1 / 35

Economics Perspective

Economics Perspective. on Health Care and Women in the US. sam.baker@sc.edu www.pnhp.org. Private market. for health services and health insurance. with an overlay of government spending. Who Pays for Healthcare?. Amount in 1998 (billions). Percent. Government. $736.8. 64.1%.

kipling
Download Presentation

Economics Perspective

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Economics Perspective on Health Care and Women in the US • sam.baker@sc.edu • www.pnhp.org

  2. Private market for health services and health insurance with an overlay of government spending

  3. Who Pays for Healthcare? Amount in 1998(billions) Percent Government $736.8 64.1% Medicare $216.2 Medicaid $170.6 Premiums for public employees $67.3 Tax subsidy for private insurance $124.8 Other* $157.9 Private employers $216.5 18.8% Individuals (excludes tax subsidy) $195.8 17.0% Total $1149.1 100% Source: Himmelstein & Woolhandler - Unpublished analysis of NCHS data, Health Affairs 1999;18(2):176* Includes VA, NIH, subsidy for public hospitals, worker's comp, health departments etc.

  4. U.S. Public Spending Per Capita for Healthis Greater than Total Spending in Other Nations Note: Public includes benefit costs for govt. employees & tax subsidy for private insuranceSource: NEJM 1999; 340:109; Health Aff 2000; 19(3):150

  5. Out-of-pocket payments, US and world

  6. Why Women Delay Prenatal CareWhen They Know They Are Pregnant Note: 11.1% of pregnant women failed to get timely prenatal care despite knowing they were pregnant Source: MMWR 5/12/2000; 49:393

  7. Infant Mortality international

  8. Infant Deaths by Income, Canada 1996Even the Poor Do Better than U.S. Average

  9. Maternal mortality

  10. 83 • 82.3 • 81.8 • 82 • 81.4 • 81.3 • 81 • 80.3 • YEARS • 80 • 79.5 • 79.4 • 79 • 78 • 77 • U.S. • U.K. • ITALY • CANADA • FRANCE • SWEDEN • GERMANY Life Expectancy For Women, 1997 Source: OECD, 1999 & NCHS

  11. Poverty Rates, 1997U.S. and Other Industrialized Nations Source: Luxembourg Income Study Working PapersNote: U.S. figure for 1997, other nations most recent available year

  12. Americans Lead the World in Hours Worked Source: International Labor Organization, 1999

  13. Medical redlining

  14. Illness and Medical Costs,A Major Cause of Bankruptcy • 45.6% of all bankruptcies involve a medical reason or large medical debt • 326,441 families identified illness/injury as the main reason for bankruptcy in 1999 • An additional 269,757 had large medical debts at time of bankruptcy • 7 per 1000 single women, and 5 per 1000 men suffered medical-related bankruptcy in 1999 Source: Norton's Bankruptcy Advisor, May, 2000

  15. Uninsured women with breast cancer, compared with the insured: • Have a 49% higher adjusted risk of death • Are 1.4 xmore likely to be diagnosed with breast cancer at a late stage

  16. Uninsured women, compared with the insured, are: • half as likely to have had both a mammogram and clinical breast examination in the previous 2 years

  17. Uninsured women aged 50-64, compared with the insured, are: • ·2.1 xless likely to have had a recent mammogram • ·1.9 xless likely to have had a recent Pap test • ·2.1 xless likely to have had a recent clinical breast examination

  18. Uninsured women aged 40-49, compared with the insured, are: • ·1.5 xless likely to have had a recent mammogram • ·1.9 xless likely to have had a recent Pap test • ·1.9 xless likely to have had a recent clinical breast examination

  19. Uninsured pregnant women, compared with the insured: • Have a 31% higher likelihood of an adverse hospital outcome

  20. Federal Tax Subsidies forPrivate Health Spending, 1998 Note: Total federal tax subsidy = $111.2 billionSource: Health Affairs 1999; 18(2):176

  21. Who Pays For Health Care? Regressive U.S. Health Financing Regressive US financing Source: Oxford Rev Econ Pol 1989;5(1):89

  22. Progressive financing in Canada (Province Of Alberta) Source: Premier's Common Future Of Health, Excludes Out-of-Pocket Costs

  23. Administrative Cost

  24. Number of Insurance Products

  25. Private insurers’ High Overhead

  26. Milliman & RobertsonPediatric Length of Stay Guidelines • 1 Day for Diabetic Coma • 2 Days for Osteomyelitis • 3 Days for Bacterial Meningitis “They're outrageous. They’re dangerous. Kids could die because of these guidelines.” Thomas Cleary, M.D. Prof. of Pediatrics, U. Texas, Houston Listed as "Contributing Author" in M&R manual Source: Modern Healthcare May 8, 2000:34

  27. Milliman & Robertson “We do not base our guidelines on any randomized clinical trials or other controlled studies, nor do we study outcomes before sharing the evidence of most efficient practices with colleagues.” Wall Street Journal 7/1/98

  28. Fraud

  29. Can We Do Better? Yes! • Every other industrialized nation has a health care system that assures medical care for all • All spend less than we do; most spend less than half • Most have lower death rates, more accountability, and higher satisfaction • Stories of shortages? If they had our system, their problems would be much worse.

  30. We Have What it Takes • Excellent hospitals, empty beds • Enough well-trained professionals • Superb research • Current spending is sufficient

  31. What We Need: • To lead our leaders

More Related