第10章 政府与医疗保健市场（课件）- 《财政学（第十版）》同步教学（人大版）

GOVERNMENT AND THE MARKET FOR HEALTH CARE Chapter 10 1 Uses of Health Care Funds in the U.S. (2010) Source: Centers for Medicare and Medicaid Services [2012c]. 10-2 Sources of Health Care Funds in the U.S. (2010) 10-3 Source: Centers for Medicare and Medicaid Services [2012c]. 3 Private Health Insurance The Implicit Subsidy for Employer-Provided Insurance World War II era price controls Federal tax subsidy 10-4 4 The Advantages of Employer-Provided Health Insurance Increase the risk pool Reduce adverse selection Lower administrative costs 10-5 5 Employer-Provided Health Insurance and Job Lock Job lock Health Insurance Policy Portability and Accountability Act of 1996 (Kennedy-Kassenbaum Act) 10-6 6 Cost Control and Private Insurance Cost-based reimbursement (fee-for-service) Managed care Capitation-based reimbursement Health Maintenance Organizations (HMOs) Preferred Provider Organizations (PPOs) Point-of-service (POS) 10-7 7 Medicare Expenditures (1966-2010) Expenditures on Medicare as a Share of GDP Real expenditures on Medicare Source: Centers for Medicare and Medicaid Services [2012c]. 10-8 8 How Medicare Works Benefits Part A – Hospital insurance (HI) Part B – Supplementary Medical Insurance (SMI) Financing Payroll tax funds HI General revenues fund SMI 10-9 9 Prescription Drug Benefit Part C – Medicare Advantage Part D – Prescription Drug Benefit Monthly premium Low deductible Donut hole Generous coverage for high costs 10-10 10 Cost Control Under Medicare Medicare’s retrospective payment system Medicare’s prospective payment system Diagnosis related groups Resource-based relative value scale system Medicare Managed Care 10-11 11 Medicare: Impacts on Spending and Health Expenditures on health care for the elderly Health outcomes 10-12 12 Medicaid: Overview Medicaid State Children’s Health Insurance Program 10-13 13 Medicaid Expenditures (1966-2010) Source: Centers for Medicare and Medicaid Services [2012c]. 10-14 14 Financing and Administration Join