COST, ACCESS, & HEALTH POLICY Flashcards
What is cost?
price
What is charged or what is paid
Payment
what is actually paid
Which should you pay more attention to as a practicing PT?
price or payment
payment
Which should you pay more attention to as a health care consumer?
(price or payment)
price
1965-1970
Passage of Medicare/Medicaid = huge increase in utilization as elderly now have coverage through Medicare
1985-1990
Medicare implementation of DRGs causing massive reduction in inpatient acute LOS
1995-2000
Implementation of Balanced Budget Act PLUS effect of HMOs in reducing utilization
2000-2005
Implosion of HMOs and subsequent reversal of cost control measures
2005-2010
Rise of CDHPs and HDHPs, putting more cost responsibility on patients
2010-2015
Passage of ACA with Medicare payment reductions implemented to pay for Medicaid expansion
Why control health care spending?
Increased NHE consumes more of the U.S. economic output
Insurance creates moral hazard
Increased cost to American business
Reduced access to insurance
Is too expensive – people cannot afford to receive care
No one wants to pay higher taxes
U.S. health care system is neither a
Highly regulated market
Highly competitive market
Life expectancy 1900
47
Life expectancy 2010
81
Certificate of Need (CON)
Meant to control capital spending = new hospitals, new buildings, new equipment
Must essentially ask for permission to add any of the above
Has largely failed to reduce NHE
