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Flashcards in Final Deck (92)
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1

Policy makers

Frame the issue, pose the questions, define the problem and find a solution

2

Accountability

Process by which a party justifies and takes responsibility for its actions

3

Health equity

Distribution of resources so they are allocated to reflect need

4

3 dimensions of health equity

Availability: How services are provided to communities
Accessibility: How system is designed to meet patient need
Acceptability: Meet needs of different cultural groups

5

Massachusetts Model

Reform law to get all residents healthcare insurance . Mandated employer insurance and publicly funded for poor people

6

Medicare

Public insurance scheme for old people.

7

Medicaid

Public insurance scheme for poor people.

8

Federal medical assistance percentage

Used to determine amount federal government gives to state for social services program like health insurance

9

How is medicare funded

Through two trusts held by the US treasury. Part A (hospitals) are self-sustaining through payroll taxes

10

VHA

Veterans health administration: Closet thing US has to social medicine

11

Where did the push for healthcare reform come from

Under insured middle class

12

How much more does the US spend on healthcare. 2 reasons why.

90% more than other OECD countries
More disposable income
Less government control over cost

13

How does the US experience both an over, and undersupply of healthcare services?

Oversupply for the rich who get more than they need. The poor do not get what they require

14

What % of US healthcare provisions went to public insurance

60-65%

15

PPACA

Patient protection and affordable care act (Obamacare). Mandated private insurance. Significant over haul

16

3 Goals of obamacare

Increase quality and affordability of healthcare insurance
Lower uninsured rate by increasing public/private coverage
Reduce costs for individuals and government

17

What did obamacare require of insurance companies

Have new minimum standards that offer everyone the same rate regardless of pre-existing conditions

18

Prior to PPACA

Insurance was employment related and not required

19

CHIP

Childrens health insurance covers kids who are not eligible for medicaid

20

Problem with US before 2005 (3)

Healthcare highly decentralized, unregulated and market dependant
Incapable of addressing social/economic problems in healthcare provision
LACK OF CENTRALIZED POLITICAL CONTROL

21

3 FIERLBECK FLAWS IN US SYSTEM

Large portion of population does not have health insurance
Costs are significantly higher in US
Inequity in coverage-- private will limit coverage to secure profit margins

22

2 parts of government funded medicare

A: Hospital insurance funded through pay roll taxes
B: Supplementary insur: pay a monthly premium that covers 1/4 of cost

23

2 parts of out of pocket medicare

C: Medicare advantage: Private fee for service plan
D: Prescription drug plan

24

Why are a lot of people uninsured in the US

Can't afford private insurance but are not eligible for medicaid. Being low SES doesnt guarantee coverage

25

Who finances medicare

Shared cost between federal and state government. FMAP gives state money based on average income to limit inequities across states

26

Who determines eligibility for medicaid

State

27

What is the downside of a multi-payer system

Increases cost and limits service

28

How are coverage and cost containment tied together in the US.

Coverage declines when premiums go up.

29

How are costs contained in Canada

Limiting market saturation of services and limiting over supply. If you dont need it, youre not getting it.

30

Barriers to healthcare policy changes

Healthcare is rarely a focus of the leader
Doctors worry a public system will effect their income
Corporate interests-- healthcare is a business