POLI 2070
10/14/13
Healthcare Policy
• Intro
o Paradox: in a nation that has the best medical care in the world & is at the
forefront of medical research, 1 in 5 people do not have regular access to
medical care
o 2009: 44% of all healthcare spending in U.S. by fed. agencies in some way
o Although the U.S. state is less involved than other states, it remains very
involved in the administration of healthcare
o Most cabinet level depts.. have some involvement in healthcare system
o All levels of gov’t have some degree of involvement
o Move from conservative toward block grants give more control to the state
& medical programs are generally expensive
o Generally, there are many differences btwn. individual states & the level
of possible involvement of the fed. gov’t
• Problems in healthcare
o U.S. is a rich country that spends much of its revenue on healthcare, but
on common health care markers are evident
o High quality healthcare is avail. but:
▪ Infant mortality rate is 48th in world
▪ Problem is particularly concentrated in minority population
▪ Disparity in infant mortality rate btwn. races has increased since
1970s
o Disparities are evident also across geographic region
o Middle class citizens are being slowly pushed out of the system b/c cost is
increasing & b/c employee healthcare is being offered
o Access to medical care
▪ Most healthcare is paid for privately by those who cannot afford it
(50 million Americans do not have health insurance)
▪ Medicine is generally not avail. to poorer individuals
▪ About 1/3 of individuals below poverty line still did not qualify for
Medicaid benefits (primarily the working poor)
▪ 24% of poor have private health insurance; 10% have nonhospital
coverage
▪ Medicare for the elderly does not always cover the whole cost of
treatment
▪ Upper limits can be problematic for even the middle class privately
covered individual
▪ Even those making $25k+ have a substantial percentage mot
covered & these individuals are employed most have members
employed full time
▪ Covered individuals as a percentage of the population is decreasing
& those covered are being required to pay more of the premium
than they were before