spend a lot but our performance is rank poorly. The only bright side is our care process
Define paradox
A statement that seem contradictory or absurd, but it actually true
Ex: US is a wealthy country and spend so much on health care but yet US get poor
results compared to other countries
How was the health care outcomes of US on different categories?
◉Maternal mortality – high
◉Infant mortality – high
◉Suicide rate – high
◉Obesity rate – high
◉Chronic condition rates among adults – high
◉Mortality “amenable” to health care – high
◉Life expectancy at 60 – low
,◉Improvements in mortality amenable to health care – slow
How was the access to care outcomes?
◉Frequency of physician visits per person – low
◉Number of practicing physicians per person – low
What are the outcomes of Efficiency and Coordination ?
◉Accurate history of care available during appointment – low
◉Time spent on billing disputes – high
◉Time spent getting approval for coverage of treatments – high
◉Used ER when an office visit would have sufficed – high
The US HC system is relatively _______ & ________
privatized & Fragmented
what type of US health care coverage? Universal or not?
not universal
,what are some good things about US health system?
Process of care
-Preventive care (screenings, lifestyle advice)
-Safe care, including medication review
-Patient engagement (Discussion and PlanninG)
In the first decades of 1900, how was the US health system?
-hospitals were primarily for deliveries and surgeries
-Doctors charged "Fee for service"
-patient paid Out-Of-Pocket for each service received
-Services was cheap but ineffective
During the great depression (late 1920s-late 1930), what company was established?
-people couldn't afford pay for health care
-hospital worried about reduced utilization
-Beginning of Blue Cross Health Insurances - to cover hospital care
-Then the started of "Blue Shield" coverage for MD care
In what year did Blue Cross and Blue Shield merge?
Blue Cross Blue Shield plans in 1980s
, During World War II (1939 -1945), what happened to the healthcare system?
-Labor unions could not negotiate for higher wages - demand more benefits (due to
shortages of good and worker)
-US tax laws in 1940s and 1950s made employer-based health care tax free - which
increased the value of this benefit relative to wages, and effectively created a
government subsidy
=>Working-age Americans now have insurance tied to employment
During world war II, where do we have the most advance medicine?
-in the military
-then the war end, the military MDs want the civilian hospital to have those lifesaving
new medical technology
(employer based coverage + technological imperative )
what happened post-war in Europe?
-Universal coverage
-National health services = public (Created in 1946
-Global budgeting: entire system and each facility works within an annual budget
-Shorter lengths of stay, fewer lab tests
-Less costly
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