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Health Care Issues. Cost – To Society Access Quality. Cost. Access: % without Health Insurance. Quality. Health Care Market. Competition large number of buyers and sellers Information buyer and seller have full information Externalities third parties do not bear costs or benefits.
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Health Care Issues • Cost – To Society • Access • Quality
Health Care Market • Competitionlarge number of buyers and sellers • Informationbuyer and seller have full information • Externalitiesthird parties do not bear costs or benefits
Competition • Licenses limit number of suppliers • Patents on pharmaceuticals create monopolies • Increasing number of health insurance providers limits bargaining powerall this increases costs
Information • Doctors, not patients, have most of the information • Doctors (providers) make the major decisions, but do not bear the costs
Externalities • Socialized costs: Insurance (government and private). • Socialized benefits: communicable diseases. • Government tax benefits subsidize expensive insurance. • Cost of care for uninsured passed on to the insured.
History of US Health Care • U.S. Health Care History • 1919: California Health Insurance defeated • 1935: Social Security Act: No Health Ins. • 1937: National Institute of Health • 1946: Hill-Burton Act: Hospital construction • 1950: Truman NHI defeated; AMA opposed • 1950's AMA supports Blue Cross\Blue Shield Health Insurance Tax deductible
History (Continued) • 1965: Medicaid and Medicare: (AMA opposed) • 1973: Health Maintenance Organizations (tax and regulatory preferences) • 1974: National Health Planning and Resources Development Act: {Certificates of Need} • 1986 (COBRA) – (continue plan after losing job) • 1994 Clintons' Health Care Plan defeated • 1996: Health Insurance Portability and Accountability Act -- continued coverage pre-existing conditions • 1997: CHIPS (children’s health insurance) • 2003: Health Savings Accounts
Europe National Health Service, or National Health Insurance Covers 80-100% of pop Covers 70-90 of costs United States Medicare (elderly) {Parts A & B} Medicaid (poor) Tax exclusion for employer coverage (middle class) Indian Health Services CHIPS (working poor, children) Veterans Health Care More…………. Health Care: Europe and US
Black Lung Health Benefits Municipal Hospitals Community Health Clinics Community Mental Health Kidney dialysis program Covers 45% of pop Covers 45% of cost (excluding tax benefits) US Programs (continued)