Class Notes (923,128)
CA (543,101)
UTSC (32,996)
IDSB04H3 (56)
Lecture 8

Lecture 8 Notes

8 Pages
135 Views

Department
International Development Studies
Course Code
IDSB04H3
Professor
Anne- Emanuelle Birn

This preview shows pages 1-3. Sign up to view the full 8 pages of the document.
IDSB04 Lec 9: Health Crisis (Nov. 2)
Neoclassical approach: if supply is free then the demand goes down
Its not as alluring, and has moral hazard (overuses it)
health care approach: demand goes up if supply is free
health care creates its own demand (by physicians recommendation, etc)
p. 542-3: why is the difference?
1.Patients dont control health spending (unless all have Munchausens syndrome)
2.Physician often spending 3rd party $$
3.Some health spending has no medical benefit (unnecessary services, profits,
corruption, malpractice premiums….
4.
Table 11-2: How the health care sector differs from markets
P. 544: key questions
P. 545: means of financing health care (3 points)
P. 546: financing health care:
Ultimately households pay but fairness differs:
General taxation is most progressive (fair)its in Canada (premiums
tailored to income)
Mandatory health insurance less fair, especially if one premium for all
Private insurance even less fair: sickest (poorest) pay higher premiums
(everyone rated to risk of becoming ill so usually older, poorer, sicker pay most
Out-of pocket least fair (most regressive)- no risk sharing at all
Inadequate health financing is an important cause of poverty and
P. 546-7: health insurance model:
Guilds and workers- mutual protection/friendly societies social
insurance (national or community-based)
www.notesolution.com
Risk pooling (to reduce costs of expected illness, burial, etc.) ((both of
these 2 = beneficial))
Versus
Risk selection (private companies select young and healthy): community
vs. experience rating (individual occupation, genetic risk, etc)
Health care costs concentrated in sick few- sickest 10% account for 64% of
expenses
P. 547: cost-sharing
Co-payments (every time you go to a health care provider, you pay a set
amount) no co-payments at point of service in Ontario
Co-insurance (set percentage, not set payment. In US was 20%.)
Deductibles (amount you have to spend and pay for out of pocket before
insurance kicks in at all. Assumes most societies are made up of
hypochondriacs that will use up health care at any opportunity)
Limits to care (ceilings, lifetime maximum, pre-existing conditions,
uncovered services)
US spends 15% of GDP on healthcare, whereas the next highest is
Switzerland at 11% (higher could mean more burden on population)
P. 547: US and Canada compared
Single payer in Canada = one source; US = multi-payer (insurance
companies, people, etc)
Health care financing in Canada: $172B in 2008 = 10.7% GDP = $5170/capita
70% funded publicly; remainder private insurance, employer benefits out-
of pocket
Provincial and federal taxes (personal and corporate)
Alta, ON, BC use premiums (one rate; no bar to access) no minimum
payment out-of pocket
Some others use sin taxes (lotteries, sales)
As of 2004 federal portion comes in block grant: Canada Health Transfer
www.notesolution.com
$2/3 funded by province
Hospitals negotiate annual budgets with province
Doctors fees negotiated between province and provincial medical
association (with ceilings) (no patient mills allowed where docs take as
many patients as they can to increase money)
Nurses salaries negotiated via collective bargaining (not applicable to
part-time nurses)
NO EXTRA BILLING and NO user fees allowed but
Chaoulli decision in Quebec: will private insurance be allowed to cover
publicly available services?
Health care un-system in the US
~6000 hospitas
~1200 insurance companies; power concentrated ina handful of corps
~700 000 docs
300M people
46M uninsured
42M > 65 covered by medicare
41M indigent covered by 51 medicaid rograms (states plus DC)
171 million covered by thousands of employer-based plans (Obamas
planoffers public subsidies to those who cant afford any insurance,
but everyone required to have insurance)
Managed care = profits over patients
This is too chaotic so there will probably more health reform in the US
Ch. 12: Dont need to know specific numbers
Why are for-profit hospitals costlier?
Admin costs; costs lower in Canada, but outcomes slightly better in
Canada
www.notesolution.com

Loved by over 2.2 million students

Over 90% improved by at least one letter grade.

Leah — University of Toronto

OneClass has been such a huge help in my studies at UofT especially since I am a transfer student. OneClass is the study buddy I never had before and definitely gives me the extra push to get from a B to an A!

Leah — University of Toronto
Saarim — University of Michigan

Balancing social life With academics can be difficult, that is why I'm so glad that OneClass is out there where I can find the top notes for all of my classes. Now I can be the all-star student I want to be.

Saarim — University of Michigan
Jenna — University of Wisconsin

As a college student living on a college budget, I love how easy it is to earn gift cards just by submitting my notes.

Jenna — University of Wisconsin
Anne — University of California

OneClass has allowed me to catch up with my most difficult course! #lifesaver

Anne — University of California
Description
IDSB04 Lec 9: Health Crisis (Nov. 2) Neoclassical approach: if supply is free then the demand goes down Its not as alluring, and has moral hazard (overuses it) health care approach: demand goes up if supply is free health care creates its own demand (by physicians recommendation, etc) p. 542-3: why is the difference? 1. Patients dont control health spending (unless all have Munchausens syndrome) 2. Physician often spending 3 party $$ 3. Some health spending has no medical benefit (unnecessary services, profits, corruption, malpractice premiums. 4. Table 11-2: How the health care sector differs from markets P. 544: key questions P. 545: means of financing health care (3 points) P. 546: financing health care: Ultimately households pay but fairness differs: General taxation is most progressive (fair)its in Canada (premiums tailored to income) Mandatory health insurance less fair, especially if one premium for all Private insurance even less fair: sickest (poorest) pay higher premiums (everyone rated to risk of becoming ill so usually older, poorer, sicker pay most Out-of pocket least fair (most regressive)- no risk sharing at all Inadequate health financing is an important cause of poverty and P. 546-7: health insurance model: Guilds and workers- mutual protectionfriendly societies social insurance (national or community-based) www.notesolution.com
More Less
Unlock Document


Only pages 1-3 are available for preview. Some parts have been intentionally blurred.

Unlock Document
You're Reading a Preview

Unlock to view full version

Unlock Document

Log In


OR

Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


OR

By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.


Submit