How Americans Pay for Health Care: A Brief Overview October 12, 2010 Merton D. Finkler, Ph.D. John...
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Transcript of How Americans Pay for Health Care: A Brief Overview October 12, 2010 Merton D. Finkler, Ph.D. John...
![Page 1: How Americans Pay for Health Care: A Brief Overview October 12, 2010 Merton D. Finkler, Ph.D. John R. Kimberly Distinguished Professor in the American.](https://reader036.fdocuments.us/reader036/viewer/2022062801/56649e445503460f94b3896e/html5/thumbnails/1.jpg)
How Americans Pay for Health Care: A Brief Overview
October 12, 2010Merton D. Finkler, Ph.D.
John R. Kimberly Distinguished Professor in the American Economic System
Lawrence University
![Page 2: How Americans Pay for Health Care: A Brief Overview October 12, 2010 Merton D. Finkler, Ph.D. John R. Kimberly Distinguished Professor in the American.](https://reader036.fdocuments.us/reader036/viewer/2022062801/56649e445503460f94b3896e/html5/thumbnails/2.jpg)
Agenda
• Spending Patterns Overall• Payment Patterns Overall• Payment Structure• Patient Protection and Affordable Care Act –
2010• Primary Sources– California HealthCare Foundation – Health Care Costs
101– Kaiser/ HRET Surveys of Employer-Sponsored Benefits– 2010 Milliman Medical Index
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National HC Spending/ GDP
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Cumulative Impact
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Spending Distribution by Sector
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Spending Distribution by Payor
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Health Plan Enrollment Distribution History
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Spending Distribution, Private Insurance vs. Out-of-Pocket
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Worker Identified Premium Payment Trend
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The 80- 20 Rule Provides Guidance
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Health Reform Effects on Payment
• Near Term – New coverage requirements– Expanded dependent coverage up to age 26– Remove of lifetime and annual limits– Elimination of cost-sharing for preventive care– Prohibition of pre-existing conditions clauses
• Since new requirements for coverage neither require healthy young adults to enroll nor extra Federal support, premiums are likely to rise
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Health Reforms continued
• Medium Term (2013 – 2014)– Creation of exchanges with a variety of provisions– Tax changes include increase in Part A payroll tax rate for
high income taxpayers– Required coverage for individuals and firms with 50 or
more employees
• Longer Term (2015 or later)– Multistate compacts for sale of insurance– Excise tax on employer plans with individual premium of
$10,200 or family premium of $27,500 (2018)
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Comments
• Three Legs of Health Care Policy (Cost, Quality, and Access) Require Coherent Attention
• Health Care Reform Addresses the Insurance Leg (and partly the access leg)
• Despite the assigned burden, the cost of employer organized health care mostly falls on the employee
• Demographics and intensive practice styles make our policy choices increasingly severe
• There are no free lunches.