1. Stephen Hansell, Ph.D.
Department of Sociology
Institute for Health Research
http://sakai.rutgers.edu
shansell@rci.rutgers.edu
609-203-2830

3. EXAM 3

4. EXAM 3
Thursday Dec. 23

5. EXAM 3
Thursday Dec. 23
8-9:20am

6. EXAM 3
Thursday Dec. 23
8-9:20am
Scott 135

7. EXAM 3
Thursday Dec. 23
8-9:20am
Scott 135
Bring Pencils

8. EXAM 3
Thursday Dec. 23
8-9:20am
Scott 135
Bring Pencils
Know your RUID

9. Class 26 – Solutions Cont.

10. • III. The New Health Care Legislation
– over a 100 different small changes, its like putting bandaids, no drastic change
– does not make docs gov employees
A. What will happen this year?
• adults with pre existing illness will get insurance for the first time
• this is from a federally funded high risk pool
• out of pocket = 6k for individuals and 12 k for families
• kids health insurance coverage will be expanded (cannot deny kids cz of health problems)
• young people can be covered under parent’s plan through 26 yrs old
• expanded coverage = insurance companies can no longer put yearly or lifetime limits for
chronic diseases
• the drug donut hole will be reduced (give 250 dollar rebate to these people )
B. What will happen in 2014?
• state based insurance for people who do not have insurance from employers
• premiums will not be based on your health, just your age
• funded jointly by states and the federal government
• there will be a requirement for health insurance for everyone from a private profit making
private health insurance companies
• no limitations on what insurance companies can charge
• government will provide tax credits to subsidize buying of health insurance
• this subsidiary will cost 450 billion dollars over 10 years

11. C. What’s the new law going to cost me?
C. lots of people will get insurance that do not have this
D. they want to increase taxes for the rich - not gonna happen
E. healthier people will pay more - will happen
F. reduce the income of healthcare providers - they are working on
that, but its not gonna help as much
G. you will be fined if you do not buy insurance
H. employers will be taxed more if they provide more that 27,000
dollars per year in insurance
I. they will cut medicare by 400 billion
D. What does this reform fail to fix?
1) there is nothing in the bill to controll cost, so everyone can charge
as much as they want, so the health insurance companies did
not fight it
2)
5

12. II. Canada
A. Overview
• almost all healthcare systems are non profit separate from the government
• reformed in 1961 = canadian national health insurance system
• government, the single source of health insurance in canada
• canadians spend more days in the hospital than US
• but cuts on primary care
• it is portable, so you can use your healthcare in other provinces
• each hospital is given a budget limit
• theres no insurance companies to ration care, doctors decide that!
• theres no detailed billing for medical procedures
• myth = canadian gov does not interfere with the choice of doctors
• canada limits tertiary care like open heart surgeries, mri’s etc and there are long waits
B. Provincial insurance coverage

13. C. Myths about the Canadian health care system
1. National health insurance leads to more
bureaucratic red-tape and higher administrative
costs
2. NHI interferes with doctor-patient relationship
3. NHI leads to long waits for treatment

14. 4. NHI lowers quality of medical care
5. NHI leads to rationing
6. NHI causes exodus of physicians
7. lower infant mortality and longer life span
8. each province has an elected health officials so if
you do not like the care you are getting, you can
vote him out
9. physicians are payed pretty well but not as well
as the US doctors
10.

15. D. Summary
• if you value easier availibility to high care you like us
• this is the land of rich people
• if you calue the average effectiveness and over all health care plans
and life span you love canada
• 80% people in canada are satisfied wit the insurance as compared to
10 in the US
E. Could we import the Canadian system in US?
• not really
• we do not trust the government to do it right
• some people think the private, for profit care is the way to go cz they
can get what they want
• powerful lobying groups
• failure of the free marked in medical care
• there would never be a political concensus

16. Stephen Hansell, Ph.D.
Department of Sociology
Institute for Health Research
www.rci.rutgers.edu/~shansell
shansell@rci.rutgers.edu
732-445-4740