POLITICS OF HEALTH RISKS
The regulation of health risks and the allocation of health research dollars complicate
health policy. It seems totally irrational. The publics perception of health risks is quite
different from that of experts. Similarly, the pre
1. Every Industrialized nation promises its citizens more comprehensive
and universal coverage than does the U.S.
2. But access varies greatly in every nation
geography-most nations have a dominant city, region (London/SE)
MARKETS AS AN ALTERNATIVE
If federal government not allowed and states cannot reform health care what is alternative-Markets
Market for education, food, transportation, energy why not health care? Better?
Today look at markets in health; not chronological
HEALTH STATUS, EXPENDITURES, AND RESOURCES
POINTS TO NOTE IN REVIEWING US AND COMPARATIVE HEALTH STATUS
US population aging (over 65) but less rapidly than Europe and Japan. They are
below population replacement rate and face an even more intense pro
THE QUEST FOR NATIONAL HEALTH INSURANCE
RISE AND FALL OF CLINTON HEALTH PLAN
Promise of Health Security -President Clinton in Fall 1993 introduces NHI Plan that his
wife was instrumental in designing. Fulfills promise of FDR
Setting: lots of health care i
HEALTH REFORM-THE STATES
States have and will keep having a role in US health system and therefore in health system
US a federal system/ constitutional division of power. GR and CANADA also federal
systems as we will see. Contrast with UK, FR, JP.
PAYING FOR HEALTH CARE: THE POLITICAL HISTORY THAT SHAPES
THE AMERICAN HEALTH CARE SYSTEM
National Health Insurance as public policy originates in Germany in the late 19th Century.
Germany was industrializing. People losing the protection, welfare
PAYING FOR HEALTH CARE: METHODS
THE SYSTEM, PROBLEMS, and POLICIES
M covers the elderly - the most expensive part of the population and the brakes on the
system -out of pocket constraint lifted.
Inflation hits system-not all just price increases
THE CANADIAN HEALTH CARE SYTEM
Popular comparison with U.S. even though health policy specialists prefer European trips.
Canada shares more than border with U.S.-economic, professional and cultural
integration. US companies often treat Canada as part of U
CAN THERE BE REFORM?
Employment based, decentralized, fragmented, variable
But most (75-80%) Americans get comprehensive access to high quality care vs. all (95%
plus) Germans, British, Japanese, Canadians get good to very good care (and 5% get