US Healthcare Systems Module 5 Course Project Final
mickey1995
mschumacher_ushealthmod5_6820.pptxHistory and Evolution of the US Healthcare System
MiKayla Schumacher
Rasmussen
May 30, 2020
Introduction
The healthcare system in the US has evolved from simple home remedies to a complex technological and scientific system between 1750 and 2000 (Randolph, 2009).
The complex system has been built by professionals in medicine, technology, and medical science.
The journey into the complex system is made up of accepting the Germ Theory as the origin of diseases, introduction of great medical institution, professionalization of healthcare personnel, and advances in the use of technology in the treatment of diseases.
The evolution also includes medical insurance, health care programs, and drug regulations.
Currently, there is the growth of corporations who provide healthcare to make profits.
Outline
1700s-1800s: first medical school established in 1765 in Pennsylvania and the existing few physicians provided medical training.
1900-1910: establishment of the medical education council and establishment of standards od medical education.
1930s: the physician and hospital landscape were dominated by men. Payment for healthcare was personal.
1940s-1990s: there was Medicare and Medicaid enactment, group insurance was offered, and federal grants supported medical school operations.
Outline (Conti….)
2000-2011: there was authorization of outpatient medicine reimbursement system, Center for Medicare and Medicaid Services was created, certificate of need (CON) became mandatory for all states, and standards to increase consumer awareness were issued.
2015: The Centers for Medicare and Medicaid Services posted its final rule that reduces Medicare payments to hospitals that have readmission rates of Medicare patients within 30 days (Niles, 2019).
2017: to support state efforts CDC received $475 million for opioid overdose prevention.
2018: CMS finalized rule on the quality payment program and the schedule of physician fees to allow access to telehealth.
Healthcare cost
Cost of healthcare in the US is very high
For the year 2018 the USA had spent on average 3.6 trillion on healthcare
This translates to $11000 per individual
Over the years the cost of health care has increased from 5% of GDP from 1960 to 18% of GDP as of 2018
According to the centers for Medicare and Medical Services (CMS) the costs will increase to $6.2 trillion by 2028
The US is pending more on health care as compared to other nations and this trend is expected to continue to grow especially taking into account the public health crises generated as a result of COVID-19 outbreak. As of 2018 the average spent on healthcare stood at $3.6trillion which translates to $11000 per individual. Over the years the cost of health care has increased from 5% of GDP from 1960 to 18% of GDP as of 2018
According to the centers for Medicare and Medical Services (CMS) the costs will increase to $6.2 trillion by 2028
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Reason for increase in Healthcare spending
Increasing cost of healthcare
Aging population
New and innovative healthcare technology that have resulted procedures and products that are more expensive
Administrative waste due to complexities of the healthcare system (Merola et al., 2018)
The aging population in the US has been increasing over the years. As at 2018 individual over the age of 2018 accounted for 16% of the total population with the census bureau projecting the figures to exceed 20% by 2030. Individual over the age of 65 spend more on healthcare than any other group age. As the number in this category increases more individuals will enroll for Medicare which in turn will increase the cost of Medicare hence increasing healthcare spending. Introduction of New and innovative healthcare technology that have resulted procedures and products that are more expensive have also contributed to this increase
Administrative waste due to complexities of the healthcare system
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Health insurance
Involves programs that help in payment or covering the cost of medical expense
The Affordable Care Act (ACA) ensures tat individuals have greater access to health insurance options that are more affordable
The health insurance plans helps in payments of medical services and prescription drugs
COBRA provides option for individuals to continue with health coverage
Long term care ensures care for individuals with chronic illnesses
Medicaid and CHIP (Health Insurance | USAGov, 2019)
For the majority of the majority of the 20th century according to Dranove (2000) the defining features with regard to healthcare in the US centered around the following three features.
The outstanding defining features of how healthcare has changed majors around the following aspects;
Optimization of health by adoption of preventive care
Standardization and of varying quality of care
Patient centered quality care approach
Medicaid covers individual with low income
Eligibility for Medicaid is based on age, income level, disability, pregnancy, and number of people in the family
CHIP covers children
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Private Healthcare coverage
Majority of Americans with this type of coverage have access to it via employer sponsored programs
60% of Americans covered via their employers
9% of Americans purchase Health insurance directly
Health insurance sponsored by the employer comes as part of the employee benefit package
Majority of employers cover 85% of insurance premium for its employees (Merola et al., 2018)
They also cover 75% of the premium or the dependents of the employees
This type of insurance can be purchased individual or as group basis e.g. an company covering its employees. Majority of Americans with this type of coverage have access to it via employer sponsored programs according to the United States Census bureau. 60% of Americans covered via their employers while 9% of Americans purchase Health insurance directly. Private insurance accounts for 29% of the total aggregate inpatient hospital costs in the United states.
Health insurance sponsored by the employer comes as part of the employee benefit package
Majority of employers cover 85% of insurance premium for its employees
They also cover 75% of the premium or the dependents of the employees
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Healthcare programs
“Medicare
Medicaid
The State Children’s Health Insurance program (SCHIP)
Department of Defense TRICARE and TRICARE for life programs (DOD TRICARE)
Veterans Health Administration program
Indian Health Service program (IHS)” (Health Insurance | USAGov, 2019)
There are six major government healthcare programs. The programs serve veterans, children, mothers wit low income, military personnel, individuals with disabilities and older persons and native Americans. Medicaid, Medicare and SCHIP majorly covers groups with low socioeconomic status while the VHA DOD TRICARE and HIS cover those Individuals with special relationship with the federal government. Majority of the Americans receive services via multiple government programs simultaneously.
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Drug regulations
FDA is the regulatory agency
No drug can be sold without approval of FDA
They are responsible for oversighting safety and effectiveness of drugs
They review applications for manufacturers and monitor their operations upon approval
In the United States the Food Regulatory Agency is the one mandated to regulate the safety and effectiveness of drugs sold in the United states. They are the on responsible for reviewing applications from manufacturers hence no drugs can be sold in the market of the united states without their approval. With regard to new drug applications the FDA is there to ensure;
The effectiveness of the proposed use of the drugs, appropriateness of the proposed labeling and adequacy of the methods used during manufacturing that ensure quality, strength, purity and identity of the drug.
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Peer Review Of Course Project Rough Draft
Mikayla,
I enjoyed reading your PowerPoint, you did a really great job :) Everything looks really clean and well put together, and your thought progression followed a clear pattern that made it super easy to follow! You used really great photos and backgrounds. A couple notes I would have is that you used "outline" for the timeline that you did, where I think the title "timeline" might work a little better. Also, in the introduction, you talked about medical insurance, healthcare programs, and drug regulations -- I would have loved to hear a little bit more about those topics!
Mehgan
References
Health Insurance | USAGov. (2019). Usa.Gov. https://www.usa.gov/health-insurance
Merola, J. F., Herrera, V., & Palmer, J. B. (2018). Direct healthcare costs and comorbidity burden among patients with psoriatic arthritis in the USA. Clinical Rheumatology, 37(10), 2751–2761. https://doi.org/10.1007/s10067-018-4187-y
Niles, N. J. (2019). Basics of the US health care system. Jones & Bartlett Learning.
Randolph, F. (2009). The evolution of the US healthcare system.
