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37 Cards in this Set
- Front
- Back
Earliest involvement of federal Government
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Establishment of Marine Hospitals under Commerce Clause
Precursor of todays public health service with DHHS |
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Pure Food and Drug Act (1906)
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Prohibited interstate commerce in misbranded and adultred drugs, food, and drink
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Before WWI
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Congress created Children's Bureau, initiated Quarintine Authority, Early worker safety legislation
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Children's Bureau (1912)
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Investigation and reporting on welfare of all children
Responsible for federal assistance to and leadership of child health and welfare programs |
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Social Security Act (1935)
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Guaranteed income for elderly
Funded by FICA payrol tax |
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Federal Insurance Contribution Act (FICA)
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deductible from paychecks and income that goes toward SS program and Medicare
Employees and employers responsible for sharing payments Flat tax |
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Hill Burton Act (1947)
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Authorized federal funds to pay for hospital construction in exchange for care of the poor
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Medicare (1965)
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Federal program providing hospital and medical service for the elderly
Part A: hospital care Part B: professional services Part C: Medicare supplemental insurance Part D: prescription drugs |
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Medicaid (1965)
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State/federal programe providing health care for the poor
Largest source of funding for medical and health related services for the poor Each state establishes its own criteria Medically needy-eligibly but have high income |
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Environmental laws (60s-70s)
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Solid waste management, safe drinking water, lead paint prohibition
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Worker Safety Acts (60s-70s)
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Coal Mine health and Safety Act
Occupational Health and Safety Act Federal Mine Safety and Health Act |
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State Children's Health Insurance Program (SCHIP) (1990s)
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Health Insurance program for children
Provision of federal matching funds for states Medicaid programs to better meet the needs of uninsured children ex: Hawk-i |
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Almshouse/poorhouse
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Where sick or indigent were cared for in the late 18th century
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Health Care Costs
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Health care consumes 17.01% of GDP
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High Cost of Health Care
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Duplication of services
High cost of technology and pharmaceuticals Lack of incentives to control costs Health insurance insulates consumers from real cost of care Heath care marketplace is not like the market for other goods and services-doesnt follow traditional laws of supply and demand |
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Controlling Health Care Costs
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Prospective payment-flat fee on diagnosis
Cost Sharing-co-pay and deductibles Caps on payments Limits on benefits Increasing low cost benefits for medicare Eliminating federal subsides for hospital construction Increasing income level for Medicaid eligibility |
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Supply
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The amount of goods available
Quantities of goods or services firm is willing and able to offer at various prices during a given time period Specialty health services supplied, increase demand |
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Demand
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The interest and available market for a particular product
Increases when people have more money to spend or interest in a particular product Shift: income, age of consumers, income coverage |
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Cost
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The amount of money it takes to produce a good
Includes materials, assembly, transportation, advertising, marketing |
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Price
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The amount charged for a good or service
Not necessarily the cost |
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Price Elasticity
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The extent to which the price is subject to change by either supply or demand
Elastic= price declines and spending increases |
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Expenditure
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Amount of money spent
Expenditure= Price x Quantity Increase: better quality and more complex procedures are provided |
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Change in Health Care System
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Costs are high
Large number of uninsured Costs to federal gov of Medicare and Medicaid programs are unsustainable |
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Robert Wood Johnson Foundation
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Not a federally funded healthcare program
Federal budget is relevant- fed got is largest single purchaser of health care services |
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Paul Krugman
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Economist who called for reductions in health care spending
Control healthcare costs and raise revenue Address the deficit |
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Deficit
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How much you spend that you dont have
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Primary Care
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Basic care
Wellness, preventative Outpatient Primary Care Provider Point of entry into the system |
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Secondary Care
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Specialist referred to by primary care provider
Usually hospital Short term |
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Tertiary Care
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Highest most comprehensive level of care provided in a hospital setting
Highly specialized, multi specialty, high tech Transplant Specialty ICU Large teaching hospitals, burn care, NICU |
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Long-term Care
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Provided to elderly who need assistance with activities of daily living and supervision to live safely
Nursing homes, skilled nursing facilities, specialized care facilities Promote maximal independence, maximize quality of life |
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Hospice Care
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Provides end of life care to terminally ill
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Health Insurance
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Mechanism to protect against unpredictable loss
Mostly provided by employers Increases the demand for healthcare ~50 mill uninsured Uninsured=working poor |
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Working Poor
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Full time/low wage job with no benefits
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Health Reform
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Individual mandate
Subsidize poor, tax high income people Expand eligibility for Medicaid Up to states (iowa/branstad resisted) Unconstitutional =4 Constitutional= 5 |
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Main Case of National Debt
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Unfunded wars and tax cuts
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Elastic
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Price declines and spending increases
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Increasing Health Care Provision
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Outpatient and ambulatory services
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