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Health Care Reform
in America
Dennis & Patten
Participation in Government
Mepham High School
ACME Insurance Agency
• Private insurance policy is available to all for the
following costs:
• Self-Employed:
– Individual- $200/month
– Family- $400/month
• Employer Contribution:
– Individual- $50/month
– Family- $120/month
• Decide whether or not you will purchase
insurance.
• List reasons for and against purchasing
insurance.
Discussion?
• How might some of these issues be resolved?
President Obama
and Healthcare Reform
“Health care reform is no longer just a moral
imperative, it’s a fiscal imperative. If we want
to create jobs and rebuild our economy and
get our federal budget under control, then we
have to address the
crushing cost of health
care this year, in this
administration.”
~ President Obama,
White House
Forum on Health Care Reform
Entitlement Programs
• Entitlements guarantee that Americans
receive benefits by federal law.
• Entitlement programs are part of the
federal budget labeled mandatory
spending that must be funded by law.
The Healthcare Problem
• The rising costs of health care and
health insurance pose a serious
threat to the future fiscal condition of
the U.S.
4% of GDP in 2009
6% of GDP in 2019
12% of GDP by 2050
The Healthcare Policy Dilemma
Policymakers will face difficult
trade offs between two objectives:
1. Expanding insurance coverage
WHILE
2. Controlling both
total and federal
costs for
healthcare
Who Pays for Health Care?
 Most Americans (85%) have some form
of health insurance
 Health insurance - any program that
helps pay for medical expenses
 Three general health care payment
categories:
1. private insurance
2. government programs
3. uninsured
Private insurance
• Most Americans (59.3%) receive their health
insurance coverage through an employer under
group coverage
• Since 2001, family coverage
premiums have increased
by 28%, while wages
have only increased by 16%
Government Programs
• 27.8% of Americans (83 million) are covered
by government health care programs
• Federal law mandates public access to
emergency services regardless of ability to
pay
• Public Programs:
1. Medicaid
2. Medicare
3. Other programs:
State Children’s Health Insurance
Program (SCHIP), military system,
veterans affairs
Medicare
• Provides health insurance
for U.S. citizens over the
age of 65
• Medicare is partially funded
by payroll taxes a.k.a.
F.I.C.A. tax
Medicaid
• Health insurance program
for low income adults,
children, and people with
certain disabilities
• Means test is required
• About 60% of the poor are
not covered by Medicaid
The Uninsured
There are millions of Americans who have
insufficient or no health care insurance
• 45.7 million (15.3% uninsured in America)
• In 2007, nearly 70% of the uninsured
lived in families headed
by a full-time worker
• 8.1 million uninsured
children
Source: http://www.hr-onesource.com/ppt/01-patton_healthcare.pdf
Why Uninsured?
• Rising healthcare costs force many employers to drop
employee health insurance
• Many working poor make too much to qualify for
Medicaid, but can’t afford health insurance
• Unemployment
• Some healthy people choose to go without health
insurance
• Some rejected by insurance
companies because they
have pre-existing conditions
• Results:
 Many don’t go to the doctor
 Increase in emergency
room care
Healthcare
in the
U.S.
Today
How do we improve our
healthcare system?