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Презентация на тему Overview of the U.S. Health Care System

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CoverageHealth Insurance Coverage of the Non-elderly Population, 2003Source: Kaiser Commission on Medicaid and the Uninsured (KCMU) and Urban Institute analysis of the March 2004 Current Population Survey
Overview of the U.S. Health Care System American Medical Student Association CoverageHealth Insurance Coverage of the Non-elderly Population, 2003Source: Kaiser Commission on Medicaid Profile of the uninsured47.0 million Americans81% from working families52-59% from low-income families Employer-sponsored insuranceOffered by employers as part of benefits packageAdministered by private insurance Individual insurancePurchased directly by people who do not get coverage through their MedicareCovers elderly (ages 65 and older) and non-elderly with disabilitiesAdministered by the Medicare Four parts:Part A – hospital insurancePart B – supplemental insurancePart C MedicaidCovers certain low-income individuals; not every poor person is covered!Administered by state State Children’s Health Insurance Program (S-CHIP)Supplements Medicaid by covering low-income children who Other public insurance programs Veterans Health AdministrationHealth benefits plan available to all Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies Financing Where the Health Care Dollar Came From, 2003Source: Centers for Medicare Financing Public versus Private Spending, 2003Source: OECD Health Data 2005publicprivate Financing Where the Health Care Dollar Went, 2003Source: Centers for Medicare & Total Spending on Health Care, 2005Source: OECD Health Data 2007International perspective Health Care Spending per Capita, 2005Source: OECD Health Data 2007International perspective Health status and outcomes Life Expectancy at Birth, 2004-5Source: OECD Health Data 2007 Health status and outcomes Infant Mortality, 2004-5Source: OECD Health Data 2007 The patchwork
Слайды презентации

Слайд 2 Coverage
Health Insurance Coverage of the Non-elderly Population, 2003
Source:

CoverageHealth Insurance Coverage of the Non-elderly Population, 2003Source: Kaiser Commission on

Kaiser Commission on Medicaid and the Uninsured (KCMU) and

Urban Institute analysis of the March 2004 Current Population Survey

Слайд 3 Profile of the uninsured
47.0 million Americans
81% from working

Profile of the uninsured47.0 million Americans81% from working families52-59% from low-income

families
52-59% from low-income families (200% FPL)
80% are adults
50% are

ethnic minorities
79% are American citizens



Source: Kaiser Commission on Medicaid and the Uninsured
Source: US Census Bureau

Слайд 4 Employer-sponsored insurance
Offered by employers as part of benefits

Employer-sponsored insuranceOffered by employers as part of benefits packageAdministered by private

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

Слайд 5 Individual insurance
Purchased directly by people who do not

Individual insurancePurchased directly by people who do not get coverage through

get coverage through their employers

Non-group (individual) plans
Premiums based on

individual health risk
High-risk individuals with limited access

Administratively expensive

Слайд 6 Medicare
Covers elderly (ages 65 and older) and non-elderly

MedicareCovers elderly (ages 65 and older) and non-elderly with disabilitiesAdministered by

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

Слайд 7 Medicare
Four parts:
Part A – hospital insurance
Part B

Medicare Four parts:Part A – hospital insurancePart B – supplemental insurancePart

– 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

Слайд 8 Medicaid
Covers certain low-income individuals; not every poor person

MedicaidCovers certain low-income individuals; not every poor person is covered!Administered by

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

Слайд 9 State Children’s Health Insurance Program (S-CHIP)
Supplements Medicaid by

State Children’s Health Insurance Program (S-CHIP)Supplements Medicaid by covering low-income children

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

Слайд 10 Other public insurance programs
Veterans Health Administration
Health benefits

Other public insurance programs Veterans Health AdministrationHealth benefits plan available to

plan available to all veterans
Services delivered through VA

health care facilities (“socialized medicine”)
Financed by the federal government
Indian Health Service

Слайд 11 Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP,

Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies

VA, IHS
payments to providers
public employees’ premiums
subsidies

Слайд 12 Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP,

Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies

VA, IHS
payments to providers
public employees’ premiums
subsidies

Слайд 13 Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP,

Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies

VA, IHS
payments to providers
public employees’ premiums
subsidies

Слайд 14 Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP,

Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies

VA, IHS
payments to providers
public employees’ premiums
subsidies

Слайд 15 Financing
Individuals/
Businesses
Government
Health Service
Providers
Private
Insurers
premiums
taxes
direct/out-of-pocket payments
Medicare, Medicaid, SCHIP,

Financing Individuals/BusinessesGovernmentHealth Service ProvidersPrivate Insurerspremiumstaxesdirect/out-of-pocket paymentsMedicare, Medicaid, SCHIP, VA, IHSpayments to providerspublic employees’ premiumssubsidies

VA, IHS
payments to providers
public employees’ premiums
subsidies

Слайд 16 Financing
Where the Health Care Dollar Came From,

Financing Where the Health Care Dollar Came From, 2003Source: Centers for

2003
Source: Centers for Medicare & Medicaid Services, Office of

the Actuary, National Health Statistics Group

Слайд 17 Financing
Public versus Private Spending, 2003
Source: OECD Health

Financing Public versus Private Spending, 2003Source: OECD Health Data 2005publicprivate

Data 2005
public
private

Слайд 18 Financing
Where the Health Care Dollar Went, 2003
Source:

Financing Where the Health Care Dollar Went, 2003Source: Centers for Medicare

Centers for Medicare & Medicaid Services, Office of the

Actuary, National Health Statistics Group

Слайд 19 Total Spending on Health Care, 2005
Source: OECD Health

Total Spending on Health Care, 2005Source: OECD Health Data 2007International perspective

Data 2007
International perspective

Слайд 20 Health Care Spending per Capita, 2005
Source: OECD Health

Health Care Spending per Capita, 2005Source: OECD Health Data 2007International perspective

Data 2007
International perspective

Слайд 21 Health status and outcomes
Life Expectancy at Birth,

Health status and outcomes Life Expectancy at Birth, 2004-5Source: OECD Health Data 2007

2004-5
Source: OECD Health Data 2007

Слайд 22 Health status and outcomes
Infant Mortality, 2004-5
Source: OECD

Health status and outcomes Infant Mortality, 2004-5Source: OECD Health Data 2007

Health Data 2007

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