2.3T

16.2% of GDP

$7,681 per capita

Illness

Disease

Sickness

Illness: patient decides

Disease: professional opinion

sickness: social status

License

Registration

Certification

License: government granted

registration: official roster

Certification: non government agency

Primary Preventative

Preventative

Primary Care

Secondary Care

Tertiary Care

Primary Preventative: clean water

Preventative: screaning

Primary Care: initial diagnosis & treatment of routine needs

Secondary Care:More specialized, surgery, back same day

Tertiary Care:Serious Opperation, overnight stay

3/4 of health workers

31% of spending

2^nd largest enployer

distribute their earnings to stock holders

"fill the cracks"

no stock holders

privately owned, often bya  family

Governing board

CEO

medical Staff

LTC

Skilled Nursing Facility (SNF)

bridge gap between hospital and home

PT stay after a surgery

medicare and medicaid payed

castodial

medicaid pay

FFS

Capitation

FFS: if the doctor does more, TP pays more

Capitation: flat payment by TP

patient-provider/payer

has capitation encourages doing less

incentive to keep people healthy

adverse selection: reject the sick

Discourage utilazation: long waits, self care, triage consultation, less freedom to pick doctors

low premiums, low choices

pt pays less if preferred provider used

more pt choice

doesn't put provider at economic risk

oversees MD's decision

MD is "gatekeeper", refer to specialist

Cost shareing

+

-

Condition

+ No wasted healthcare

- No use of necesary HC

Condition: PT can distinguish what is necesary healthcre

MD gets $, must pay for services out of pocket.

more tests = less $ for MD

Heart Atack

Cancer

Stroke

(infectious diseases are making a comback because of drug resistance)