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1. Health Care Reform) – Describe what health care reform means, its goals, and the main changes or proposals discussed in the video.
2. U.S. Health Care System– Explain how the U.S. health care system is structured, including its strengths, weaknesses, and unique features.
3. Health Care Divide – Discuss what is meant by the “health care divide,” including factors that contribute to it and its impact on different populations.
Main Changes and Proposals (Specifically the ACA)
The main changes introduced by the ACA, which drove much of the recent reform discussion, include:
Guaranteed Issue: Prohibiting insurance companies from denying coverage or charging higher premiums based on pre-existing conditions.
Individual Mandate: Requiring most individuals to have health insurance or pay a penalty (though the penalty was later eliminated).
Medicaid Expansion: Allowing states to expand Medicaid eligibility to cover all low-income adults up to 138% of the Federal Poverty Level.
Health Insurance Marketplaces: Creating state-based or federal exchanges where individuals and small businesses can shop for insurance plans and receive premium tax credits (subsidies).
Dependent Coverage: Allowing young adults to stay on their parents' insurance plans until age 26.
The U.S. health care system is unique in that it is highly fragmented and primarily market-based, utilizing a mix of four distinct models, often described as a patchwork of public and private financing.
Structure and Unique Features
The system lacks universal coverage and is characterized by a multi-payer model:
Private Insurance: The largest segment, primarily funded through employer-sponsored insurance (ESI) or individual plans purchased on the Marketplace.
Public Insurance:
Medicare: Federal program for people aged 65 or older, and certain younger people with disabilities.
Medicaid: Federal-state program for low-income adults, children, pregnant women, elderly adults, and people with disabilities.
Tricare/VA: Coverage for military personnel and veterans.
Uninsured/Out-of-Pocket: Individuals who pay for care directly, often relying on emergency rooms for acute needs due to the legal requirement that ERs treat everyone regardless of ability to pay (EMTALA).
Strengths
Technological Innovation: The U.S. leads the world in medical research, development, and the rapid adoption of cutting-edge technology (e.g., advanced medical imaging, specialty pharmaceuticals).
Health care reform refers to the comprehensive change in the law, conduct, and structure of a nation's health care system. In the U.S., the term is often used to discuss major policy changes intended to address long-standing issues like cost, access, and quality. The landmark example is the Patient Protection and Affordable Care Act (ACA) of 2010.
Goals of Health Care Reform
The main goals are broadly agreed upon, though the methods vary:
Improve Access: Broaden the population that receives health care coverage, eliminating financial or administrative barriers.
Control Costs: Decrease the overall expense of health care for individuals, governments, and businesses.
Improve Quality: Enhance patient safety, patient outcomes, and the overall quality and efficiency of care delivery.