Policy-Making & Healthcare Systems Flashcards
Three types of insurance are prevalent in the US
- Employment Sponsored Insurance
- Medicare/Medicaid
- Uninsured
Understand the value of cost-effectiveness of MNT in health care
How insurance and health care are provided in other modern nations
- Our total health expenditures per capita are way more
- universal coverage
- uniform coverage
- costs paid by tax revenues or a combo of taxes, with the government
Two overall types of insurance
- Private: for a fee service
- Government/public health insurance: Medicare/Medicaid/CHIP
Describe Private Insurance
- Accounts for small percentage of insurance coverage today
- Pro: Greater flexibility and unrestricted access to providers/facilities
- Con: fee for service, may encourage providers for not needed services
Describe Government/Public Insurance plans
- Medicare/Medicaid
- workers comp
- CHIP
Describe Medicare
- Federally run 65+ or older
A. Hospital insurance, inpatient care–long-term care for 100 days annually, may have deductibles
B. Optional medical insurance, outpatient care–supplemental medical insurance benefits for certain medical expenses
Government/Public Insurance coverage gaps Medicare
Medicare, Part C: covers prescription drug coverage and skilled nursing/long term institutional care
What is medicaid
- joining state and federal for low-income, aged. blind, disabled, and children of one parent families
- income must be less than 133% of poverty line of state
- covers inpatient and outpatient
Talk about Medicaid CHIP
- for children in families with income above poverty level but too low to afford private health insurance
- federal and state
- inpatient and outpatient
Describe the uninsured
- working poor and self-employed, early retirees, unemployed
- use hospital emergency room care
- delayed treatment
What is the triangle need for health care reform
- Cost
- Access - Quality
What is the Affordable Care Act 2010
- reduces the number of people who are uninsured
- makes the health insurance system work better fr consumers
- focus to prevention and primary care
List and define 3 elements of policy making
Problem–discrepancy of what is and what should be
Policy– course of action by authorities
Policymaking– the actual process of which public authorities decide what they can do to address the problem
Describe the policy cycle
- Problem Definition and Agenda Setting
- Formulation of Alternatives
- Policy Adoption
- Policy Implementation
- Policy Evaluation
- Policy terminated if loss of support or not effective
Describe Formulation of Alternatives
Is it reasonable?
Policy Adoption
- tools and instruments are selected to achieve the policy goal
- on all levels of government
Policy Implementation
process of putting policy into action after modification if needed to target certain clientele
Policy of evaluation
Did it achieve its goal?
- 4 purposes of evaluation
Why would a policy be terminated?
- public need met
- nature of problem changed
- no longer mandated
- lost support
- policy too costly
Describe the process of a bill becoming law at the federal level
1) Citizen, group, or organization brings attention to legislative rep.
2) Bill is written, submitted to the clerk, where it is numbered and printed
3) Bill must be sponsored by at least one legislative member (house, senate, or both)
- Bill is referred to committee and subcommittee (voted on)
What are the two types of funding
Mandatory spending for entitlement programs: cannot be cut
ex. SNAP
Discretionary Spending: can be cut.
ex: energy expenses, defense expenses
What are the two additional SWOT Analysis Steps?
- Target Markets
- Market Segmentation
Target Markets
Develop a specific marketing strategy for each target audience
