《社会保险》PPT课件

McG raw-H ill/Irwin Copyright 2008 by The McGraw-Hill Companies, Inc. All rights reserved. CHAPTER 10 10-2SOURCE: Centers for Medicare and Medicaid Services 2005a. 10-3SOURCE: Centers for Medicare and Medicaid Services 2005a. 10-4 Private Health Insuranceo The Implicit Subsidy for Employer-Provided Insurancen World War II era price controlsn Federal tax subsidy 10-5 The Advantages of Employer-Provided Health Insuranceo Increase the risk poolo Reduce adverse selectiono Lower administrative costs 10-6 Employer-Provided Health Insurance and Job Locko Job locko Health Insurance Policy Portability and Accountability Act of 1996 (Kennedy-Kassenbaum Act) 10-7 Cost Control and Private Insuranceo Cost-based reimbursement (fee-for-service)o Managed caren Capitation-based reimbursementn Health Maintenance Organizations (HMOs)n Preferred Provider Organizations (PPOs)n Point-of-service (POS) 10-8 Medicare: Overview SOURCE: Centers for Medicare and Medicaid Services 2005a. Real expenditures on MedicareExpenditures on Medicare as a Share of GDP 10-9 How Medicare Workso Benefitsn Part A Hospital insurance (HI)n Part B Supplementary medical insurance (SMI)o Financingn Payroll tax funds HIn General revenues fund SMI 10-10 Prescription Drug Benefito Part C Medicare Advantage o Part D Prescription Drug Benefitn Monthly premiumn Low deductiblen Donut holen Generous coverage for high costs 10-11 Cost Control Under Medicareo Medicares retrospective payment systemo Medicares prospective payment systemn Diagnosis related groupsn Resource-based relative value scale systemo Medicare Managed Care 10-12 Medicare: Impacts on Spending and Healtho Expenditures on health care for the elderlyo Health outcomes 10-13 Medicaid: Overviewo Medicaido State Childrens Health Insurance Program 10-14SOURCE: Centers for Medicare and Medicaid Services 2005a. 10-15 Financing and Administrationo Joint Federal-State financingo State administration 10-16 Benefitso States obligated to offer minimum package of benefitso States may offer more generous benefitso State administrative flexibility 10-17 Medicaid: Impacts on Healtho Take-up rateo Crowding outo Empirical evidence: Are Medicaid expansions effective? Crowding out and taking up 10-18 Health Care Reformo Individual mandateso Health savings accountsn Catastrophic insurance policyo Single payer 10-19 Final Thoughtso Security v efficiencyo No free luncho Connection between health care expenditures and health 10-20 Does Public Insurance Crowd Out Private Insurance? Health insurance Health insurance Health insurance Quantity of all other goods Quantity of all other goods Quantity of all other goodsA A AF F FB B BM M M0 0 0 Amount of publiclyprovided insurance Amount of publiclyprovided insurance Amount of publiclyprovided insuranceC C C