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Healthcare. What are the issues?. Some interesting statistics-Uninsured by income level (WA state office of financial management). Uninsured by age New York Times, March 2, 2010. Type of Insurance Coverage Kaiser Study. Definitions. Important terms: Single payer system
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Healthcare What are the issues?
Some interesting statistics-Uninsured by income level • (WA state office of financial management)
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.
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.
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?
Discussion • What criteria did you use? • What were some of the differences of opinion? • What was the reason for the differences of opinion?
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
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
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.
Medicaid-aka “coupons.” • Federal and state funded • Pregnant women up to 185% of fpl • People receiving SSI for a disability • Other groups of people
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
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.
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.
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.
CONCLUSION? A patchwork quilt of a healthcare system-lots of possibilities, difficult to navigate.
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.
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?
Quiz review, continued • Senior Services • Adult Protective Services • SNAP • AFH • COPES • GRAT • Long Term Care Ombudsman • What is an AFH?