Disease, Healthcare, and Poverty

1
Disease, Healthcare, and Poverty

• Addison Chung
• Alexia Capsuto
• Glenn Burgan
• Serena Anand

2
Common Medical Procedure Costs

• A regular office visit
•     80
• Ambulance ride
•     500-1,000
• Step on a rusty nail
•     1,030
• Allergic reaction to a bee sting 
•     1,050
• Fixing a broken arm
•     2,523
• Appendectomy
• 12,000-14,000 (depending on hospital stay)
• Healthcare per person on average annually
• 8,160

3
How do disease, healthcare, and poverty connect?

• Those who are in poverty don't have access to
  healthcare, which means that when they get sick
  they can't afford medical services to recover.
• Often, people's healthcare comes from their
  employer, so if the primary provider for a family
  is unemployed (and therefore the family is in
  poverty), the family doesn't have medical
  insurance.
• "Health Inequality" is the term used to describe
  unfair disparities between two demographics

4
How many people have healthcare in America?

• Nearly 45.5 million Americans-- 7 million of whom
  are children-- are uninsured (about 15 of the
  total population)
• 16 million (about 5 of the population) more have
  such inadequate coverage that they are forced to
  forgo needed care.

5
How much does healthcare cost?

• It costs an average of 8,160 per person to be
  insured, and is expected to reach 13,100 by the
  year 2013.
•  
• The United States currently expends 14 percent of
  its gross domestic product (GDP) on health care,
  but that is expected to rise in the next decade.

6
Indemnity vs. HMO vs. Medicare

• Indemnity Insurance
• Before 1990, most health insurance was this type
• Simply reimburses patients for medical expenses
• Patient is free to see any doctor
• The patient pays the doctor and receives back
  most of the cost from the insurance company.
•  Health Maintenance Organizations (HMO)
• Also called managed care
• Since 1990, it has dominated the market and now
  covers 85 of employed Americans
• Insurance companies hire doctors and hospitals to
  provide care for their subscribers, who pay a
  monthly premium and small copayments to use those
  services.
• Costs somewhat less
• Subscribers  agree to go to only the doctors and
  hospitals the company employs and the insurer
  decides what medical care they will pay for.
• Medicare/Medicaid 
• National healthcare plans 
• Medical insurance programs for the elderly, the
  disabled, and the poor created by President
  Lyndon B. Johnson in 1965 through an amendment to
  the 1935 Social Security Act

7
More on Medicare and Medicaid

• Medicaid (Title XIX of the Social Security Act)
• Provides insurance for certain needy individuals.
• Federal government provides partial funding but
  states run the program within broad guidelines.
• The states must cover hospital, physician,
  diagnostic, and home health services nursing
  home care and family planning for
  beneficiaries. 
• Coverage of prescription drugs, eyeglasses, and
  intermediate care is optional.
• Provides money for the treatment of patients with
  AIDS.

• Medicare (Title XVIII of the Social Security Act)
• Provides health insurance for people aged 65 and
  over and those seriously disabled
• Covers short-term hospital and nursing home
  expenses, physician and outpatient services, and
  home health care. 
• Does not cover long-term nursing home care,
  dental and eye care, or prescription drugs.
  Beneficiaries pay a portion of the insured
  services.

8
Who gets government healthcare?

• People with disabilities and the elderly have the
  highest priority.
• Parents, or adults with many dependents, have
  priority for government healthcare when in
  poverty.
• In 1997, Massachusetts raised the income
  threshold for Medicaid eligibility for parents
  from 86 to 133 of poverty, and began providing
  premium assistance support to parents with
  incomes up to 200 of poverty. 
• In 1999, Wisconsin expanded coverage to parents
  with incomes up to 185 of poverty, an increase
  from 51. 
• In 2000, New Jersey expanded coverage to parents
  with incomes up to 200 of poverty, up from 41. 
• Also in 2000, California raised the income
  threshold for parents from 74 to 100 of
  poverty. 
• Those without dependents have lower priority.
• Massachusetts, which had previously not provided
  any coverage for nondisabled childless adults,
  began in 1997 providing premium assistance to
  such adults with incomes up to 200 of poverty.

9
What will President Obama do?

• Obama has pledged to "lower costs by taking on
  anticompetitive actions in the drug and insurance
  companies.
• He will support disease prevention and health
  promotion efforts and invest 50 billion over the
  next 5 years to accelerate adoption of health
  information technology.
• Healthcare issues are being considered as part of
  the early stimulus package to prevent people who
  lose their jobs from losing their coverage.
• These items include increased federal support to
  states to maintain or expand their Medicaid
  enrollment
• Reauthorization of and increased funding for the
  State Children's Health Insurance Program
• Grants to states to speed adoption of health
  information technology
• Expansion of the Consolidated Omnibus Budget
  Reconciliation Act (COBRA) to give certain
  laid-off workers the right to temporarily
  continue insurance coverage at group rates.

10
Who has access to healthcare?

• 86 of women in the United States report having
  some sort of healthcare, compared to only 74 of
  men who have healthcare.
• In a study by the Centers for Medicare and
  Medicaid Services (CMS), the greatest deficiency
  in care was observed for African Americans, who
  had a 60 greater likelihood of receiving
  inadequate dialysis (treatment for kidney
  disease) compared with whites.
• The young adult population are the least insured
  in America. Because theyre off their parents
  healthcare plan and not yet into a steady job
  with provided healthcare, they dont often have
  insurance.

11
Lack of Healthcare kills....

• According to Urban Institute, there are 27,000
  preventable deaths in America each year due to a
  lack of healthcare
• Uninsured people often postpone getting checked
  out by doctors because they know it will be too
  expensive, and often only seek care when it is
  too late. By that time, the procedures necessary
  are far more costly.

12
Trying to End the Inequalities

• In 2004 the Commonwealth Fund wrote a report
  outlining steps to combat healthcare disparities
• expanded access for minorities
• greater minority representation within the
  healthcare workforce
• consistent racial and ethnic data collection by
  healthcare providers

13
Citations

• "Healthcare Coverage Study asks if adults
  benefiting from state health insurance
  expansions." Life Science Weekly. 14 Feb 2006.
  869. eLibrary. Proquest CSA. MOUNTAIN VIEW HIGH
  SCHOOL. 17 May 2009. lthttp//elibrary.bigchalk.com
  gt.
• Iglehart, John K. "Visions for Change in U.S.
  Health Care -- The Players and the
  Possibilities." New England Journal of Medicine.
  15 Jan 2009. 205. eLibrary. Proquest CSA.
  MOUNTAIN VIEW HIGH SCHOOL. 21 May 2009.
  lthttp//elibrary.bigchalk.comgt.
•  
• J. McDonough, B. Gibbs, J. Scott-Harris, K.
  Kronebusch, A. Navarro, and K. A. Taylor, "State
  Policy Agenda to Eliminate Racial and Ethnic
  Health Disparities," Commonwealth Fund (June
  2004).
• Krugman, Paul. "Health Care Horror Stories." New
  York Times. 17 May 2009      lthttp//www.nytimes.
  com/2008/04/11/opinion/11krugman.htmlgt. 
•  
• Michael E. Makover, MD. "What's wrong with
  managed care and how to fix it." World I. 01
  Feb 2000. 299. eLibrary. Proquest CSA. MOUNTAIN
  VIEW HIGH SCHOOL. 17 May 2009. lthttp//elibrary.bi
  gchalk.comgt.
•  
• Minnesota Council of Health Plans. "How Much Does
  It cost." mmhealthplans. 17 
• May 2009 ltwww.mnhealthplans.org/consumers/document
  s/ 
• HowMuchDoesItCost2005.docgt. 
• Owen, William F Jr Szczech, Lynda A
  Frankenfield, Diane L. "Healthcare system
  interventions for inequality in quality
  Corrective action through evidence-based
  medicine." Journal of the National Medical
  Association. 8 2002. S83. eLibrary. Proquest CSA.
  MOUNTAIN VIEW HIGH SCHOOL. 17 May 2009.
  lthttp//elibrary.bigchalk.comgt.
•  
• Robert M. Hayes. "Preserve Medicare The program
  could offer a solution to our nation's deepening
  healthcare crisis." Financial Planning. 01 Jul
  2006. eLibrary. Proquest CSA. MOUNTAIN VIEW HIGH
  SCHOOL. 17 May 2009. lthttp//elibrary.bigchalk.com
  gt.
•  
• Sitkoff, Harvard. "Medicare and Medicaid."
  Postwar America A Student Companion. n.p.,
  Oxford University Press. 2000. n.pag. eLibrary.
  Proquest CSA. MOUNTAIN VIEW HIGH SCHOOL. 17 May
  2009. lthttp//elibrary.bigchalk.comgt.