It has been estimated that 30 per cent of all direct

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It has been estimated that 30 per cent of all direct U.S. health care outlays – $390 billion – are the result of “poor quality care, consisting primarily of overuse, misuse and waste.” 12 Much of this is caused by providers performing unnecessary or unnecessarily expensive procedures because they profit from them, and consumers have little reason to question the costs.
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15 1 Johan Hjertqvist. Blair Repeats the Stockholm Sea Change, Fact Sheet. The Timbro Health Unit. Stockholm, Sweden, May 2002. 5. Clinical autonomy : Physicians are sometimes required to obtain prior authorisation from insurers before performing procedures or tests. However, new legislation being considered by Congress may give physicians more power by allowing them to form unions and bargain collectively. 6. Conflicts of interest with the third party payer : Insurers, driven by stakeholders ranging from employers, to providers, to patients, generally serve the needs of their covered population. Managed care, in which third party payer and provider are integrated, clearly alters the patient- provider relationship. 7. Responsiveness: Treatment capacity is high and most hospitals are private (87% non-profit), but there is some government funding of hospitals and a great deal of regulation of hospital prices and capacity in most states. However, because the majority of health care in the United States is delivered through private-sector programmes, the system overall is better than most in encouraging continual innovation and new technology. For example, the strength of the U.S. health sector is evident through pharmaceutical innovation and new medical techniques and technologies, rewarded by policies that, for the most part, value and pay for these advances. 8. Fiscal viability : US health care is the most expensive in the world, and there are widespread concerns about its viability, especially as so many remain uninsured. Many are coming to realise that pouring millions more dollars into malfunctioning systems only perpetuates their problems. 1 7. Voluntary insurance paid by individuals with tax subsidies (Australia). Australia has a government-funded universal public healthcare system (Medicare), partly (27 per cent) financed by a hypothecated tax (the Medicare levy). However, Australia encourages private supplementary insurance for hospital care and ‘extras’, through the tax system. Such insurance now accounts for eight per cent of total expenditure on health. 1. Price consciousness: 45 per cent of Australians purchase private insurance from one of about 40 insurers. They do so, bearing in mind carrot and stick tax incentives, in order to obtain greater comfort, to be treated by a doctor of their choice, or to cover co-payments. The privately insured also benefit from shorter waiting times, and can receive assistance with meeting the costs of services which are not covered by Medicare – such as dental, optical, and physiotherapy services.
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  • Fall '18
  • Universal health care

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