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Health Care Policy

Health Care Policy. Introduction. Why health care policy matters The problem in (sort of) 3 charts. Health in America. US vs. the world Emphasis on elderly Health care vs. health. Life Expectancy!. Infant Mortality. Life expectancy after 80. The U.S. Health Care System.

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Health Care Policy

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  1. Health Care Policy

  2. Introduction • Why health care policy matters • The problem in (sort of) 3 charts

  3. Health in America • US vs. the world • Emphasis on elderly • Health care vs. health

  4. Life Expectancy!

  5. Infant Mortality

  6. Life expectancy after 80

  7. The U.S. Health Care System • Complexity of system

  8. The U.S. Health Care System • Fee for Service • Managed Care • Government subsidized care

  9. Problems with the U.S. System: Cost • High relative cost

  10. Health Care and GDP

  11. Problems with the U.S. System: Cost • Fee-for-service system • Technology • Market Failure • Aging public • Medical culture • Prescription Drugs • Administrative costs • It’s the prices, stupid • What it is not

  12. Retail Price Indexes for Basket of In-Patent Pharmaceuticals, 2010US is set at 100 Price level Note: Calculations weighted relative to U.S. consumption patterns. U.S. retail prices were discounted from manufacturer prices according to the rebates obtained by the Medicaid program. THE COMMONWEALTH FUND Source: P. Kanavos, A. Ferrario, S. Vandoros et al., "Higher U.S. Branded Drug Prices and Spending Compared to Other Countries May Stem Partly from Quick Uptake of New Drugs," Health Affairs, April 2013 32(4):753–61.

  13. Diagnostic Imaging Prices, 2013 MRI CT Scan (abdomen) Dollars ($US) Dollars ($US) Notes: US refers to the commercial average. MRI refers to magnetic resonance imaging; CT refers to computed tomography. Source: International Federation of Health Plans, 2013 Comparative Price Report.

  14. Total Hospital and Physician Costs, 2013 Appendectomy Bypass Surgery Dollars ($US) Dollars ($US) Notes: US refers to the commercial average. Appendectomy prices reflect a blend of inpatient and outpatient prices based on relative utilization in each setting. Source: International Federation of Health Plans, 2013 Comparative Price Report.

  15. Spending on Health Insurance Administration per Capita, 2012Adjusted for Differences in Cost of Living Dollars ($US) * 2011. Source: OECD Health Data 2014.

  16. Spending per Hospital Discharge, 2012Adjusted for Differences in Cost of Living Dollars ($US) * 2011. ** 2010. Source: OECD Health Data 2014.

  17. Spending per Hospital Discharge, 2012Adjusted for Differences in Cost of Living Dollars ($US) * 2011. ** 2010. Source: OECD Health Data 2014.

  18. Problems with the U.S. System: Access • Inadequate Access • Why so many uninsured? • Maldistribution of resources • Employer-based issues • Rationing

  19. Rationing the wait

  20. Problems with the U.S. System: Quality • Quality in cross-national perspective

  21. Problems with the U.S. System: Quality • Lack of Access • Focus on sickness instead of health • Overspecialization

  22. Contemporary Policy • Medicare • Medicaid • ACA

  23. Affordable Care Act/ “ObamaCare” • Goals • Basics/Three-legged stool • What it’s not • Early Assessment • “Repeal and Replace” and ACA under President Trump

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