US Health Care System
Slide 3 of 29
US Health Care System--
Context.
* Fragmented financing and delivery of health care
In contrast to European countries which generally have broad health and welfare systems for your citizens, the US health care system is quite fragmented, particularly for patients with chronic illnesses.
* US health care is a patchwork of providers who have been increasingly organized into medical groups, institutional networks and corporate managed care organizations.
* Payors are mostly employer based, private insurance firms, and there are large government programs for retirees (Medicare) and for low income (Medicaid). These insurance programs are managed largely by private and increasingly for profit health plans. With growing cost concerns of both payers and health plans, access to the benefits of scientific progress is uneven
* Emphasis on medical technology
* Large investments in biomedical research - NIH x 2
As a nation the US invests heavily in biomedical science and medical technology. The NIH budget is up 15% for 3€rd€ year in 2001 to more than $21B and is on track to double in 5 years -- as we will see PD is getting an increasing % of the pie.
* Bias in reimbursement toward procedures, technology, acute care and institutional care.
* Insurance coverage varies and is especially limited for prescription drugs and long term care.
See later, this is problem for PD
