The American Health Care System. Tom Schlesinger, Ph.D . Executive Consultant Gundersen Lutheran. How the current system came about. Medicine in early 20 th Century. Physician. Patient. Medicine in the 1930s-1970s Third Party Payment. Physician. Problems Overconsumption
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Tom Schlesinger, Ph.D.
Payer has no impact on supply and demand
How else can we as a society try and control costs while improving quality?
U.S. only developed country w/o near universal coverage*
US has over 15% uninsured
- 45.7 million people
Equal to populations of
New York, Ohio, Pennsylvania
Liberty/ Minimal government
Emphasis on Equity/Fairness
Role of Government to correct market failures
Subsidies for poor/small businesses
Expansion of Medicaid Coverage
Improve individual/sm business market
the United States ranks:
Infant mortality – ?
Life Expectancy – ?
U.S. health status varies based on race, income
But in terms of:
We rank near the top
- Much of this due to lifestyle choices
The top-spending 5% of patients account for almost 50% of all costs!
Pay for Performance