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Overview of the U.S. Health Care System презентация
Содержание
- 1. Overview of the U.S. Health Care System
- 2. Coverage Health Insurance Coverage of the Non-elderly
- 3. Profile of the uninsured 47.0 million Americans
- 4. Employer-sponsored insurance Offered by employers as part
- 5. Individual insurance Purchased directly by people who
- 6. Medicare Covers elderly (ages 65 and older)
- 7. Medicare Four parts: Part A –
- 8. Medicaid Covers certain low-income individuals; not every
- 9. State Children’s Health Insurance Program (S-CHIP) Supplements
- 10. Other public insurance programs Veterans Health
- 11. Financing Individuals/ Businesses Government Health Service
- 12. Financing Individuals/ Businesses Government Health Service
- 13. Financing Individuals/ Businesses Government Health Service
- 14. Financing Individuals/ Businesses Government Health Service
- 15. Financing Individuals/ Businesses Government Health Service
- 16. Financing Where the Health Care Dollar
- 17. Financing Public versus Private Spending, 2003 Source: OECD Health Data 2005 public private
- 18. Financing Where the Health Care Dollar
- 19. Total Spending on Health Care, 2005 Source: OECD Health Data 2007 International perspective
- 20. Health Care Spending per Capita, 2005 Source: OECD Health Data 2007 International perspective
- 21. Health status and outcomes Life Expectancy at Birth, 2004-5 Source: OECD Health Data 2007
- 22. Health status and outcomes Infant Mortality, 2004-5 Source: OECD Health Data 2007
- 23. The patchwork
Coverage Health Insurance Coverage of the Non-elderly Population, 2003 Source: Kaiser Commission on Medicaid and the Uninsured (KCMU) and Urban Institute analysis of the March 2004 Current Population Survey
Слайд 2Coverage
Health Insurance Coverage of the Non-elderly Population, 2003
Source: Kaiser Commission on
Medicaid and the Uninsured (KCMU) and Urban Institute analysis of the March 2004 Current Population Survey
Слайд 3Profile of the uninsured
47.0 million Americans
81% from working families
52-59% from low-income
families (200% FPL)
80% are adults
50% are ethnic minorities
79% are American citizens
80% are adults
50% are ethnic minorities
79% are American citizens
Source: Kaiser Commission on Medicaid and the Uninsured
Source: US Census Bureau
Слайд 4Employer-sponsored insurance
Offered by employers as part of benefits package
Administered by private
insurance companies (for-profit and non-profit)
Employer pays bulk of premium; employee pays remainder
Significant erosion of employer-sponsored insurance in recent years
Employer pays bulk of premium; employee pays remainder
Significant erosion of employer-sponsored insurance in recent years
Слайд 5Individual insurance
Purchased directly by people who do not get coverage through
their employers
Non-group (individual) plans
Premiums based on individual health risk
High-risk individuals with limited access
Administratively expensive
Non-group (individual) plans
Premiums based on individual health risk
High-risk individuals with limited access
Administratively expensive
Слайд 6Medicare
Covers elderly (ages 65 and older) and non-elderly with disabilities
Administered by
the federal government (essentially a single-payer system)
Financed through:
Federal income taxes
Payroll taxes
Out-of-pocket payments by enrollees
Financed through:
Federal income taxes
Payroll taxes
Out-of-pocket payments by enrollees
Слайд 7Medicare
Four parts:
Part A – hospital insurance
Part B – supplemental insurance
Part
C – managed care
Part D – prescription drugs
Significant coverage gaps - most enrollees obtain supplemental insurance
Spending growth generally slower than private insurance
Aging population and increased technology presents challenges for the future
Part D – prescription drugs
Significant coverage gaps - most enrollees obtain supplemental insurance
Spending growth generally slower than private insurance
Aging population and increased technology presents challenges for the future
Слайд 8Medicaid
Covers certain low-income individuals; not every poor person is covered!
Administered by
state governments
Often out-sourced to non-government administrators
Financed jointly by the state and federal governments
Benefits are fairly comprehensive, but many providers won’t take care of Medicaid patients
Often out-sourced to non-government administrators
Financed jointly by the state and federal governments
Benefits are fairly comprehensive, but many providers won’t take care of Medicaid patients
Слайд 9State Children’s Health Insurance Program (S-CHIP)
Supplements Medicaid by covering low-income children
who are ineligible for Medicaid
Administered and financed similarly to Medicaid
Similar problems to Medicaid:
Low reimbursement rates → some providers refuse to accept S-CHIP
Under-enrollment
Eligibility varies by specific populations and states
Administered and financed similarly to Medicaid
Similar problems to Medicaid:
Low reimbursement rates → some providers refuse to accept S-CHIP
Under-enrollment
Eligibility varies by specific populations and states
Слайд 10Other public insurance programs
Veterans Health Administration
Health benefits plan available to
all veterans
Services delivered through VA health care facilities (“socialized medicine”)
Financed by the federal government
Indian Health Service
Services delivered through VA health care facilities (“socialized medicine”)
Financed by the federal government
Indian Health Service
Слайд 11Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP, VA, IHS
payments to
providers
public employees’ premiums
subsidies
Слайд 12Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP, VA, IHS
payments to
providers
public employees’ premiums
subsidies
Слайд 13Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP, VA, IHS
payments to
providers
public employees’ premiums
subsidies
Слайд 14Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP, VA, IHS
payments to
providers
public employees’ premiums
subsidies
Слайд 15Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP, VA, IHS
payments to
providers
public employees’ premiums
subsidies
Слайд 16Financing
Where the Health Care Dollar Came From, 2003
Source: Centers for
Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group
Слайд 18Financing
Where the Health Care Dollar Went, 2003
Source: Centers for Medicare
& Medicaid Services, Office of the Actuary, National Health Statistics Group
