SLIDE 13 A Very Short Primer on American A Very Short Primer on American Health Care Financing:
$ illi h l h i P i i d $2.5 trillion spent on health care in 2009. Private insurance covered 59% of Americans. Government programs paid for 53% of direct health care costs and 62% if tax exemptions counted. More than 50 illi A i ith t h lth million Americans without health care coverage.
Private insurance policies Private insurance policies Medicare Trust Fund Medicare Trust Fund
- Elderly and those qualifying for
Elderly and those qualifying for di di bili di di bili
Largely paid for by em ployers em ployers
Usually sm all, but increasing, out increasing, out-
pocket Medicare disability Medicare disability
- For outpatient care, covers 8 0 % of
For outpatient care, covers 8 0 % of professional fee schedule for visits professional fee schedule for visits and procedures + APC for technical and procedures + APC for technical g, g, p costs borne by individuals costs borne by individuals
Thousands of com panies
- ffering tens of thousands of
- ffering tens of thousands of
individual policies individual policies charges charges
- In 20 0 6 outpatient m edications
In 20 0 6 outpatient m edications were covered were covered
- For inpatient care, covers 8 0 % of
For inpatient care, covers 8 0 % of individual policies individual policies
Range m inim al coverage for catastrophic illness to for catastrophic illness to full coverage full coverage p , p , fee schedule for professional costs + fee schedule for professional costs + DRG for technical costs DRG for technical costs
- Covers 55% of psychiatric care
Covers 55% of psychiatric care charges (Chapter 5 of ICD charges (Chapter 5 of ICD-
9) g ( p 5 g ( p 5 9) 9)
