Study guide for exam 1 Questions to review (will be updated and changed throughout semester) ? In the context of healthcare who are the main payers? ? What is the difference between a payer and a provider? ? What are the main ways that people pay for healthcare? Know approximately the breakdowns in %'s. ? What is guaranteed issue? ? What does community rating mean? ? What natural problem would occur in the insurance market if both guaranteed issue and community rating are required? What is the "solution" to this problem offered by the ACA? ? What is the iron triangle of health care? Be able to explain why this is an important concept in some detail ? How much does the US spend on healthcare annually in dollars? in dollars per person? as a percentage of GDP? Be able to understand why we care about these numbers ? How do the above numbers compare to other countries ? What is GDP? Be able to understand when something would be considered in our GDP and when it would not, based upon the definition. ? Roughly how many people are employed in the healthcare field? ? How does the US compare to other countries in terms of access to medical care? Give a few example ? How does the US compare to other countries in terms of quality of medical care? What about quality of outcomes? Give examples ? What are some inputs that go into producing high quality health? How important is health care to this health production function? ? What are the leading determinants of overall health? What are the biggest three groups and how much do they matter? ? Be able to understand the concept of a health production function and be able to use it as we did in class to think about cost effectiveness ? What are diminishing returns? Why is this related to the health production function? ? Across the three time periods we divided US history, what were the respective changes in life expectancy in each period and what drove the life expectancy changes in each period? Give some examples within each. ? What is the relationship between income and life expectancy? ? What is the relationship between mortality and body mass? How would you graph it? ? How has the health of the population, as measured by length of life, changed over the last 265 years? ? How important has medical care been in improving population health relative to other factors, and has the impact of medical care changed over time? ? What is the relationship between acute and chronic causes of death across time? ? List the factors contributing to the persistent growth of US health care spending. Be able to describe in some detail the "perfect spending storm." ? What is meant when we say medical technology? Give some examples. ? Consider the two scenarios given in class regarding medical spending growth. Be able to succinctly argue the reasons that would make you prefer one scenario to the other. ? In order to understand if increased medical spending is "worth it" we talked about cost-benefit analysis. How is Value of a Statistical Life related to this? What are some estimates of VSL? What does Cutler use? How does quality factor in? ? What does cutler think about the value to cost ratio of all medical care (combined) since 1950? ? Do his conclusion apply to ALL types of medical care? Give an example of one technology that doesn't fit his analysis. ? How are drug prices determined in the US? ? How is drug and medical technology regulated in the US? ? Be sure to be familiar with all of the articles (That is, able to summarize all of the readings).
 

Question 1

Uninsured around 15%, Medicare 10 %, private non-ESI less than 1 %, Medicaid around 10 %, and employed private insurance approximately 60 %.

What is the difference between a provider and a payer?

Providers are organizations that give care to their patients, and for that care, they charge the payers. At the same time, payers are organizations that particularly pay providers for healthcare services like the government, insurance carriers, individuals, and private workers.

What are the main techniques that individuals pay in the healthcare setting? (know the % breakdowns)?

There are three main ways that individuals pay for healthcare in the US. They include individuals, the government, and private insurers. The national government insures around half of all medical expenditure among Medicare, Medicaid, and various healthcare departments it controls. For example, the private health insurance plans budgeted approximately $917 billion in health care expenditure, approximating around a third of all medical dollars budgeted that year. Notably, uninsured around 15 percent, employed private insurance round 60 percent, private non ESI lower than 1 percent, Medicaid around 15 percent, and the Medicare approximately 10 percent.

What does community rating mean?

It simply implies that it requires health insurance providers to give health insurance regulations at a similar price to all individuals without medical endowing, within a specified region, despite the health status.

What natural problem would occur in the insurance market if both guaranteed issues and community rating are required? What is the “solution” to this problem offered by the ACA?

The natural problem is that the insurance would have to be sold to anyone despite what, so they could still be on loan. The solution to the problem would only be to select specific individuals to offer insurance to. Notably, ACA implements or modifies this ground on the little information, for example, geography, family status, and smoking.

Question on Iron triangle of Healthcare

The iron triangle of health care is broad access, low cost, and high quality. This is a critical concept because one can only advance or improve one at a time, although one still has to trade-off or compromise the other two.

How much does the US spend on healthcare annually in dollars per person? As a percentage of GD? Be able to understand why we are about these numbers?

Annually, the United States spends approximately $3.2 trillion. In dollars per individual, around $10k, which sums up to approximately 17.6 people of the Gross Domestic Product (GDP).

How do the numbers compare to other countries?

Compared to other countries, the number is high; this is because we spend most on healthcare.

What is GDP?

Gross Domestic product.

Question

GDP= the market price or the market value of all final services and goods manufactured within a nation in a specified period. It is worth noting is simply a flow and not a stock.

Question

Approximately 11 million individuals.

Question

It is worth noting that the United States leaves millions of individuals uninsured. Because of rising expenses, the United States is spending very minimal on social services, for example, Medicaid, and the approval for particularly the coverage.

Question

Although not impressive or amazing, the United States has remarkable healthcare.

Particularly in expertise in cancer. The concerns especially lie with the expense to impress or benefit and the inadequate of specifically the accessibility due to expense. It is worth noting that the United States spends most federal dollars per individual than every nation apart from Norway and Netherlands, which do not have any public health care systems. Furthermore, the United States also budgets huge amounts on innovative and procedures or systems, which raises expenditure with minimal impact on results. Notably, this is the ideology of reducing, particularly the marginal utility.

Question

In healthcare, among the top three include socioeconomic, genetic, and behavioral.

Question

In healthy behavior, education, exercise, medical services, diet, environment, and smoking.

 

Question

The leading determinants of health include: healthcare, environment, behavioral, environment, socioeconomic, and genetic.

Question

It is worth noting that the health production function evaluates the relative contribution of every factor that has an impact to health to determine the highest cost, the effective technique to advance health.

What are diminishing returns? Why is this related to the health production function?

It is worth noting that the more one produces the little the profit, therefore at certain consideration health advancement are developing smaller gain as compared to the beginning.

Question

Economic advancements and growth in nutrition particularly made infants more resilient to these illness during the 1750-1850 era. For example, the life expectancy at birth raised by approximately 4 years in wales and England between 1750 and 1850.

What is the relationship between income and life expectancy?

The relationship is simply the higher individual’s income the longer they live. For example, a household with income of around $20000 puts woman at 83 and men at 77years, and household with income of around $100000 puts women at 89 and men at 87 years.

What is the relationship between mortality and body mass? How would you graph it?

Among both men and women, higher BMI in early adulthood was particularly linked with higher-general- effect mortality. On graphing it, mortality is U shaped in general individual’s body mass index.

Question

It is worth noting that from 1750-1850 the life expectancy increased 4 years because of factors like advanced nutrition and economic expansion, medical care, and early public health departments or programs.

From the year 1850- 1950 life expectancy increased to exactly 24 years as a result of medical care, public health programs, and economic growth and nutrition. Lastly, from 1950 to date factors include economic and nutrition growth, medical care, for instance antibiotics and vaccinations.

How important has medical care been in improving population health relative to other factors, and has the impact of medical care changed over time?

It is worth noting that modern medical care is leveled the same as deciding whether to drink or not with a specified duration of 10 years’ impact, while smoking has a 13-year impact.

What is the relationship between acute and chronic causes of death across time?

Chronic death has enormously risen while acute deaths has remained steady.

List the factors contributing to the persistent growth of US health care spending. Be able to describe in some detail the “perfect spending storm.”

Among the factors leading to persistent growth of US healthcare spending are: Innovation, growth of public insurance departments to pay for them, charges for service reimbursement, and patients font face the general expense of medical services at the level of care, so they are especially willing to implement the new technologies.

What is meant when we say medical technology? Give some examples.

The goods and services like nursing care, prescription drugs that a patient receives when they require treatment. For example, when Ex. Franklin Delano Roosevelt suffered from heart failure disease, and bed rest was the standard medical technology in 1945.

Consider the two scenarios given in class regarding medical spending growth. Be able to succinctly argue the reasons that would make you prefer one scenario to the other.

In scenario 1 and scenario 2, the United States can spend more funds on both medical services and all other things until 20240. However, to particularly sustain scenario 1 beyond 2050, the US will be required to cut back on particularly non-medical spending. Furthermore, in scenario 1, the US would spend around $5400 extra per individual in 2040 on medical services compared to scenario 2.

In order to understand if increased medical spending is “worth it” we talked about cost-benefit analysis. How is value of a statistical life related to this? What are some estimates of VSL? What does Cutler use? How does quality factor in?

It is worth noting that the value of a statistical life is particularly related to cost-benefit analysis. This is because annual of life is determined or considered to be equivalent to 100K; therefore, when summing up the cost-benefit ratio of particularly a new drug when compared to the old one, we view at particularly the cost price of the previous drug and its assurance and quality-adjusted life-year (QALY). We then compare the new drug price with its quality-adjusted life-year (QALY) to establish or acknowledge the cost-benefit ratio.

What does cutler think about the value to cost ratio of all medical care (combined) since 1950?

According to Cutler, the value to cost ratio of all medical care has enormously increased dramatically over a long time in the United States. Notably, in the world, it had most of it advanced. Furthermore, the United States spent approximately 5 percent of the Gross Domestic Product on health in 1950; during late 1990, the US spent approximately 12 percent or higher. Moreover, according to Cutler, most of this increased expenditure is because the United States population was older during 1990 compared to 1950. Additionally, older individuals spend little extra on medical services when compared to younger individuals.

Do his conclusion apply to all types of medical care? given an example of one technology that does not fit his analysis

Even though medical expenditure has raised enormously, not all of Cutler’s conclusions apply to all types of medical care. For example, particularly for the elderly, there was a similar increase in medical expenditure. The average individual at the age of 65 could even spend around $4000 on medical care in 1950 and approximately $59000 in 1990. Therefore, since the public sector caters for around three-quarters of medical spending for the elderly, the rise in expenditure reflects an enormous raise in the public sector burden, where the medical expenditure has increased and the duration or duration length of life.

How are drug prices determined in the US?

The United States government is not responsible for determining the pre of technologies; instead, they allow manufacturers to set or determine the price. However, “market forces” regulate or moderate the United States prices.

How is drug and medical technology regulated in the US?

In the United States, the FDA is responsible for categorizing medical technology into either one of the three classes, Class I, II, or III. Furthermore, based on their regulatory and the risks control necessary to give valid assurance of effectiveness and safety, it is worth noting. Notably, Class I devices particularly have the least risk to the patient or user, while Class III technology or devices pose high levels of risks.

 

Healthcare Review Sheet Outline

• The main payers in the context of healthcare
• The difference between payer and a provider
• Main ways individuals pay for healthcare
• The definition of guarantee issue
• The definition of community rating mean
• The natural problem that occurs in the insurance market if both guaranteed issue and community rating are required, and the solution to the problem offered by ACA
• Definition of iron triangle of healthcare and its importance
• The amount spent by US on healthcare annually in dollars, dollars per person, as percentage of GDP, my understanding why we care about this numbers
• The above numbers compare to other nations
• Definition of GDP, my understanding when something is considered GDP
• Roughly prediction of how many individuals are employed in the field of healthcare
• Comparison of United States with other nations in terms of access to medical care, with examples provided
• Comparison of United States with other nation in terms of quality of medical care, quality outcomes with examples provided
• Inputs that go into producing high quality health, importance of healthcare to this health production function
• The leading determinants of health, and the biggest three groups and how they matter
• My understanding on the concept of a health production function
• My definition of diminishing returns and how it is related to the health production function
• The respective changes in life expectancy in each period and the factor that drove the life expectancy changes in each period, with examples provided in each
• Relationship between mortality and body mass, and its graph
• The ways health of the population as a measure by length of life has changed over the last 265 years
• The importance of medical care in improving population health relative to other factors, and ways its impact has changed over time
• The relationship between acute and chronic causes of death across time
• Factors contributing to the persistent growth of US healthcare spending, “perfect spending storm”
• Two scenario provided in class on medical spending growth, my argument on the reasons that would make me prefer one scenario to the other
• The statistical life related to medical spending, the estimates of VSL, what Culter use, ways the quality factor in
• Cutler’s reasoning about the value to cost ratio of all medical care (combined) since 1950
• Cutler’s conclusion does not apply with examples provided
• Ways drug prices are determined in the United States
• Ways in which drug and medical technology are regulated in the United State