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Public Health Exam #2 (A broken system?)
Terms in this set (31)
3 trillion (18% GDP)
9,000 per person/year
How much money is spent on US healthcare each year?
10th with lower life expectancy
Where is the united states ranked in health of most developed nations?
companies offered health insurance
healthcare during 1940-60
those who weren't employed by big companies could not find insurance and retirees were not covered by insurance either
health care costs rise; specializations increase and caps to payments
premiums and deductibles rise national healthcare system is proposed but fails
employees share of health cost increases
recession caused high rates of unemployment which lead to emergency room treatment
ACA is signed
post world war II : companies offered health benefits because prohibited from raising wages
When did employment based health insurance begin?
Fee for service plan
employment based insurance that charges paid for the services provided
Preferred provider organizations (PPOs)
employment based insurance that is a fee-for-service insurance system that decided to only work with a limited number of clinicians and forms network that agrees to a set of conditions that includes reduced payments
Health maintenance organization (HMO)
employment based insurance that charges patients a monthly fee designed to cover a comprehensive package of services
clinicians are paid based on the number of individuals enrolled in their practice
fixed number of dollars per month to provide services to an enrolled number regardless of the number of services provided
A limit on the total amount that the insurance will pay
for a service per year (or lifetime)
An amount that the insured is responsible for paying
when the service is covered by the insurance
The amount that an individual or family is responsible for paying before being eligible for any insurance coverage
The price paid by the purchaser for the insurance policy on a monthly or yearly basis.
federal program for those 65+ years old
A: hospital care
B: extended medical coverage
C: encourage medicare beneficiaries to enroll in HMO,PPO
D: prescription drug benefit
(does not provide nursing home coverage)
Describe Medicare and its 4 parts
federal state partnership
insurance for those of lower socio economic status
federal government provides matching funds
treats those who are most at risk
screening and treatment for children exposed to lead trauma
2/3 medically fragile children
enroll in Medicaid at any time
What is irreplaceable about Medicaid?
People who are eligible for both medicate and medicaid
administered through medicaid for children in families that earn too much to qualify for Medicaid
covers 9 million children and 360,00 pregnant women
until you are 26!
With the ACA how long can you stay on your parents plan?
to reduce the number of uninsured and underinsured people
What was the overall goal of the ACA?
1. no exclusions for pre-existing conditions
2. coverage on parent's insurance plan until age 26
3. employer mandate
4. preventative services and contraception
5. essential benefits
6. no annual lifetime limits and caps
6. premium tax credit and cost sharing subsidies
Name the seven provisions of the affordable care act
individual mandate (removed in 2019)
tax charged to those without health insurance
only people who need insurance will purchase it which is bad for insurers who need the healthy to subsidize the sick.
What occurs without a mandate
20 million more Americans now have health insurance because of the law
uninsured rate went from 16% to 9%
improved health insurance coverage for those who already had it
what were the main points made in JAMA article by President Obama
-no more individual mandate
-cost sharing subsidies have decreased
- contraceptive benefit decreased
- health insurance plans have backed out
- less advertisement of open enrollment
How the ACA been weakened by the current administration
-employers cutting full time positions so they do not have to follow the employer mandate
-many people can no longer afford the costly premiums
What are some criticisms to the ACA
Medicare for all
Bernie Sanders single payer plan where everyone would be covered, deductibles, copays and premiums would be eliminated, dental and vision care would be provided (not currently covered by Medicare
get the 13 states that didnt expand Medicaid to do so
What are the overarching goals of medicaid for more?
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