Week 4 Flashcards
American’s view of US healthcare quality and coverage
-44% think good quality
-28% say good coverage
-with own healthcare: 71% and 65%
What is right w the US healthcare system
-tech
-knowledge
-large and well trained HCPs
-facilities
-lots of $$$
-preventative care (flu shots, screenings)
-engaging
-safety (alerts and review)
Healthcare sector employment
-lots of people employed compared to other professions
What’s wrong with healthcare system
-cost (17% of gnp) and rising
-higher spending for worse outcomes (about twice as much)
-higher costs for inpatient/outpatient care(hospital and clinics) and Rx
-access
-financial toxicity
-Disconnect between what we pay for and what we value and outcomes achieved: pay more for doing more, incentives to produce better health are lacking, life expectancy, infant mortality, etc doesnt measure up
-spend too much on elderly without clear benefits
-small % of population consumes most recources
-drug companies can charge whatever they want
-lack of cost transperancy
-equity issues
-too few PCPs
-practitioner burnout
-lack of care coordination
-powerful healthcare lobby
-politicians dictate how HCP should practice
-public health underfunded and pushed off as a local responsibility
-no focus on preventable deaths (gun violence, drug OD, alcohol injuries, suicide)
Financial toxicity
-14% of individuals contacted by a collection agency for unpaid bills
US life expectancy 2024
-79.25 years
-trending up but kinda plateau
-likely to be flat by 2050
-COVID19 and opioid epidemic cause a down in 2020
Life expectancy by race 2022
-Hispanic = 80 years
-white is at life expectancy avergage = 77.5
-black = 72.8
life expectancy by region
-worse in the south
-pacific and NE have higher life expectancy
Life expectancy in comparable countries
-80 years
-5 years higher than US
-also had less of a dip during COVID (response to covid but also opioid epidemic)
US healthcare ranking
-10th overall, in access, and in outcomes
-2nd in care process
-9th in efficiency and equity
-australia is number 1
Top performing countires:
-provide universal coverage and remove barriers
-invest in primary care systems to ensure high-value services are equitably available in all communities to all people
-reduce admin burdens that divert times, efforts, and spending on HC improvements
-invest in social services (esp for children and workers)
Trajectory of Medicare spending in last year of life
-rapidly increases no matter if high or moderate persistent or progressive or late rise
impact of age on spending
-36% of healthcare expenditures are by 65+
Healthcare spending by income
-top 1% spends 24%
-top 50% spends 97%
-bottom 50% spends 3%!!!
cost of drugs in US vs rest of world
-sky-high
-over double compared to other countries
-4k vs $800 for humira
-humira price increased from $500 to $3k in less than 20 years, profits inc by $13k million!!!
-drug companies get exclusivity w PBMs which deincentivizes competition
Generic drug share of rxa
-makes up 90% of dispensed Rxs but only accounts for 19.8% of spending
-brand name drugs are driving high costs
healthcare access issues
-esp poor and rural
-geography (nebraska, kansas, dakotas)
-pharmacy deserts (25% of neighborhoods)
-# PCP per 10k pt
-avg costs of annual health insurance premiums
equity issues
-adults w below avg income have poorer access to healthcare, less timely care, less engagement w providers
-race
-ppl employed by larger employers have better access to healthcare and better coverage
Coverage in small firms vs large firms
-workers at small firms pay HIGHER premiums and HIGHER deductibles than workers at large firms
Too few PCPs
-poorly distributed
-poorly reimbursed
-5-7% off total $ spent on primary care
-2.8% on public health
Politicians dictatin how HCP should practice
-women’s health
-pediatrics
-gun violence deaths
-mental health
-public health (underfunded)
