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Notes 03-11 - Lecture 12 Rationing Health Care I Backstory...

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Lecture 12: Rationing Health Care I. Backstory a. AHCCCS i. Arizona’s alternative to Medicaid: wanted to avoid the corruption and expenses of Medicaid ii. Enacted in 1981 iii. Previously had a county-based system (each county had a different plan) iv. AHCCCs was one standard, used some federal money to pay for health care v. Contained costs through using HMOs: competition between different HMOs, capitation, gatekeepers vi. Traditional Medicaid paid a percentage of all expenses that states incurred. AHCCCs was paid by capitation vii. Compared to traditional Medicaid, AHCCCS had different eligibility rules (covered fewer people) viii. AHCCCs also didn’t cover some expenses that traditional Medicaid did, such as nursing homes 1. Medicaid was traditionally an insurer of last resort for Nursing Homes ix. AHCCCS thought of itself as a general/basic insurance plan for the truly poor b. Transplants i. Were going from being an experimental form of treatment to a more standard one ii. Initially was not covered by insurance; those who needed transplants would have to fundraise on their own iii. Were covered by the late 1980s iv. Original AHCCCS policy regarding transplants was for the
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