US Healh Care System, Reform, National Health Insurance

Question 1

What is primary, secondary and tertiary care

Answer 1

P: common health problems, preventative cre
S: more specialized care, hospital based
T: Rae and complex care

Question 2

What is the regionalized model

Answer 2

The traditional British National health service
1. GP
2. Hospital-based clinics
3. Sub specialists
*located at few tertiary care medical centers

Question 3

What is the disperse model

Answer 3

Traditional untied states health care organization
1. Much less structure
2. Patients can choose to self refer to specialist
3. Primary care + generalists = 33%

Question 4

What are the concepts of primary care

Answer 4

1. First contact
2. Longitudinality
3. Comprehensiveness
4. Coordination

Question 5

What are the goals of primary care

Answer 5

1. Better patient experiences
2. Better outcomes
3. Lower costs

Question 6

What is patient-centered medical home

Answer 6

Has four basic concepts
1. Primary care
2. Patient-centered care
3. New-model practice
4. Payment reform

Question 7

What is patient centered medical home needed?

Answer 7

1. Impending collapse of primary care medicine
   *too fe PCP
   *Lower pa for PCP
   *Gaps in quality

Question 8

What is national health insurance

Answer 8

The guarantee of health insurance for all the nations residents

Question 9

What is the affordable care act?

Answer 9

1. Increase the quality and affordability of health insurance
2. Lower the number of uninsured by expanding public and private insurance coverage
3. Reduce the costs of health care for individuals and government

Question 10

What is the pluralistic reform model (ACA)

Answer 10

1. Individual mandate
2. Employer mandate
3. Medicaid eligibility expansion
4. Insurance market regulation

Question 11

What would happen if the pluralistic reform model was implemented

Answer 11

1. 32 million uninsured Americans would receive insurance coverage
   *1/2 through Medicaid expansion
   *1/2 through individual mandate
   *would not benefit the undocumented immigrants

Question 12

Is the individual mandate still around? (ACA)

Answer 12

No
1. It would require all US citizens to have insurance coverag
2. If a person could not purchase insurance there would be a tax penalty
3. Indented to reduce uncompensated care and expand insurance plan risk pools to reduce coverage price

Question 13

What is the employer mandate (ACA)

Answer 13

1.large employers must offer an affordable health plan providing minimum value to >95% of full time employees or face a fine
*affordable cost less than 9.5% of employee only income

Question 14

What is the Medicaid eligibility expansion (ACA)

Answer 14

1. Went into effect 1/1/2014
2. Eliminated categorical eligibility (made it more income based)
3. Meet the national Medicaid minimum 138% FPL

Question 15

What is insurance marketplace regulation (ACA)

Answer 15

1. Private plans required to cover young adults up to age 26 on parents plan
2. Eliminates cap on total insurance benefit payouts

Question 16

How is ACA funded

Answer 16

1. New taxes
2. Cost savings in Medicare and Medicaid programs

Question 17

What are some of the problems with ACA

Answer 17

High deductible for some
Unaffordable out-of-pocket limit

Question 18

What are some of the advantages of universal health care

Answer 18

1. Equality
2. Cost savings
3. Employers relieved of burden of supplying health insurance
4. Health insurance delinked from job

Question 19

What are some of the disadvantages of universal health care

Answer 19

1. Bureaucracy
2. Too much power over peoples health choices
3. Tax burden