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Understanding U.S. Health Care Policy: Challenges and Solutions

Explore the impact and complexities of U.S. health care policy, addressing cost, access, quality, and systemic issues. Learn about Medicare, Medicaid, ACA, and the push for reform under different administrations. Delve into charts and statistics comparing health care in America to global standards.

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Understanding U.S. Health Care Policy: Challenges and Solutions

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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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