1. A brief summary of health care reform

1. A brief summary of health care reform - Health care...

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Health care reform: A brief summary ECO 381 08/30/11
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Outline Overview of the US health care system and its challenges (Shih & Singh, 2005) Main components of health care reform Health care expenditures – how much do we spend, what do we get for it, and how can we control expenditures? Expanding insurance coverage – who is uninsured, why, and what are the policy options?
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Brief overview of the US health care system and its challenges
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Basic components of US health care system US health care “system” is fragmented and massive All functional components (financing, insurance, delivery, and payment) represent a mixture of public and private sources Primarily market-based “system” with no guarantee of access to services Most developed countries have government-run, national health insurance programs financed through taxes Almost all citizens are entitled to receive health services There is some central oversight, coordination, and standardization of care
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Basic components of US health care system Employers purchase health insurance for employees through private sources, and people receive care in the private sector Prior to March 2010: In most states, employers were NOT mandated to provide health insurance In many workplaces, purchase of insurance was NOT mandatory Individual insurance policies were expensive and not offered to those with certain health conditions As a result, many low-wage workers and unemployed individuals were uninsured Government finances public insurance through programs such as Medicare, Medicaid and SCHIP – these programs serve very low-income, elderly, disabled, and pediatric populations Insurance and delivery of services generally provided through private entities such as HMOs, private physicians, and private hospitals
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Basic components of US health care system A multiple payer system (our system) Since each employer can determine the health plans it offers, numerous health plans and insurance companies
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