Stephen Hansell, Ph.D.
 Department of Sociology
Institute for Health Research
  http://sakai.rutgers.edu
 shansell@rci.rutgers.edu
       609-203-2830
EXAM 3
EXAM 3
Thursday Dec. 23
EXAM 3
Thursday Dec. 23
   8-9:20am
EXAM 3
Thursday Dec. 23
   8-9:20am
   Scott 135
EXAM 3
Thursday Dec. 23
    8-9:20am
    Scott 135
  Bring Pencils
EXAM 3
Thursday Dec. 23
    8-9:20am
    Scott 135
  Bring Pencils
Know your RUID
Class 26 – Solutions Cont.
•       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
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
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
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
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.
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
Stephen Hansell, Ph.D.
  Department of Sociology
Institute for Health Research
www.rci.rutgers.edu/~shansell
  shansell@rci.rutgers.edu
        732-445-4740

Lecture 26

  • 1.
    Stephen Hansell, Ph.D. Department of Sociology Institute for Health Research http://sakai.rutgers.edu shansell@rci.rutgers.edu 609-203-2830
  • 3.
  • 4.
  • 5.
  • 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 aboutthe 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 lowersquality 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