Đang tải... (xem toàn văn)
After reading this chapter, you should be able to: Convey important facts about rising health care costs in the United States, relate the economic implications of rising health care costs, discuss the problem of limited access to health care for those without insurance, list the demand and supply factors explaining rising health care costs, summarize the goals of the Patient Protection and Affordable Care Act and the major changes that it institutes.
21 HealthCare McGrawưHill/Irwin Copyrightâ2012byTheMcGrawưHillCompanies,Inc.Allrightsreserved U.S.EmphasisonPrivateHealthInsurance Patient Protection & Affordable Care • • • • LO1 Act (2009) During WWII employers offered insurance Continued as an employee benefit Led to overuse & higher prices Tendency to regulate industry 21-2 Costs and Access • Costs increased rapidly • Higher prices • Increased quantity of services • Projected to grow at 6.1% annually • LO1 over next 10 years Access • 46 million uninsured 21-3 Health Care Spending Sources of Funds Health Care Expenditures Dent al, Vision, Misc., 22% Physicians, 21% LO1 Medicaid, 15% Program Admin, 7% Prescript ion Drugs, 10% Hospit als, 31% Medicare, 20% Nursing Homes and Home Healt h Care, 9% Private Health I nsurance, 33% Military, Other Public I nsurance, 13% Other Private Expend., 7 % Copayments, Deductibles, etc., 12 % 21-4 Health Care Spending • Costs as a percentage of U.S GDP LO1 21-5 Health Care Spending • Is the U.S healthier? • Longer life expectancies • Most advanced medical equipment and technologies • Half of medical research funding is in U.S • Increase in breast cancer mortality • TB has reappeared • AIDS epidemic LO1 21-6 Economic Implications of Rising Costs • Reduced access to care • Labor market effects • Slower wage growth • Part-time and temporary workers • Outsourcing and offshoring • Personal bankruptcies • Impact on government budgets LO2 21-7 Limited Access • The poor are likely to be uninsured • Make “too much” to qualify for • LO3 Medicaid Waiting for treatment increases costs 21-8 Why the Rapid Rise in Costs? • Peculiarities of the health care market • Ethical and equity considerations • Asymmetric information • Positive externalities • Third-party payments: insurance LO4 21-9 Why the Rapid Rise in Costs? • Increasing demand for health care • Rising income • Role of elasticity • Aging population • Unhealthy lifestyles • Role of doctors • Supplier induced demand • Defensive medicine • Medical ethics LO4 21-10 Why the Rapid Rise in Costs? • Role of health insurance • The moral hazard problem • Less prevention • Overconsumption • Government tax subsidy • Rationing to control costs LO4 21-11 Supply Factors in Rising Health Costs • Supply of physicians • Slow productivity growth • Changes in medical technology • Relative importance of supply and demand factors LO4 21-12 Cost Containment: Altering Incentives • Deductibles and copayments • Health Savings Accounts (HSA) • Managed care • Preferred Provider Organizations (PPO) • Health Maintenance Organizations (HMO) • Medicare and DRG • Limits on malpractice awards LO4 21-13 Patient Protection & Affordable Care • Preexisting conditions, caps, and • • • • • • LO5 drops Employer mandate Personal mandate Covering the poor Insurance exchanges Other provisions Taxes 21-14 Patient Protection & Affordable Care • Objections and alternatives • Greater inefficiencies in health care • First step to national health insurance • Lack of revenue sources • Increased consumption • Need to force consumers to weigh marginal benefits and costs LO5 21-15 ... Expend., 7 % Copayments, Deductibles, etc., 12 % 2 1-4 Health Care Spending • Costs as a percentage of U.S GDP LO1 2 1-5 Health Care Spending • Is the U.S healthier? • Longer life expectancies • Most... exchanges Other provisions Taxes 2 1-1 4 Patient Protection & Affordable Care • Objections and alternatives • Greater inefficiencies in health care • First step to national health insurance • Lack of revenue... • Peculiarities of the health care market • Ethical and equity considerations • Asymmetric information • Positive externalities • Third-party payments: insurance LO4 2 1-9 Why the Rapid Rise in Costs?