PB HLTH 150D Lecture Notes - Lecture 12: Ken Jacobs, Managed Care, Health Policy

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24 Jul 2018
School
Department
Professor
Ken Jacobs
Single Payer - public paid, private provided
Top 3 health systems in the world:
1. UK (Public)
2. Australia (single payer system)
3. The Netherlands (shared responsibility)
California .. Why not implement?
Legal system - need change in the actual law to bring about change
Congress/voting ---> if you want to enforce, need to vote on it
Select Committee
Process to get to broader transformation
Help for all
o Affordability
o Cost and quality
*more than 3 million Californians are uninsured
1.787 million are not eligible for Medicaid due to immigration status
Not enough subsidy money to cover the bronze deductible
Bottom are those who are not eligible for cost sharing subsidies
Second set of rules
1. California wants to increase cost sharing subsidies
a. Middle class are the voters
Increased affordability
1. State premium subsidies for those eligible for the ACA puts the risk on the state
2. State cost sharing
Cost, Quality and Equity
1. Contain costs
2. Ensure quality in medical managed care
3. All payer claims data-base
4. Increase oversight on health industry consolidation
a. Health plan mergers
b. Ant-competitive contacts
5. Prescription dugs
6. Patient protections
Costs keep rising
Price is driving everything
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Document Summary

Top 3 health systems in the world: uk (public, australia (single payer system, the netherlands (shared responsibility) Legal system - need change in the actual law to bring about change: congress/voting ---> if you want to enforce, need to vote on it. Select committee: process to get to broader transformation, help for all, affordability, cost and quality. 1. 787 million are not eligible for medicaid due to immigration status. Not enough subsidy money to cover the bronze deductible. Bottom are those who are not eligible for cost sharing subsidies. Second set of rules: california wants to increase cost sharing subsidies, middle class are the voters. Increased affordability: state premium subsidies for those eligible for the aca puts the risk on the state, state cost sharing. Cost, quality and equity: contain costs, ensure quality in medical managed care, all payer claims data-base. Increase oversight on health industry consolidation: health plan mergers, ant-competitive contacts, prescription dugs, patient protections.

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