The Health of the Nation

1. The Health of the Nation

2. Judging the Health of a Nation • Quality of its doctors and medical institutions • Doctors from all over the world come to the U.S. to study and learn • Infant Mortality Rate • This is the number of deaths of infants under one year old for every 1,000 live births • Life Expectancy at Birth • This is the number of years a newly born infant is expected to live

3. Quality of Health Care in the U.S. • Americans die younger and lose more of their babies than the people of other industrialized nations • Not everyone benefits from the advances the U.S. has made in health care • Depends on race, money, and job

4. http://apps.who.int/gho/data/node.main.688 • http://apps.who.int/gho/data/node.main.ChildMort-1?lang=en

5. Why are people in the U.S. not the Healthiest • Diet • Poor Eating Habits • Lifestyles • Not Enough Exercised, Stressed Out • Smoking, Drinking, Drugs • Main reasons for large numbers of Americans: • The rising cost of health care • Lack of Health Insurance

6. Rising Costs of Health Care • Pose serious problems for everyone, but especially for people with catastrophic illnesses (illnesses who treatments cost so much that they bring financial ruin to victims) • Rising cost can be explained by advances in procedures, equipment, and services • Inflation is another reason • Aging population because elderly requires more care • Government or insurance company was picking up the tab so patients, hospitals, and doctors had no incentive to reduce costs.

7. http://www.aetna.com/health-reform-connection/aetnas-vision/facts-about-costs.html#breakdownhttp://www.aetna.com/health-reform-connection/aetnas-vision/facts-about-costs.html#breakdown

8. Reducing Health Care Costs • Until the 1980’s, most insurance providers offered fee-for-service plans. • Patients go to any doctor or hospital they chose. • Doctors decided what treatment a patient needed and the insurance company paid all or most of the fees. • These plans were largely blamed for the rising cost of health care • Efforts to reduce cost • Shift away from fee-for-service to managed care plans

9. Managed Care Plans • Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan's network. How much of your care the plan will pay for depends on the network's rules.

10. Types of Managed Care Plans • Plans that restrict your choices usually cost you less. If you want a flexible plan, it will probably cost more. There are three types of managed care plans: • Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care. • Preferred Provider Organizations (PPO) usually pay more if you get care within the network. They still pay part of the cost if you go outside the network. • Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care. • http://www.nlm.nih.gov/medlineplus/managedcare.html

11. Side Effect of Managed Care • Lack of access and choice • Patients resent not being able to choose what doctors and hospitals they can see • Recent insurance companies because they make decisions about what treatment individuals get or do not get

12. Patient’s Bill of Rights (2010) • The Departments of Health and Human Services, Labor and Treasury collaborated on the Patient’s Bill of Rights – which will help children (and eventually all Americans) with pre-existing conditions gain coverage and keep it, protect all Americans’ choice of doctors, and end lifetime limits on the care consumers may receive. These new protections create an important foundation of patients’ rights in the private health insurance market that puts Americans in charge of their own health. • http://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/Patients-Bill-of-Rights.html

13. Medicare and Medicaid • Medicare (age 65 and over) • Pays a large share of their doctor, hospital, and nursing home bills. • Medicaid (very poor and disabled) • Pays for the medical expenses for poor people all ages, except those covered by Medicare • Federal government supply states with half the funds needed for the program • States come up with the rest of the funds and determine who is eligible for payments

14. Improving the Health Care System • Expand Government-Funded Programs • Child Health Insurance Program (CHIP) • Mandatory Coverage for Workers • Require all companies to provide health insurance for employees • Tax Reform • Tax breaks to people who must purchase their insurance on their own • Medical Savings Account • Employers would buy less expensive catastrophic coverage for their employees • Employers would use the money save to open a tax-free medical savings account

15. Improving the Health Care System • Managed Competition • Place the responsibility for providing health care in the hands of local, regional, or corporate health care networks • Insurance Pools for At-Risk People • Insurance companies to establish a pool for at-risk people similar to the pool for at-risk drivers • Universal Health Care • Health care for every American paid for by the government