaid In 2005, 6.1 million children (strictly for them) were enrolled Up for re-authorization in 2007
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Health Insurance - 3 Health Insurance Policy: a written agreement between an insurance company (or the government (state/federal)) & an individual or group of individuals to pay for certain health care costs during a certain period in return for regular, periodic payments (a set amount of money) called premiums-who pays for what
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This note was uploaded on 08/21/2011 for the course KIN 4601 taught by Professor Debradailey during the Fall '10 term at LSU.

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McKenzie_6e_PPT_CH14 - Health Care System Function Chapter...

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