Module 1
The US healthcare system is not broken. Actually, it was never a put together, cohesive entity in
the first place. It has only just gotten more complex. We have been facing the same issues in
healthcare for decades
As it stands there might be a crisis. This is because everyone needs healthcare yet there are
high costs for the services, staffing issues, and chronic diseases that need long-term
management
There appears to be a boom in occupations and organizations within health care in the recent
years
Health care has an increasing share in the US economy. Majority of the spending comes from
the over 65 group and this portion will continue to increase. Increased healthcare spending does
not automatically mean increased quality of healthcare
Some places are able to deliver high-quality care at low costs
Principles to follow: Everyone deserves healthcare, important to contain costs, we need to focus
on population-based medicine
Health reforms need to address the issues in the system
- Many people do not have adequate health coverage
- We need to look more at prevention instead of treatment
- Unsustainable health care spending
- Inadequate healthcare delivery and spending systems
- Lower than expected health outcome
- Social determinants of health and disparities, inequities, and inclusive health
Health care differs from other industries which causes market failure (market forces not working
well in the industry):
a. Third parties often separate buyers/patients from sellers/healthcare provider. This
disconnect can cause insensitivities in prices and there is a lack of price transparency
b. Healthcare is very local so the system of health care in neighboring cities within a
country can vary wildly. This makes healthcare very complex
c. Lack of consumerism: Patients don’t usually have all the information, technology, or
means to make informed choices on their healthcare
d. Healthcare is dominated by extensively educated health professionals. Imbalance in
knowledge and power which usually means that the decisions are made more by the
providers than the patients
e. Healthcare information is not as digitized as it should be. Even when it is, it is not as
transmissible between information systems for various reasons
f. It is a very regulated industry. Unlike many other industries in the US
g. There are nonprofit organizations that dominate the industry that don’t necessarily make
the most market-friendly decisions
The rapid growth of the healthcare system is not specific to the US. Other countries face the
same issues that come with the growth of that industry
,Healthcare quadrilemma: 4 key factors interact with one another in health care
There is no clear linear relationship between the quality and the cost of healthcare
Commonwealth fund proposes some factors to help rate how good health care systems are
- Access to care
- Healthcare equity
- Administrative efficiency
- Care process
- Healthcare outcome
The US health system has a bad rating despite being a prosperous country
With healthcare expenses rising, people are not able to afford housing, food, entertainment etc
PPO- Preferred provider options have high choice/access in health care but higher premiums
HMO- Health maintenance organization. Low premiums with limited choice. You have to select
providers within the company’s network
The health industries have many tradeoffs and choices that need to be made e.g Health plans
(PPO vs HMO), Healthcare spending or other basic needs, generalist vs specialist, Rationing
(making choices for certain services as opposed to others due to limited finances)
Mutual Causation of health and wealth: Health causes wealth and wealth causes health
Module 2
The federal government has had an increasing involvement in healthcare over time. The federal
government had to even expands its bureaucracy to deal with its growing involvement and
expanding activity in healthcare.
The fed govt handles medicare, VA stuff, medicaid, and SCHIP (State Children’s Healthcare
Insurance Program) . They also support education (med school construction, education loans),
finance roles, research (through NIH) etc.
Medicare, medicaid, and SCHIP stuff falls under the Department of Health and Human Services
(DHHS)
Roles of fed govt: financing (payer of healthcare), delivery (provider of healthcare), and
regulation (oversight of healthcare)
Regulation happens through the FDA (food and drug administration), FTC (federal trade
commission), and DOJ(Department of Justice) etc.
The federal government has a largely nonprofit behavior
US Congress(Senate and House of Reps), the legislative branch, is also involved in healthcare-
Healthcare policy, allocating funding, overseeing the implementation of funding
, Mandatory budget: Mandatory/entitlement spending is required by law. It does not go through
appropriations e.g social security, medicare, and Medicaid. Congress does not have much goal
The US healthcare system is not broken. Actually, it was never a put together, cohesive entity in
the first place. It has only just gotten more complex. We have been facing the same issues in
healthcare for decades
As it stands there might be a crisis. This is because everyone needs healthcare yet there are
high costs for the services, staffing issues, and chronic diseases that need long-term
management
There appears to be a boom in occupations and organizations within health care in the recent
years
Health care has an increasing share in the US economy. Majority of the spending comes from
the over 65 group and this portion will continue to increase. Increased healthcare spending does
not automatically mean increased quality of healthcare
Some places are able to deliver high-quality care at low costs
Principles to follow: Everyone deserves healthcare, important to contain costs, we need to focus
on population-based medicine
Health reforms need to address the issues in the system
- Many people do not have adequate health coverage
- We need to look more at prevention instead of treatment
- Unsustainable health care spending
- Inadequate healthcare delivery and spending systems
- Lower than expected health outcome
- Social determinants of health and disparities, inequities, and inclusive health
Health care differs from other industries which causes market failure (market forces not working
well in the industry):
a. Third parties often separate buyers/patients from sellers/healthcare provider. This
disconnect can cause insensitivities in prices and there is a lack of price transparency
b. Healthcare is very local so the system of health care in neighboring cities within a
country can vary wildly. This makes healthcare very complex
c. Lack of consumerism: Patients don’t usually have all the information, technology, or
means to make informed choices on their healthcare
d. Healthcare is dominated by extensively educated health professionals. Imbalance in
knowledge and power which usually means that the decisions are made more by the
providers than the patients
e. Healthcare information is not as digitized as it should be. Even when it is, it is not as
transmissible between information systems for various reasons
f. It is a very regulated industry. Unlike many other industries in the US
g. There are nonprofit organizations that dominate the industry that don’t necessarily make
the most market-friendly decisions
The rapid growth of the healthcare system is not specific to the US. Other countries face the
same issues that come with the growth of that industry
,Healthcare quadrilemma: 4 key factors interact with one another in health care
There is no clear linear relationship between the quality and the cost of healthcare
Commonwealth fund proposes some factors to help rate how good health care systems are
- Access to care
- Healthcare equity
- Administrative efficiency
- Care process
- Healthcare outcome
The US health system has a bad rating despite being a prosperous country
With healthcare expenses rising, people are not able to afford housing, food, entertainment etc
PPO- Preferred provider options have high choice/access in health care but higher premiums
HMO- Health maintenance organization. Low premiums with limited choice. You have to select
providers within the company’s network
The health industries have many tradeoffs and choices that need to be made e.g Health plans
(PPO vs HMO), Healthcare spending or other basic needs, generalist vs specialist, Rationing
(making choices for certain services as opposed to others due to limited finances)
Mutual Causation of health and wealth: Health causes wealth and wealth causes health
Module 2
The federal government has had an increasing involvement in healthcare over time. The federal
government had to even expands its bureaucracy to deal with its growing involvement and
expanding activity in healthcare.
The fed govt handles medicare, VA stuff, medicaid, and SCHIP (State Children’s Healthcare
Insurance Program) . They also support education (med school construction, education loans),
finance roles, research (through NIH) etc.
Medicare, medicaid, and SCHIP stuff falls under the Department of Health and Human Services
(DHHS)
Roles of fed govt: financing (payer of healthcare), delivery (provider of healthcare), and
regulation (oversight of healthcare)
Regulation happens through the FDA (food and drug administration), FTC (federal trade
commission), and DOJ(Department of Justice) etc.
The federal government has a largely nonprofit behavior
US Congress(Senate and House of Reps), the legislative branch, is also involved in healthcare-
Healthcare policy, allocating funding, overseeing the implementation of funding
, Mandatory budget: Mandatory/entitlement spending is required by law. It does not go through
appropriations e.g social security, medicare, and Medicaid. Congress does not have much goal
