2014 - Many ACA provisions take effect Remaining provisions will be phased in by 2020 Part 1. Health Care Costs and the Search for Solutions What is health care spending? Health care spending is a function of quantity (how much care is used) and the price paid for that care Americans currently spend more on healthcare than any other nation, but our outcomes are not better High levels of US spending is the result of far higher out-of-pocket payments by individuals and employers' contributions to workers' health insurance coverage Causes of increased spending Quantity is increased by poor health Americans are in poorer health than other nations when it comes to infant mortality and preventable chronic illness In the US obesity increases spending by 50%, but Americans are less likely than other nations to have access to the type of care that can actually help with obesity. Lack of access to the right care in the right place at the right time is a significant factor in cost. 100 million Americans live in communities designated as medically underserved because of poor health indicators and lack of access to primary care "Increased capability of medicine" A philosophy about medicine that values the steady and rapid introduction into the health care economy of high process technologies whose effectiveness and value are not well-analyzed before they become available. Problems - not necessarily more efficient or effective. Can increase cost without bettering outcomes. Health care fragmentation When different health care providers (doctors, therapists, hospitals, insurance companies) don't coordinate or work together to increase quality and efficiency of care The majority of the US health system is fragmented, cause problems with the continuity of care Integrated care, health care systems in which hospitals and physician practices are combined into a single enterprise that provides more complete integrated care, has proven to be significantly more effective and efficient. Cost of health insurance US relies on many small regional and national health insurance networks Other nations risk across the entire country, which cuts down on administrative costs and allows for collective bargaining The many different companies attempting to look for the best risks while excluding the worst The system results in a bad combination of risk selection market instability higher administrative costs insurance tied to employment the inability to control costs unpredictable and uncontrollable flow of financing Part 2. The Evolution of Heath Insurance and Health Insurance Law State Regulation of the Insurance Industry McCarran-Ferguson Act - left insurance regulation to the states by stipulating primacy of state law
2014 - Many ACA provisions take effect Remaining provisions will be phased in by 2020 Part 1. Health Care Costs and the Search for Solutions What is health care spending? Health care spending is a function of quantity (how much care is used) and the price paid for that care Americans currently spend more on healthcare than any other nation, but our outcomes are not better High levels of US spending is the result of far higher out-of-pocket payments by individuals and employers' contributions to workers' health insurance coverage Causes of increased spending Quantity is increased by poor health Americans are in poorer health than other nations when it comes to infant mortality and preventable chronic illness In the US obesity increases spending by 50%, but Americans are less likely than other nations to have access to the type of care that can actually help with obesity. Lack of access to the right care in the right place at the right time is a significant factor in cost. 100 million Americans live in communities designated as medically underserved because of poor health indicators and lack of access to primary care "Increased capability of medicine" A philosophy about medicine that values the steady and rapid introduction into the health care economy of high process technologies whose effectiveness and value are not well-analyzed before they become available. Problems - not necessarily more efficient or effective. Can increase cost without bettering outcomes. Health care fragmentation When different health care providers (doctors, therapists, hospitals, insurance companies) don't coordinate or work together to increase quality and efficiency of care The majority of the US health system is fragmented, cause problems with the continuity of care Integrated care, health care systems in which hospitals and physician practices are combined into a single enterprise that provides more complete integrated care, has proven to be significantly more effective and efficient. Cost of health insurance US relies on many small regional and national health insurance networks Other nations risk across the entire country, which cuts down on administrative costs and allows for collective bargaining The many different companies attempting to look for the best risks while excluding the worst The system results in a bad combination of risk selection market instability higher administrative costs insurance tied to employment the inability to control costs unpredictable and uncontrollable flow of financing Part 2. The Evolution of Heath Insurance and Health Insurance Law State Regulation of the Insurance Industry McCarran-Ferguson Act - left insurance regulation to the states by stipulating primacy of state law
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