Week 9 Flashcards
Does the U.S. have a universal healthcare system?
No, it has a mixed system with public and private insurance.
What are the main public health insurance programs in the U.S.?
Medicare, Medicaid, CHIP, VA, and TRICARE.
Who qualifies for Medicare?
Seniors (65+), certain disabled individuals, and those with end-stage renal disease.
What is Medicaid?
A joint federal-state program providing health coverage for low-income individuals.
What is CHIP?
The Children’s Health Insurance Program for low-income families.
What are the primary forms of private health insurance in the U.S.?
Employer-sponsored plans and individual market plans (ACA Marketplace).
How is healthcare financed in the U.S.?
Through a combination of employer/individual premiums, government funding, and out-of-pocket costs.
What is the largest category of health insurance in the U.S.?
Employer-sponsored health insurance.
What are high-deductible health plans (HDHPs)?
Insurance plans with lower premiums but higher out-of-pocket costs, often paired with Health Savings Accounts (HSAs).
What are the main challenges of the U.S. healthcare system?
High costs, uninsured populations, health disparities, and an aging population
What is value-based payment in healthcare?
A model where providers are paid based on patient outcomes rather than services provided.
How does the Affordable Care Act (ACA) help individuals get insurance?
It provides subsidies for low-income individuals to buy private insurance through the Marketplace.
Why is U.S. healthcare so expensive?
High administrative costs, expensive pharmaceuticals, and service fees.
How do patients pay for healthcare services?
Through insurance coverage, out-of-pocket costs, deductibles, and co-pays.
What is telemedicine?
The use of digital technology to provide remote medical care, which grew significantly during COVID-19.
What are some efforts to improve price transparency in healthcare?
Policies requiring hospitals to disclose service costs and insurers to list out-of-pocket estimates.
What role do hospitals play in the U.S. healthcare system?
They provide emergency, inpatient, and outpatient care through a mix of public, private non-profit, and for-profit facilities.
What is TRICARE?
health insurance program for active-duty military members, retirees, and their families.
How does Canada’s healthcare spending compare to Europe?
Canada spends 11% of GDP on healthcare, similar to high-spending European countries.
How does Canada limit private healthcare compared to Europe?
Canada restricts private insurance, while Europe allows public and private systems to coexist.
What is a key difference between Canada and Europe in healthcare governance?
Canada’s provinces manage healthcare, while most European systems are centrally controlled
(national government)
What are the two main European healthcare models?
Bismarck Model (Social Insurance - Germany) and Beveridge Model (National Health Service - UK).
What makes Germany’s system unique?
Patients choose providers and insurers; covers dental, vision, and prescriptions unlike Canada.
What are the pros and cons of the UK’s system?
Pros: Universal access, no direct payment.
Cons: Long wait times, strict government control.
