last three lectures Flashcards

1
Q

first state that required employers to provide insurane for workers

A
  • Hawaii Prepaid Health Care Act passes requiring employers to cover any employee working more than 20 hours/week, later expanded to State Health Insurance Program
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2
Q

who is eligible for healthy SF coverage

A

run by SF DPH

living on a combined family income at or below 400% of the Federal Poverty Level.
A San Francisco resident who can provide proof of San Francisco residency*;
Uninsured for at least 90 days**;
Not eligible for public insurance programs such as Medi-Cal, Medicare, or financial assistance to purchase insurance through Covered California;
Age 18orover

Some Healthy San Francisco Participants pay a fee for their health coverage. The Healthy San Francisco Participant Fee is based on a “sliding scale

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3
Q

individual mandate of obamacare

A

everyone needed insurance and subsidies provided to those that could not afford

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4
Q

how does medicare expansion cut costs

A

Reforms to the Medicare payment system are meant to promote greater efficiency in the healthcare delivery system by restructuring Medicare reimbursements from fee-for-service to bundled payments

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5
Q

4 commonly cites reasons we see increased spending per capita in US

A

administrative costs -BIGGEST DIFFERENCE
price (costs of doctor, procedure, drugs)
use of high technology
Health care outcomes same or worse

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6
Q

what current trend have we seen with premiums

A

Over the prior 10 years, insurance premiums had

risen 131%.

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7
Q

Four Basic Modes of Health Care Financing:

A

Out-of-pocket payment

Individual private insurance

Employment based private insurance

Government financing

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8
Q

free market

A

let individuals buy health insurance / care, subsidize the poor. Often called “consumer driven” but with issues of moral hazard.

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9
Q

what % of cancers are thought to be caused by environmental triggers

A

Approximately 80 – 90% of all cancers may be caused by environmental and lifestyle triggers1

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10
Q

6 major disparities in the US healthcare system

A

Infant Mortality

  1. Cancer Screening and Management
  2. Cardiovascular Disease
  3. Diabetes
  4. HIV Infection/AIDS
  5. Immunizations
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11
Q

3 layers of racism

A

institutionalized
personally mediated
internalized

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12
Q

New infections resulting from changes or evolution of existing organisms.

A

emerging

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13
Q

what is re-emerging disease

A

Answer: Cholera, Dengue fever, Diphtheria: Meningococcal meningitis, Yellow fever

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14
Q

Epidemiology looks at what?

A

Examines RISK FACTORS or EXPOSURE

that lead to DISEASE or OUTCOMES

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15
Q

the number or proportion of cases or events or conditions in a given population.

A

prevalence

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16
Q

Incidence

A

the frequency with which an event, such as a new case of illness, occurs in a population over a period of time

17
Q

measure of association which quantifies the relationship between an exposure and health outcome

A

Odds Ratio

different than relative risk which looks at exposure

18
Q

Bradford-hill criteria

A
temporal
strength 
dose-required relationship
consistency
plausability
consideration of alternative
experiment
specificity
coherence
19
Q

Free market - why is moral hazard an issue

A

consumer driven
Free market Free Patients who have low-deductible, low co-payment insurance will demand any and all pharmaceuticals and other treatments that promise any benefit at all, net of the risks and side effects of the treatment, without regard to cost. This is a standard “moral hazard” problem.
market

20
Q

how does improved mixed system work

A

Improved mixed system – regulate private insurance, expand public insurance (PPACA). “Managed competition”

21
Q

key provisions of patient Protection and Affordable Care Act

A

Private insurance regulation - fairer, plainer
Insurance exchanges - individuals / small business
Public expansion for poor (Medicaid, CHIP)
Medicare - close gaps, control costs
Individual mandate
Subsidies for poor / near-poor to purchase insurance
Payment reforms and quality initiatives

22
Q

Association Health Plans

A

all for negotiating power with small business

…can exempt people with pre-existing conditions.