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WENDI EVANS
HCA 205: INTRODUCTION TO HEALTH
INSTRUCTOR: BRETT GARCIA
JANURARY 7, 2015
My name is Wendi Evans, I am pursing a degree in Health Care Administration. I am a single mother of
three. I love to sing, shop, cook, and spend time
with my family and friends.
This presentation will explain the history of the US Health Care System. I will be defining the Healthcare system, describing the cost, comparing the US Healthcare system to Canada’s healthcare system, and discussing reforms and improvements.
Definition of US Healthcare system – It is and organization of people, institutions, and resources that delivers health care services to meet the health needs of individuals of a targeted population.
1900’s - The beginning of organized medicine.
The American Medical Associations gains powerful influence as the National Organization of State and Local Associations. Social Insurance including Health Insurance gains public attention. Baylor Hospital in Dallas, Texas starts a pre-paid hospital insurance program with a local teacher’s union, ( first example of modern health insurance).
1965 to 1980 ‘s – President Johnson signs into law the most significant
Health Care Reform of the century Medicare. Medical cost rapidly
escalate , President Nixon sign Health Maintenance Organization Act.
2006 to present- Massachusetts implements laws to provide health care
coverage. President Obama signs Landmark
Health Care Legislation called the Patient Protection
and Affordable Care Act.
The marine hospital service was establish with the July 16, 1798 signing by President John Adams for relief of sick and disabled seamen. In 1875 a title of Surgeon General came into being.
March 3 a bill passed that authorized admission of navy seamen an seamen of other government services to Marine Hospitals on a reimbursable basis.
January 4, 1889 the Public Health Services Commission Corp. was authorized. Julius Richmond was the first Surgeon General of Public Health Service.
Financial – PPAC has
grand ambitions to provide insurance coverage to more than 30 million people.
2.7 trillion spent on health care is income to some person or organization.
The law also authorizes an additional 11 billion for federally qualified community Health Centers.
Legal- HIPPA protects
patients.
Federal Anti-trust laws
False claims whistle blower suits
Ethical- Balancing
quality care and efficiency.
The end of life issues financing that pays for this service forced to pull the plug due to insurance.
Regulatory – 1879-The Department of
Public Health
established by US
Congress.
The government
regulates laws for
Health care system.
Social - Civil War was
instrumental in
establishing the US
Health Care System.
At the turn of the 20th
century break through in
Medicine and
Technology.
1929 to 1941- The great
Depression
STAKEHOLDERS Patient- Expects an employer to offer a wide variety of options for health
coverage.
Employers – Want to maintain or lower cost contributions.
Providers – Want to provide the best service using the most accurate and
newest test and treatments.
Payers- Want providers to follow a clear, evidence based diagnostic plan.
Political Figures – The government regulate laws to be enforced for the
Health Care Systems.
Schools – Most Colleges and University Campuses offers some type of
general medical care.
Reimbursement methodsFee of service: the oldest form of medical reimbursement
doctors charge for every test and service provided.Capitation: Method of which employers pay a set price for
services no matter how many times patient visits the doctor puts cap on spending.
Valued based: Rewards the organization for the value of health care services delivered.
Managed Care Organizations: They enter into contracts with hospitals and healthcare professionals to provide health care to individuals enrolled in the plan.
MCO gives the provider economic incentives to offer less costly care.
Provider records are reviewed regularly.
Medical research : Research on different diseases such as cancer, and heart disease has increased.
Developing new treatment for previously untreated terminal conditions. Cost for workers time spent on
experimenting.
Equipment improvements: New medical and surgical procedures, drugs and medical
devices such as CT scanners, and defibrillators.
Delivery of quality care: Reduce hospital acquired conditions. Better preventive measures. Better doctors to patient ratio.More concern with cures for major diseases such as diabetes and
high blood pressure increase cost.
How do Canadians access Healthcare?
Apply for provincial health card.
After obtaining coverage one can register with primary care physician.
Card is used whenever visiting a physician or health care provider.
How do Canadians pay for Healthcare?
Health care is funded by both Federal and
Provincial levels.
By taxation both from personal and corporate
income taxes.
Sales taxes and lottery taxes.
There are no deductibles.
Quality of Healthcare Providers.
Canada has seen a significant decline in morality
rates from major killers such as cancer and heart
disease.
Immunization rates are low.
More than 80% have access to regular doctors.
Unique services provided
No National plan Canada’s Healthcare is based on
its 13 provinces and territories.
Hospital services provided to inpatient and out-
patients.
Services medically necessary for purpose of
maintaining health.
PRO’S AND CON’S SIMILARITIES
AND DIFFERENCES
Pro’s Con’s
* The elimination * Patients in
Of unnecessary Canada wait
risk of harm to longer for
patients. primary care
* Doctors always appointments.
involve patients * Greater use
in decision about of ER for
Treatment. primary care
factor longer
wait time in
ER.
• The government of both Nations are closely involved in the Healthcare system process.
• Us spends more money on healthcare than Canada.
• They have different mix of funding mechanism’s.
• In Canada all residents must be covered by the public insurance plan run by their province on uniform term and conditions.
• In the US all residents must have some type of insurance not necessarily government funded.
Medicare reform: Raised the income limit on eligibility.
Lower spending
Readmission rates lower
Seniors are able to choose from a broader range of higher quality Medicare plans.
Programs encouraging providers to invest in redesigning care.
Making information available for consumers.
Higher quality and more efficient services.
State modifications:
Has no affect on how much insurance cost.
State regulations which mandate the group health insurance plans must include certain benefits.
The cost of policies being too expensive
The availability of insurance in each state.
American Journal of Public Health. (AMJ Public Health),
October, 2011; 101(10)1841.4.
Batnitzky, A., Hayes, D., & Vinall, P.E. (2014). The U.S. healthcare system: An
introduction. San Diego, CA: Bridgepoint Education, Inc.
This text is a ConstellationTM course digital materials (CDM) title.
Weather, C. ( 1900& 1908). “New York Health Board Supervising Babies”.
Clark, E. & Bidgood, E (2011-2013). “Civitas”; Canada Health website.:
FAQ Canada Healthcare Act;
http://hc-sc.gc.ca/hcs-sss/medi-sssur/faq-eng.php
Canadian Foundation of Health Care Improvement (2014).
Accelerating Health Care Improvement: CFHI’s Assessment tool of Healthcare
Delivery Organization and Systems.
http://www.amnhealthcare.com
http://www.Annenburgclassroom.org/files/documents
http://www.profiles.nlm.nih.gov/ps/access/QQBBCZ
www.parlgc.ca/information/library/prbpubs/944-e.htm
Canadianhealthcare.org
Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, http://www.cms.hhs.gov/NationalHealthExpendData/ (see Historical, NHE summary including share of GDP, CY 1960-2005, file nhegdp05.zip; and Historical, Projected, NHE Historical and projections, 1965-2015, file nhe65-15.zip).
Mark. V. Pauly, “Competition And New Technology,” Health Affairs 24(6) (November/December 2005): 1523-1535.