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Understanding U.S. Healthcare: Challenges, Coverage, and Key Programs

This document explores the multifaceted issues surrounding healthcare in the U.S., analyzing statistics on uninsured populations by income and age. It delves into the definitions of key terms such as single-payer systems, socialized healthcare, and universal coverage. It highlights crucial legislative developments like the Affordable Care Act and discusses the variety of state and federal programs, including Medicaid, Medicare, and community health services. Through strategic discussions, it aims to define "Basic Health Care" and addresses public health challenges and funding structures within the U.S. healthcare system.

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Understanding U.S. Healthcare: Challenges, Coverage, and Key Programs

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Presentation Transcript

  1. Healthcare What are the issues?

  2. Some interesting statistics-Uninsured by income level • (WA state office of financial management)

  3. Uninsured by ageNew York Times, March 2, 2010

  4. Type of Insurance CoverageKaiser Study

  5. Definitions • Important terms: • Single payer system • Socialized/nationalized system • Universal healthcare • We have a variety of county, state, federal and private institutions providing healthcare funding and services.

  6. Patient’s Bill of Rights Affordable Care Act, March 23, 2010 • End limitations on care, e.g. pre-existing conditions, cancelling insurance plan, lifetime limits. • Remove insurance company barriers. • Review insurer premium increases. • Medical care and efforts to improve care must equal 80/85% of premium dollars. • Maintain young adult coverage. • Provide affordable coverage to those with pre-existing conditions.

  7. Small Group Strategizing • You are given a collection of healthcare services. • Your task is to define “Basic Health Care.” That is, which of these should everyone be guaranteed? • Which should definitely NOT be included? • Which are you unsure of? Why? • What criteria or principles are you using? • What information would help you decide to include or not include those in the “unsure” category?

  8. Discussion • What criteria did you use? • What were some of the differences of opinion? • What was the reason for the differences of opinion?

  9. Some Healthcare Programs 1. Basic Health Plan • Established in 1993 to insure more people and contain the costs of healthcare • State funded with individual contribution • Private providers • Income guideline-200% of FPL

  10. Washington Association of Community and Migrant Health Services • 103 clinics in the state; examples-45th St. Clinic, Odessa Brown, Pike Market Medical Clinic, etc. • Provides care for underserved populations. • Accepts medicaid, private pay, private insurance

  11. Indian Health Service, providing healthcare to members of the 557+ federally recognized tribes and descendants…approximately 1.8 million Alaskan Natives and American Indians in the U.S. (from IHS website) • Includes direct services and contracted services • Is funded enough to serve about 60% of those eligible.

  12. Medicaid-aka “coupons.” • Federal and state funded • Pregnant women up to 185% of fpl • People receiving SSI for a disability • Other groups of people

  13. State Children’s Health Insurance Program (SCHIP)-Apple Health for Kids) • 200% of fpl for kids under 19 • 250% WITH $20 co-pay • 300% with a $30 co-pay • Funded by both state and federal gov’t

  14. 6. Public Health-Seattle/King County • Some direct service provision (immunizations, asthma prevention/tx services, etc). • Emphasis on prevention of accidental death, disease, community health issues (SIDS, asthma) and environmental health.

  15. 7. Medicare • Healthcare for older adults and some people with disabilities. • Part A-Hospitalization, post hospitalization and hospice care. • Part B-Medical insurance with a monthly premium.

  16. Veteran’s Affairs system • Private system, largely paid for through employers but also individuals can purchase. • In 2014, a new “health insureance marketplace” will exist.

  17. CONCLUSION? A patchwork quilt of a healthcare system-lots of possibilities, difficult to navigate.

  18. An example of a socialized system: Cuba • Healthcare system is one of three priorities of the revolution: Education, Healthcare and Literacy • It is a socialized system, wherein the government both funds and provides healthcare services. • Education is free in Cuba, which means the country produces many healthcare personnel.

  19. Quiz review • Define single payer, universal and socialized healthcare • Healthcare services – • Basic Health • Medicare • Medicaid • Washington Association of Community and Migrant Health Services • Public Health • State Children’s Health Insurance Program • Children and Family Services • Institute of Family Development? •  CCORS stand for?  What is it?   • What does the Casey Family Foundation focus on?     

  20. Quiz review, continued • Senior Services • Adult Protective Services • SNAP • AFH • COPES • GRAT • Long Term Care Ombudsman • What is an AFH?

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