1. Health Care Policy

2. Introduction Why health care policy matters
The problem in (sort of) 3 charts

7. Health in America US vs. the world Emphasis on elderly
Health care vs. health

8. Life Expectancy!

9. Infant Mortality

11. Life expectancy after 80

13. The U.S. Health Care System
Complexity of system

15. The U.S. Health Care System
Fee for Service
Managed Care
Government subsidized care

16. Problems with the U.S. System: Cost
High relative cost

19. Health Care and GDP

20. Problems with the U.S. System: Cost
Fee-for-service system
Technology
Market Failure
Aging public
Medical culture
Prescription Drugs
Administrative costs
It’s the prices, stupid
What it is not

21. Retail Price Indexes for Basket of In-Patent Pharmaceuticals, 2010 US is set at 100
Price level
This certainly seems to be true for pharmaceuticals. This chart shows findings from an analysis of IMS Health data by Jerry Anderson at John Hopkins University.
It shows that prescription drugs are more expensive in the U.S. than in other countries – even though drugs are pretty much the same in whichever country they’re taken: we’re just paying more for them.
THE
COMMONWEALTH
FUND
Note: Calculations weighted relative to U.S. consumption patterns. U.S. retail prices were discounted from manufacturer prices according to the rebates obtained by the Medicaid program.
Source: P. Kanavos, A. Ferrario, S. Vandoros et al., "Higher U.S. Branded Drug Prices and Spending Compared to Other Countries May Stem Partly from Quick Uptake of New Drugs," Health Affairs, April (4):753–61.

22. Diagnostic Imaging Prices, 2013
Dollars ($US)
MRI
Dollars ($US)
CT Scan (abdomen)
Notes: US refers to the commercial average. MRI refers to magnetic resonance imaging; CT refers to computed tomography.
Source: International Federation of Health Plans, 2013 Comparative Price Report.

23. Total Hospital and Physician Costs, 2013
Dollars ($US)
Appendectomy
Dollars ($US)
Bypass Surgery
Notes: US refers to the commercial average. Appendectomy prices reflect a blend of inpatient and outpatient prices based on relative utilization in each setting.
Source: International Federation of Health Plans, 2013 Comparative Price Report.

24. Spending on Health Insurance Administration per Capita, 2012 Adjusted for Differences in Cost of Living
Dollars ($US)
* 2011.
Source: OECD Health Data 2014.

25. Spending per Hospital Discharge, 2012 Adjusted for Differences in Cost of Living
Dollars ($US)
* 2011.
** 2010.
Source: OECD Health Data 2014.

26. Spending per Hospital Discharge, 2012 Adjusted for Differences in Cost of Living
Dollars ($US)
* 2011.
** 2010.
Source: OECD Health Data 2014.

29. Problems with the U.S. System: Access
Inadequate Access
Why so many uninsured?
Maldistribution of resources
Employer-based issues
Rationing

33. Rationing the wait

37. Problems with the U.S. System: Quality
Quality in cross-national perspective

43. Problems with the U.S. System: Quality
Lack of Access
Focus on sickness instead of health
Overspecialization

47. Contemporary Policy
Medicare
Medicaid
ACA

48. Affordable Care Act/ “ObamaCare”
Goals
Basics/Three-legged stool
What it’s not
Early Assessment
“Repeal and Replace” and ACA under President Trump

55. Further reform? The long-term cost problem Lessons from abroad
Policy Options
Single-payer
“Medicare for all”?
“Gradual” single payer/Other public options
Employer-based reforms
Expanded individual market reforms
So, what happens?

56. Reforms/International Lessons
Single Payer Plan
Employer Mandates
Socialized Medicine
Individual Mandates
Future of Health Care Reform?