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A discussion of the state and future of the healthcare industry.

June Tran

on 16 February 2014

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Transcript of Healthcare

A discussion of the current state of the healthcare industry.
Health Care
Policy Economics
We can improve the healthcare system by:
1) Expanding the Medicaid program to include all of the impoverished.
2) Create a creative mix of public and private sectors in order to provide cheap and regulated health care.
3) Eliminate pre-existing conditions from individual health care.
Advantages and Disadvantages of the system
15.7% of the population is still uninsured (48.6 million people.
Managed Healthcare
Healthcare Cost
The United States spends tremendous amount of money on healthcare, nearing $2.6 trillion in 2010 (ten times the amount spent in 1980).
Since 2002, employer-sponsored health care premiums have increased by 97%. Today the health care premiums is 4% (last year the premiums leaped 9% from the year before).
This rate had slowed relative to the early 2000’s, but this growth is still expected for the future.
Hospital care and clinical/physician services (combined) accounts for 51% of the nation’s health expenditures (2010).
What is driving the healthcare spending?
Technology & prescription drugs- the availability of more sophisticated and updated drugs fuels healthcare spending for development costs.

Rise in chronic diseases- the prevalence of chronic diseases places pressure on the health care system. Chronic disease treatment accounts for over 75% of health care expenditures.

Administrative costs- At least 7% of health care spending goes to administrative costs of government health care programs and the net cost of private insurance.
Individual health insurance is purchased by a single person, either for oneself or for one's family.
Group health insurance is designed for the purpose of a company purchasing insurance for its employees.
Cost: Rated based on the applicant sole lifestyle, medical history, and social affiliations.
Coverage: Individual health insurance requires all applicants to undergo medical examination before their policy can be approved. They're tailored to fit the needs of the insured just by adding or removing certain policy riders.
Accessibility: Easy to obtain quote by going on the internet.
Average cost of private insurance rose to $4,547 in 2011, compared with $4,349 in 2010.
Cost: Usually cheaper than individual since it is coverage for a group of people. Typically group insurance is very comprehensive, meaning that each employee will not have to pay any additional fees unless anyone opts for additional benefits that are not offered within the group.
Coverage: Guarantees that every individual who applies for a plan gets accepted just as long as one is an employee of the company. No individual can be denied insurance coverage due to pre-existing conditions, however, employer or company decide which benefits to purchase.
Employers continues to subsidize the big chunk of costs, covering 73% over the bill for family coverage.
Most of the nation’s 48.6 million uninsured are low or moderate income. In all, nine in ten of the uninsured are in low- or moderate-income families (400% below poverty). Since the average annual cost of employer-sponsored coverage in 2012 was $15,745, many cannot afford the premiums without employer contribution.
Characteristics of the uninsured
Children are the least likely to be uninsured because they are more likely to qualify for public coverage (Medicaid or the Children’s Health Insurance Program).
The uninsured rate among young adults was 27.9% in 2011. However, there been a 40% overall decline in the number of uninsured, due in part to the ACA provision allowing them to remain on a parent’s private health plan until age 26.
Over three-quarters of the 48.6 million uninsured in the U.S. are in working families . Most of these workers are self-employed or work at small companies (unlikely to be covered). Low-wage workers who are offered coverage often cannot afford their share of the premiums, especially for family coverage.
Workers usually enroll in employer-sponsored health insurance if they are eligible. However, due to high premiums, it has become increasingly difficult for many workers to afford coverage.
The uninsured pay for more than one-third (35%) of their care out-of-pocket. They are usually billed for any care they receive, often paying higher charges than the insured.
Freedom of choice

C) Best medical research system due to a combination of private and public fundings.
A) Doctors can choose where to practice medicine.
B) Patients can choose the doctor from whom they want to receive care.
A) Cost of medical care in the United States is rising at a faster pace than other national expenses. In 2010, health expenditures accounted for 17.9% of the nation’s Gross Domestic Product.
B) Even though the United States spends outrageous amount of money in the healthcare industry, 48.6 million people are still uninsured (15.7% of the total population).
C) High administrative costs due to the aggregation of funding sources, insurance carriers, payment mechanisms, and hospital administration systems.
E) Health maintenance organizations tends to seek out subscribers who are healthy and young, since it will profit by not spending the subscriber's fees on health care.
Why is it difficult to reform the healthcare system?
1) There is an absence of collective responsibility for the vulnerable members of the American society (low income families, the elderly and veterans). Discussions within the administration are mainly about the cost and protection of certain industry rather than about people who needs help.

2) Difficult to balance between the polarized goals of increasing access and maintaining cost. There is a lot of debate about the distribution of resources and assessment of who will bear the burden of keeping these costs in check.
3) There is a large debate about the roles of competition and regulation; whether or not the patients will be served better by the market/private sector or government regulated organizations. The legislation must find a way to balance the system to contain a mix of regulation as well as market incentives.
4) Political partisanship: there is a decline in cooperation between the two major parties due to an unwillingness to overcome differences and reach a general consensus.
1) Universal healthcare: a system in which residents of the area covered are automatically insured with basic healthcare services. Many countries offer universal healthcare to its citizens in a public-private combination. Proponents of this system believes the federal and state government should play a major role in providing health care. Similarly, they also believe that it would solve the problems of cost, access and equality. Opposition for this theory believes that the government should allow its people to deal with their health care as they see fit. Another reason stems from the system’s ability to significantly increase taxes.

4) Putting faith in the free market competition.
2) Expanding Medicare to the entire population.
3) Price control and imposing a strict budget on healthcare spending.
1) Americans can take personal responsibilities for their health. This would involve going on a proper diet, getting regular exercising and sufficient sleep.
2) Following the doctor’s recommendations with regular visits and preventative care.
Under the federal law, less than one half of those
who are at or below the poverty line are covered
by Medicaid (national: 43%).
Accessibility: This type of coverage may be purchased on the open market, similar to individual health insurance.
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"What you need to know about Individual Health Insurance vs. Group Health Insurance". Health.org. <http://www.healthcare.org/resource-center/individual-vs-group-health-insurance/>(12 January 2013).
Baribault, Maryann and Cloyd, Carey. "Health Care Systems: Three International Comparisons". Stanford.edu. July 1999. <http://www.stanford.edu/class/e297c/poverty_prejudice/soc_sec/health.htm> (12 January 2013).
Steinbrook, Robert. "Imposing Personal Responsibility for Health". The New England Journal of Medicine. August 2006. <http://www.nejm.org/doi/full/10.1056/NEJMp068141> (12 January 2013).
Fox, Emily Jane. "Fewer Americans uninsured - Census Bureau". CNNMoney. September 2012. <http://money.cnn.com/2012/09/12/news/economy/census-bureau-health-insurance/index.html> (12 January 2013).
Walling, Linda Hanna. "Why Is Health Care Reform So Difficult?". Huffington Post. March 2012. <http://www.huffingtonpost.com/linda-hanna-walling/why-is-health-care-reform_b_486100.html> (12 January 2013).
Klff, Sarah. "Health insurance costs grew slowly for two years. Now, they’re speeding up". Washington Post. September 2012. <http://www.washingtonpost.com/blogs/wonkblog/wp/2012/09/25/health-insurance-costs-grew-slowly-for-two-years-now-theyre-speeding-up/> (14 January 2013).
(Costs on picture are not accurate)
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