SCOPE OF THE HEALTH CARE COST CHALLENGE National Health Policy Audioconference July 30, 2002 Professor James C. Robinson University of California, Berkeley.

Slides:



Advertisements
Similar presentations
Containing Health Care Costs: Market Forces and Regulation Paul B. Ginsburg, Ph.D. Center for Studying Health System Change and National Institute for.
Advertisements

The Costs of Employee Benefits
Single Payer 101 Training Universal Health Care for Massachusetts.
Overview of Health Care Coverage and Cost Trends in Minnesota Presentation to the State Budget Trends Study Commission April 22, 2008 Julie Sonier Director,
Conflict and Change in America's Health Care System
SINGLE PAYER The Next Step for Health Reform (Beyond the Affordable Care Act of 2010) Prepared by Randy Block Co-Chair, Gray Panthers of Metro Detroit.
Limited Networks Paul B. Ginsburg, Ph.D. FTC-DOJ Workshop on Competition in Health Care February 24, 2015.
1 HealthcareWebSummit December, 2002 Dana E. McMurtry Vice President, Health Policy & Analysis WellPoint Health Networks Inc. A Case Study in Health Plan.
MEDICARE: PAST, PRESENT AND FUTURE James G. Anderson, Ph.D. Department of Sociology & Anthropology.
Part I: Basic Economics Tools
Working Together to Help Keep Connecticut’s Economy Healthy Eileen Auen, President Health Net of the Northeast CBIA Economic Forum September 4, 2003.
New Health Plan Strategies for Containing Medical Costs Leonard Davis Institute of Health Economics 2002/2003 Health Policy Seminar Series University of.
Affordability: The New Imperative Northeastern University Open Classroom October 27, 2010 Andrew Dreyfus President & CEO Blue Cross Blue Shield of Massachusetts.
1.03 Healthcare Finances Understand healthcare agencies, finances, and trends Healthcare Finances Government Finances Private Finances 2.
Evaluating Economic Performance
Growing Unaffordability of Health Care: Incremental vs. Real Health Care Reform John P. Geyman, MD Professor Emeritus- Family Medicine University of Washington,
Shift to Consumerism: Change Story for Managers Rising healthcare.
Health Care You Can Count On AFSCME’s Campaign for Guaranteed, Quality, Affordable Health Care for All.
CHCWG DRAFT March 2, 2006 Hearing from the American People: Preliminary Overview of Sources and Reports March 2006 Caution: Preliminary Data Do not cite.
U.S. Healthcare Policy. Project 4: One page summary of the project including comments on the student's contributions. Describe how the project contributed.
1 An Overview of the Evolving World of Health Insurance and the Role of Defined Contribution Jon B. Christianson James A. Hamilton Chair in Health Policy.
Stay Well Afford Care Secure Coverage. Our Broken Health Care System 6.5 Million Uninsured 20% of Population Source: California Health Interview Survey,
Understanding Health Reform CHOICE Regional Health Network.
Managed Care & Health Care Reform Cost of Health Care $1.03 trillion in % of GNP 4%-5% annual increase in health care spending.
Exhibit ES-1. Synergistic Strategy: Potential Cumulative Savings Compared with Current Baseline Projection, 2013–2023 Total NHE Federal government State.
To Accompany “Economics: Private and Public Choice 10th ed.” James Gwartney, Richard Stroup, Russell Sobel, & David Macpherson Slides authored and animated.
California Foundation for Commerce & Education May 2008 Internet Survey of California Business Executives’ Attitudes June 5, 2008.
1 Elements Transforming the Delivery System Accountable Health Networks Receive payment for value not volume Drive quality and efficiency by providing.
Stay Well Afford Care Secure Coverage. Our Broken Health Care System 6.5 Million Uninsured 20% of Population Source: California Health Interview Survey,
Financing Health Care United States Healthcare. PRIVATE INSURANCE Pays for all or part of a person’s health care Pays for all or part of a person’s health.
Managed Care & Health Care Reform Cost of Health Care $2.4 trillion in 2008 ($7.900 per person) 17% of GDP US 10.9% Switzerland 10.7% Germany 9.7% Canada.
Solution-Oriented Approaches to Control Health Care Costs Alpha Benefits March 31 & April 1, 2004.
BALANCING LIMITED RESOURCES AND UNLIMITED EXPECTATIONS IN HEALTH CARE Colloquium on Workers Compensation May 2, 2003 Professor James C. Robinson University.
Health Economics & Policy 3 rd Edition James W. Henderson Chapter 9 The Market for Hospital Services.
Chapter 13. Learning Objectives (part 1 of 3) Describe the two major philosophies of investing and the investment implications of each Describe the features.
Professor James C. Robinson University of California, Berkeley Aligning Incentives in the Context of Biomedical Innovation IHA Pay-for-Performance Summit.
McGraw-Hill/Irwin Copyright © 2008 by The McGraw-Hill Companies, Inc. All rights reserved. CHAPTER 10 GOVERNMENT AND THE MARKET FOR HEALTH CARE.
Improving Total System Performance & Public-private Partnership Dr. FUNG Hong Hospital Authority May 2001.
Consumers Have Spoken Job Creation The National Debt Healthcare Costs.
Presented by Janki Shah and Ella Teplitsky The High Cost Of Health Insurance in New York State.
1.03 Healthcare Finances Understand healthcare agencies, finances, and trends Healthcare Finances Government Finances Private Finances 2.
The Health of the Nation. Judging the Health of a Nation Quality of its doctors and medical institutions Doctors from all over the world come to the U.S.
The Uninsured. Many Specialists Won’t See Kids With Medicaid Bisgaier J, Rhodes KV. N Engl J Med 2011;364:
The Federal Reserve System. Prior to 1913, hundreds of national banks in the U.S. could print as much paper money as they wanted They could lend a lot.
Providing Insights that Contribute to Better Health Policy Patient Cost Sharing: An Overview Joy M. Grossman, Ph.D. December 3, 2003.
CHAPTER 10 Government and the Market for Health Care Copyright © 2010 by the McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill/Irwin.
Voluntary Benefits A solution for employees and employers Cobbs Allen and Cobbs Allen.
Risk Movement past, present & future Life Seminar th February Presented by: Dr Brad Beira.
5-1. Employer-Sponsored Health Insurance McGraw-Hill/Irwin Copyright © 2009 The McGraw-Hill Companies, Inc. All rights reserved. Chapter 5.
Health Policy Issues An Economic Perspective Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.
Chapter 7 The Demand for Healthcare Products Copyright 2015 Health Administration Press.
5-1. Employer-Sponsored Health Insurance McGraw-Hill/Irwin Copyright © 2006 The McGraw-Hill Companies, Inc. All rights reserved. Chapter 5.
1.03 Healthcare Finances.
The Big Healthcare Issues
Medicare, Medicaid, and CHIP
1.03 Healthcare Finances.
Health Insurance.
1.03 Healthcare Finances.
Medicare, Medicaid, and CHIP
March 2006 Caution: Preliminary Data Do not cite or distribute
1.03 Healthcare Finances.
HOW DO YOU CHANGE YOUR PLANS TO MAKE THEM AFFORDABLE TO BOTH EMPLOYEES AND EMPLOYERS? FEI BOSTON PROFESSIONAL DEVELOPMENT SESSION SEPTEMBER 12, 2014.
Responses to Rising Costs: Private and Public Sectors
Chapter 2: Health Care Economics
Tax Subsidy for Employer Provided Insurance Insurance Option Marginal Product of Labor Insurance Provided by Employer Pre-tax Income (20% tax.
1.03 Healthcare Finances.
GOVERNMENT AND THE MARKET FOR HEALTH CARE
Health Insurance: The Basics
1.03 Healthcare Finances.
1.03 Healthcare Finances.
Presentation transcript:

SCOPE OF THE HEALTH CARE COST CHALLENGE National Health Policy Audioconference July 30, 2002 Professor James C. Robinson University of California, Berkeley

Surge in Health Insurance Premiums  Insurance premiums:  Large groups: 10-20%  CalPERS 25%?  Small groups and individuals: 10-50%  Effect on number of Californians with health insurance coverage?  Effect on the insurance benefits for those who retain coverage?

Short Term Drivers of Health Care Cost Inflation  Pharmaceutical products  Labor market: nurses, techs, pharmacists  Hospital consolidation and market power  Unsustainably low margins in physician practices, nursing homes, home health, etc.  Regulations and benefit mandates

Long Term Drivers of Health Care Cost Inflation  Continuing clinical innovation  Drugs, devices, procedures  Continuing regulation and litigation  Demographics: only a minor contributor  Most important: rising social expectations

What Do People Want from Their Health Care System?  Afghanistan: Reduce mortality  Portugal: Reduce morbidity  Canada:Improve functionality  United States:Feel better  California:Look better  West L.A.:Look real good

Revenues are Limited  Even with unprecedented prosperity, social resources for health care were limited  We cannot spend the same budget surplus twice  Non-health priorities: education, social security  Taxpayer support for tax cuts  Unprecedented prosperity is gone  Budget deficits  Tight employer budgets and cost cutting

The Fundamental Imperative  Limited resources, unlimited expectations  Setting priorities is imperative  Where and by whom will this be done?  Government?  Employers, insurers, providers?  Consumers themselves?

The End of Managed Care  Politicians, the press, and the public love to use HMOs as a whipping boy for system ills  But health plans are tired of this  Strategy A: merge with a tobacco company  Strategy B: merge with a drug company  Strategy C: re-invent health insurance

From Managed Care to Health Insurance  Major drivers of cost inflation are not under control of health plans (drugs, expectations)  Controlling costs (provider revenues, consumer expectations) is a dirty job  Health insurance: America wants more  Managed care: America want less  The industry is shifting to consumerism

Health Insurance Consumerism: Models from other Industries  Mutual fund companies sell an array of investment products, add information and decision support tools, and facilitate rather than supplant consumer decisions  Non-health insurers predict trends, charge actuarially fair premiums, but do not seek to control the costs of the services they insure

Components of Health Insurance Redesign  Benefit design  Network design and contracting  Medical and disease management  Connectivity among all participants  Info and decision support to consumers

Challenges to a Consumer-Driven Health Insurance System  Consumers lack good information on benefits, providers, prices, quality  Consumers vary in health status  Risk selection and cherry picking  Consumers vary in income  Easier to do implicit than explicit subsidies

Virtues of a Consumer-Driven Health Insurance System  Everyone feels strongly about health care, but everyone has unique preferences, goals  No one size fits all  We are all more careful spending our own money than somebody else’s money  America wants a system based on responsible individual choice, with protections for the most vulnerable

A Bit of Wisdom  “We have met the enemy, and he is us.”  (Pogo)