Role Of Goverment Flashcards
What does Laissez faire economics depend on?
Degree of competition, information and spillovers (lots of comp and free flowing information, few spillovers)
What are the problems with healthcare being laissez faire?
Competition is restricted, information is asymmetric, and spillovers are ubiquitous
What is the Department of Health and Human Services?
A government agency that oversees the FDA, CDC, Center for Medicare and Medicaid Services, and more
What are some implementations RFK would like to make?
- stricter food policy (less processed foods and less dyes)
- fewer protections for vaccine manufacturers
What is the FDAs job?
Ensure safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices
What is the trade-off the FDA is plagued with when it comes to products?
The speed vs the thoroughness of their approval
What do the Centers for Medicare & Medicaid Services do?
Manage Medicare, Medicaid, and the children’s health insurance program, and the ACA health insurance marketplace
What is the CDCs job?
Identify preventable health problems and maintains active surveillance of diseases
What is the job of the NIH?
Lead founder of medical and public health research
What is the Federal Trade Commissions job?
Monitor market power and consumer welfare
Hopes to prevent mergers and acquisitions and other anticompetitive practices that will reduce competition and increase prices
What do the DOJ, Department of Agriculture, and National Center for Health Statistics do?
- handle criminal prosecutions, survey health care fraud and medical malpractice
- oversees supplemental nutrition assistance program and children’s nutrition programs
- part of the CDC and oversees population surveys and vital records
When was Medicare Part D introduced?
2006
What is the Employee Retirement Income Security Act (ERISA)?
Provides minimum standards for plans but exempts self-insured plans from state-level legislation
What is the Consolidated Omnibus Budget Reconciliation Act (COBRA)?
Allows for continued coverage when an employee leaves a job, which is an attempt to reduce job lock
What is the Emergency Medical Treatment and Active Labor Act?
Requires emergency departments that accept Medicare to provide medical screenings to any patient, regardless of ability to pay
What is the Health Insurance Portability and Accountability Act (HIPAA)?
Provides guidelines for group health plans and some individual plans, also introduces minimum standards for electronic health records
What did the Balanced Budget Act of 1997 create?
Medicare Part C and CHIP
What insurance plans are exempt from policies related to insurance because of ERISA?
Self insured plans
What are is the major examples of state-level legislation of healthcare?
Medicaid is determined heavily by the states including covered services, payment levels, and expansion
What are certificate of need (CON) laws?
CON regulation assumes excess capacity stems from overbuilding of healthcare facilities
CON laws regulate the number of hospital beds (can extent to nursing homes, etc)
Do all states follow CON laws?
No
Where do federal and state government use price controls?
Medicare, Medicaid, and VA
What are price controls?
Cost containment tool
What are the tradeoffs of price controls?
Indirect rationing via waitlists, deterioration of quality, and gaming the system to increase revenues
What are the main focuses of courts regarding health policy?
- coverage provisions of private insurers
- antitrust
- tax exemption status
- medical malpractice
- antitrust law
What are some issues in expanding the courts role in healthcare?
Lack of proper knowledge of healthcare in judges, decentralized judicial system leads to inconsistent rulings, rulings not generalizable
What is a monopsony power?
One buyer (insurers)
What can antitrust consist of?
Monopoly power and monopsony power
What does the FTC and DOJ consider for monopoly power?
Natural monopolies, the need for intellectual property rights, and patient safety
What do courts focus on with monopsonies?
They often side with the insurer who can bargain as hard as it wants for lower prices from providers, when its not predatory ofc
What is medical malpractice?
When a provider, through negligence or omission, deviates from standard practice and causes injury to a patient
What are malpractice premiums?
Premiums doctors must pay for malpractice insurance which is needed because getting sued is so common
What are some proposed changes to malpractice?
- damage caps
- limits on attorneys fees
- joint and several liability
- evidence-based guidelines
- special health courts
- no-fault malpractice
- community and resolution programs
What is the Chevron Doctrine?
Held that when statutes are unclear and a federal agency regulates based on a “reasonable” reading of them, judges should uphold the regulation
