Week 11: Health Reform and Policy Flashcards
Six ideals for The Need for Health Reform
- Too many people lack health coverage and care
- System focuses on treatment instead of prevention
- Lack of attention to health disparities
- Inefficient delivery and payment system
- U.S healthcare spending is unsustainable
- low -ranking U.S health outcomes
Three aims moving forward for ObamaCare
1.Improving the individual experience of care
2.Improving the health of populations
- Reducing the per capita cost of care for populations
Medicaid expansion
-Expanded eligibility for Medicaid through income levels
-Made the amount of income to qualify much higher for people threshold
-Higher paid people could qualify
-Good for childless adults and working parents
-Was not withheld in every state did adopt the expansion
-In the not expanded state there are still millions in the gap with no insurance
Health insurance marketplaces and subsidies
-New options for consumers
-Makes it user friendly and easier to find health insurance for consumers
-3 models of these marketplace
State run
State-federal partnership
Federally facilitated
Qualified Health Plans → private health plans sold to consumers
Must cover essential health benefits
Mandated in every healthcare insurance plans
Ambulatory
Emergency
Hospital
Maturity
Mental health
Prescription
Rehab
Lab
Wellness
Pediatric services
Insurance reforms
What they now CANNOT do→ what was happening before Obama care
Deny coverage due to existing conditions
-Rescind coverage over simple paperwork mistakes
-Lifetime caps on essential coverage
Charge women more than men
Most insurer have to do more →
Cover essential health benefits
-Cover preventive services with no copays or deductibles
-Young adults can now be covered up until the age of 26
-Justify double-digit rate increases (justified now)
Individual and employer mandates
“ Shared responsibility”
-Most individuals and families must obtain minimum essential coverage or pay a penalty
-Acceptable coverage included employer-based, plans in the marketplaces, public insurance and more
-Exemptions → religious objections, financial hardship, undocumented immigrants
-An employer of 50 or more employers must offer minimum essential coverage of full time employees or pay penalties
-Employers just made a bunch of part time employees
Affordable Care Act Summary :Insurance Reforms
- Medicaid expansion
- Health insurance marketplaces and subsidies
- Insurance reforms
4.Individual and employer mandates
- Health System Reform:
1.Prevention and Public Health ; Workforce and infrastructure provisions
- Improve quality and efficiency
.Prevention and Public Health ; Workforce and infrastructure provisions
-Prevention and public health fund
-Too much focus on treatment
US first mandatory funding for public health
-Meant to supplement existed funding
-Still under funded but a start
-Funding has since been cut back since the passing
4 major goals
1. Clinical prevention
2. Community prevention
Community transformation Grants (CTG)
Invested in evidence-based and practice based community strategies and programs
3. Workforce and infrastructure
-National Public Health Improvement Initiative (NPHII)
Focused on health departments to building tem and male more structural changes
4. Research and tracking
-National prevention council and strategy
-Community health needs assessments
-Community and school-based health center funding
-Public health and primary care workforce development
Health equity promotion
-Public health research
-Public education campaigns
-Menu labeling
Improve quality and efficiency
- Accountable Care Organizations (ACO)
Interdisciplinary medical sites
Coordinate care for medicare patients (those over age 65)
Providers get paid more if their patients are well
Networks of providers - Patient Centered Medical Homes
Primary care practices give monthly care for patients with chronic illness
Monthly fees - Other delivery and payments ( see slide 29)
Attitudes & Opinions
-It has become more favorable since 2017
-Dipped because the employer mandates were in effect
-Is health insurance necessary ??
Having Medicaid you are more likely to feel healthier
-Advantages and Disadvantages of the ACA
Obama Care Pros
-millions will now be insured
- cannot be dropped for little mistakes or when you get sick
-small business get tax credit for employee health insurance premium costs
young adults can stay on their parents until 26
Obama Care Cons
-in order to get money the rich will be more taxed
-not all states have expanded Medicaid
-cost of insurance overall goes up
-doesn’t address the qualify of care as much as just access in general
State polices for COVID19
-Happen a year after the quarantine started
- Use of CARES act funding to Address multiple social determinants of health
- Focused programs targeting specific pandemic-related social determinants of health and social needs
- Equity task forces for cross-government collaboration
State Policies Decrease
-hussain
-Social distancing plays a significant role on covid 19 pandemic
-Show relationship between the strictness of country wide policies and social distancing practice’s
-More people follow rules for pandemic when given
-The less strict the states are with social distancing policies, the more time it takes for life to return to normal
-The faster the government reacts, the less cases
-Governments with better policies see better compliances and therefore more cases
