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Forum on Healthcare Reform September 16, 2009 UNF University Center

Forum on Healthcare Reform September 16, 2009 UNF University Center Health Care Reform: Rhetoric or Reality? Aims and Elements of Reform. Otmar Kloiber World Medical Association Secretary General. Health Care System USA. High performance Multifaceted Private care Mutuality based care

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Forum on Healthcare Reform September 16, 2009 UNF University Center

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  1. Forum on Healthcare Reform September 16, 2009 UNF University Center Health Care Reform: Rhetoric or Reality? Aims and Elements of Reform Otmar Kloiber World Medical Association Secretary General

  2. Health Care System USA • High performance • Multifaceted • Private care • Mutuality based care • Employer based care • Gov. insurance based care • Special systems (VA, Tri-Care) • Incomplete (non comprehensive, not universal) • Expensive • Abused (tort system)

  3. Health (Care) Reform • Access • Affordability • Availability • Universal coverage • Equitable care • Comprehensiveness • Single Payer • Government option • Comparative effectiveness research • End of life questions • Increasing efficiency(EHR)

  4. Prevailing State Models ofHealth Care Systems

  5. Successful Elements • Dedicated funds (cut of from political desires – not under direct control of the government/parliament) • Balanced powers between care givers and payers • Clear and equal rules for all insurers • No exclusions (e.g. pre-existing conditions) • No discrimination • Defined basket – by inclusion or exclusion (not under sole control of the insurers) • No adverse selection (risk adjustment)

  6. Premium Coverage Insurance Private Care Care Honorarium Patient Physician

  7. Managed Care Organization The Dominance Model Social Insurance National Health Service Contribution Payment Care Patient Physician

  8. Corporative Model Provider Organization Insurance Payment Contribution Honorarium Care Patient Physician

  9. Conclusions • A health care system reflects the values of society – get clear about your values • The health care system has to be cleaned from abuse – the tort system is a good place to start • State run health care is not a guaranty for anything • Proper laws can ensure universal and comprehensive coverage, choice of the care giver and competition between insurers • It is possible to do this with private insurances –but it requires a level playing ground for them

  10. Caring, Ethics, Science www.wma.net

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