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1、CHAPTER10GOVERNMENTANDTHEMARKETFORHEALTHCARESOURCE:CentersforMedicareandMedicaidServices[2005a].SOURCE:CentersforMedicareandMedicaidServices[2005a].PrivateHealthInsuranceTheImplicitSubsidyforEmployer-ProvidedInsuranceWorldWarIIerapricecontrolsFederaltaxsubsidyTheAdvantagesofEmployer-Provid

2、edHealthInsuranceIncreasetheriskpoolReduceadverseselectionLoweradministrativecostsEmployer-ProvidedHealthInsuranceandJobLockJoblockHealthInsurancePolicyPortabilityandAccountabilityActof1996(Kennedy-KassenbaumAct)CostControlandPrivateInsuranceCost-basedreimbursement(fee-for-service)Managedc

3、areCapitation-basedreimbursementHealthMaintenanceOrganizations(HMOs)PreferredProviderOrganizations(PPOs)Point-of-service(POS)Medicare:OverviewSOURCE:CentersforMedicareandMedicaidServices[2005a].RealexpendituresonMedicareExpendituresonMedicareasaShareofGDPHowMedicareWorksBenefitsPartA–Hospi

4、talinsurance(HI)PartB–Supplementarymedicalinsurance(SMI)FinancingPayrolltaxfundsHIGeneralrevenuesfundSMIPrescriptionDrugBenefitPartC–MedicareAdvantagePartD–PrescriptionDrugBenefitMonthlypremiumLowdeductibleDonutholeGenerouscoverageforhighcostsCostControlUnderMedicareMedicare’sretrospective

5、paymentsystemMedicare’sprospectivepaymentsystemDiagnosisrelatedgroupsResource-basedrelativevaluescalesystemMedicareManagedCareMedicare:ImpactsonSpendingandHealthExpendituresonhealthcarefortheelderlyHealthoutcomesMedicaid:OverviewMedicaidStateChildren’sHealthInsuranceProgramSOURCE:Centersfo

6、rMedicareandMedicaidServices[2005a].FinancingandAdministrationJointFederal-StatefinancingStateadministrationBenefitsStatesobligatedtoofferminimumpackageofbenefitsStatesmayoffermoregenerousbenefitsStateadministrativeflexibilityMedicaid:ImpactsonHealthTake-uprateCrowdingoutEmpiricalevidence:

7、AreMedicaidexpansionseffective?CrowdingoutandtakingupHealthCareReformIndividualmandatesHealthsavingsaccountsCatastrophicinsurancepolicySinglepayerFinalThoughtsSecurityvefficiencyNofreelunchConnectionbetweenhealthcareexpendituresandhealthDoesPublicInsuranceCrow