资源简介

(共21张PPT)
GOVERNMENT AND THE MARKET FOR HEALTH CARE
Chapter 10
Uses of Health Care Funds in the U.S. (2010)
Source: Centers for Medicare and Medicaid Services [2012c].
10-*
Sources of Health Care Funds in the U.S. (2010)
10-*
Source: Centers for Medicare and Medicaid Services [2012c].
Private Health Insurance
The Implicit Subsidy for Employer-Provided Insurance
World War II era price controls
Federal tax subsidy
10-*
The Advantages of Employer-Provided Health Insurance
Increase the risk pool
Reduce adverse selection
Lower administrative costs
10-*
Employer-Provided Health Insurance and Job Lock
Job lock
Health Insurance Policy Portability and Accountability Act of 1996 (Kennedy-Kassenbaum Act)
10-*
Cost Control and Private Insurance
Cost-based reimbursement (fee-for-service)
Managed care
Capitation-based reimbursement
Health Maintenance Organizations (HMOs)
Preferred Provider Organizations (PPOs)
Point-of-service (POS)
10-*
Medicare Expenditures
(1966-2010)
Expenditures on Medicare as a Share of GDP
Real expenditures on Medicare
Source: Centers for Medicare and Medicaid Services [2012c].
10-*
How Medicare Works
Benefits
Part A – Hospital insurance (HI)
Part B – Supplementary Medical Insurance (SMI)
Financing
Payroll tax funds HI
General revenues fund SMI
10-*
Prescription Drug Benefit
Part C – Medicare Advantage
Part D – Prescription Drug Benefit
Monthly premium
Low deductible
Donut hole
Generous coverage for high costs
10-*
Cost Control Under Medicare
Medicare’s retrospective payment system
Medicare’s prospective payment system
Diagnosis related groups
Resource-based relative value scale system
Medicare Managed Care
10-*
Medicare: Impacts on Spending and Health
Expenditures on health care for the elderly
Health outcomes
10-*
Medicaid: Overview
Medicaid
State Children’s Health Insurance Program
10-*
Medicaid Expenditures
(1966-2010)
Source: Centers for Medicare and Medicaid Services [2012c].
10-*
Financing and Administration
Joint Federal-State financing
State administration
10-*
Benefits
States obligated to offer minimum package of benefits
States may offer more generous benefits
State administrative flexibility
10-*
Medicaid: Impacts on Health
Take-up rate
Crowding out
Empirical evidence: Are Medicaid expansions effective Crowding out and taking up
10-*
Does Public Insurance Crowd Out Private Insurance
Health insurance
Health insurance
Health insurance
Quantity of all other goods
Quantity of all other goods
Quantity of all other goods
A
A
A
F
F
F
B
B
B
M
M
M
0
0
0
Amount of publicly provided insurance
Amount of publicly provided insurance
Amount of publicly provided insurance
C
C
C
10-*
E
A. Person who places relatively high value on private insurance
B. Person who places relatively low value on private insurance
C. Person who is uninsured before public insurance
Health Care Reform
Individual mandates
The Massachusetts Plan
Health savings accounts
Catastrophic insurance policy
Single payer
International experiences
Canada
United Kingdom
10-*
Health Care Costs and Health Outcomes:
U.S., Canada, United Kingdom
10-*
Final Thoughts
Security vs. efficiency
No free lunch
Connection between health care expenditures and health
10-*

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