Health and Health Care Systems in the USA

1. Population Health in the USA

2. Health Spending as % of GDP

3. Health Spending as % of GDP
16
12
$(int)
8
4
0
USA Canada Mexico Cuba UK
$int

4. Health Spending as % of GDP
16
15.4
12
$(int)
8
4
0
USA Canada Mexico Cuba UK
$int

5. Health Spending as % of GDP
16
15.4
12
9.8
$(int)
8
4
0
USA Canada Mexico Cuba UK
$int

6. Health Spending as % of GDP
16
15.4
12
9.8
$(int)
8
6.5
4
0
USA Canada Mexico Cuba UK
$int

7. Health Spending as % of GDP
16
15.4
12
9.8
$(int)
8
6.5 6.3
4
0
USA Canada Mexico Cuba UK
$int

8. Health Spending as % of GDP
16
15.4
12
9.8
$(int)
8 8.1
6.5 6.3
4
0
USA Canada Mexico Cuba UK
$int

9. Total per capita expenditure on Health

10. Total per capita expenditure on Health
7,000
5,250
$(int)
3,500
1,750
0
USA Canada Mexico Cuba UK
$int

11. Total per capita expenditure on Health
7,000
6,096
5,250
$(int)
3,500
1,750
0
USA Canada Mexico Cuba UK
$int

12. Total per capita expenditure on Health
7,000
6,096
5,250
$(int)
3,500
3,173
1,750
0
USA Canada Mexico Cuba UK
$int

13. Total per capita expenditure on Health
7,000
6,096
5,250
$(int)
3,500
3,173
1,750
655
0
USA Canada Mexico Cuba UK
$int

14. Total per capita expenditure on Health
7,000
6,096
5,250
$(int)
3,500
3,173
1,750
655
0 229
USA Canada Mexico Cuba UK
$int

15. Total per capita expenditure on Health
7,000
6,096
5,250
$(int)
3,500
3,173
2,560
1,750
655
0 229
USA Canada Mexico Cuba UK
$int

16. Life expectancy

17. Life expectancy
81.00
80 81
78 79
77 76
75 75 75
72
60.75
40.50
20.25
0
M F M F M F M F M F
USA Canada Mexico Cuba UK

18. Under 5 Mortality

19. Under 5 Mortality
30.0
22.5
21.1
15.0
7.5 7.9
6.8
5.9
0
USA Canada Mexico Cuba
per 1,000 lb

20. Adult Mortality Rate (aged 15-60 per 1,000)

21. Adult Mortality Rate (aged 15-60 per 1,000)
200
162
150
137
128
100 101
90 94
81 83
62
50 56
0
M F M F M F M F M F
USA Canada Mexico Cuba UK

22. Ideology and Culture

23. Ideology and Culture
Libertarian Individualism

24. Ideology and Culture
Libertarian Individualism Conservative

25. Ideology and Culture
Libertarian Individualism Conservative
National Identity

26. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity

27. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity
National Legislation- Federal

28. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity
Local Legislation- State National Legislation- Federal

29. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity
Local Legislation- State National Legislation- Federal
Influence of Religious
Right

30. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity
Local Legislation- State National Legislation- Federal
Influence of Religious
Separation of Religion and State
Right

32. Obesity Trends* Among U.S. Adults
BRFSS, 1990, 1998, 2006
(*BMI ≥30, or about 30 lbs. overweight for 5’4” person)
1990 1998
2006
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System.

33. Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: Behavioral Risk Factor Surveillance System, CDC.

34. Diabetes
20.8 Million (7%) Americans are
diabetic
54 Million Americans are ‘pre diabetic’
American Indians (18%)
Non Hispanic Blacks (16%)
Hispanic/Latino (14%)
Non Hispanic Whites (8%)

35. Cortland County, NY.

36. Cortland County, NY.

37. Cortland County, NY.

38. Rural Experiences

39. Social Indicators
Teen preg. Child Abuse Calls

40. Social Indicators
Teen preg. Child Abuse Calls
40
30
Per 1000 pop
20
10
0
Cortland NY State

41. Social Indicators
Teen preg. Child Abuse Calls
40
40.0
30
Per 1000 pop
20
18.3
10
0
Cortland NY State

42. Social Indicators
Teen preg. Child Abuse Calls
40
40.0
30
Per 1000 pop
20 22.1
18.3
10
9.1
0
Cortland NY State

43. Drunk Driving
DWI arrests Under 20 DWI

44. Drunk Driving
DWI arrests Under 20 DWI
60
45
Per 10,000
30
15
0
Cortland NY State

45. Drunk Driving
DWI arrests Under 20 DWI
60
56.2
45
Per 10,000
30
25.3
15
0
Cortland NY State

46. Drunk Driving
DWI arrests Under 20 DWI
60
56.2
54.2
45
Per 10,000
30 30.9
25.3
15
0
Cortland NY State

47. Social indicators
Unemployment High School Droputs

48. Social indicators
Unemployment High School Droputs
6.0
4.5
3.0
%
1.5
0
Cortland NY State

49. Social indicators
Unemployment High School Droputs
6.0
6
6
4.5
3.0
%
1.5
0
Cortland NY State

50. Social indicators
Unemployment High School Droputs
6.0
6
6
4.5
4
3.0
%
2
1.5
0
Cortland NY State

51. Average Income

52. Average Income
$50,000
$46,195
$37,500
$34,867
$25,000
$12,500
$0
Cortland NY State

53. Physical Activity
Moderate 30 x 5 Vigorous 20mins x 3

54. Physical Activity
Moderate 30 x 5 Vigorous 20mins x 3
70.0
52.5
35.0
17.5
0

55. Medicare

56. Medicare
• Department of Health and Human Services

57. Medicare
• Department of Health and Human Services
• Social insurance covering 43 Million
Americans

58. Medicare
• Department of Health and Human Services
• Social insurance covering 43 Million
Americans
• 65+ US citizens or permanent legal resident
for 5 yrs

59. Medicare
• Department of Health and Human Services
• Social insurance covering 43 Million
Americans
• 65+ US citizens or permanent legal resident
for 5 yrs
• Or under 65 with permanent disability social
security benefit for more than 24 months

60. Medicare
• Department of Health and Human Services
• Social insurance covering 43 Million
Americans
• 65+ US citizens or permanent legal resident
for 5 yrs
• Or under 65 with permanent disability social
security benefit for more than 24 months
• End stage renal disease, renal failure,

61. Finance

62. Finance
• Payroll tax- 1.45% worker/ 1.45%
employer

63. Finance
• Payroll tax- 1.45% worker/ 1.45%
employer
• Total medicare spending $440
billion (2007) 16% of all federal
spending

64. Hospital care

65. Hospital care
• At least 3 days (midnights) not counting discharge
day

66. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)

67. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)
• Only “Skilled Care” covered for up to 100 days

68. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)
• Only “Skilled Care” covered for up to 100 days
• First 20 days full cost

69. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)
• Only “Skilled Care” covered for up to 100 days
• First 20 days full cost
• 80 days part payment (above $128)

70. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)
• Only “Skilled Care” covered for up to 100 days
• First 20 days full cost
• 80 days part payment (above $128)
• After 100 days must have a gap of 60+ days before
eligible for more care support

71. Medicines and other out patient costs

72. Medicines and other out patient costs
• Optional cover
• Local and National Determinations of Cover
• Outpatient procedures
• Physician, nursing, x-ray, laboratory and other diagnostic tests
• Canes, walking and mobility aids,
• one pair of spectacle after cataract surgery
• Oxygen for home use
• Influenza and other vaccines
• Blood transfusions, renal dialysis
• Chemotherapy
• Immunosuppresive drugs for organ transplant patients
• Medications administered by a physician in the doctor’s office

73. Medicare +

74. Medicare +
• Additional or alternative private
medical insurance
• Equivalent to medicare but may
be variable in cover offered
• Co payment required for many
areas of health care

75. Additional costs

76. Additional costs
• Hospital Cover
• 10 years+ (40 quarters) contributions
$233 per month
• Less than 7.5 yrs (30 quarters)
Contributions $423 per month
• Medicines cover- $89 per months

77. Deductibles

78. Deductibles
• 1- 60 days hospital care $1,024

79. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day

80. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day
• 91- 150 days $512 per day

81. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day
• 91- 150 days $512 per day
• $128 per day for skilled nursing home
care 21- 100 days

82. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day
• 91- 150 days $512 per day
• $128 per day for skilled nursing home
care 21- 100 days
• Blood deductible for first 3 units of blood
unless replaced

83. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day
• 91- 150 days $512 per day
• $128 per day for skilled nursing home
care 21- 100 days
• Blood deductible for first 3 units of blood
unless replaced

84. Payments to providers

85. Payments to providers
• Fixed amount per condition not
actual treatment costs

86. Payments to providers
• Fixed amount per condition not
actual treatment costs
• “Upcoding” by Physician to cover
unexpected costs

87. Payments to providers
• Fixed amount per condition not
actual treatment costs
• “Upcoding” by Physician to cover
unexpected costs
• Hospitals can keep money not
spent on patient (cover shortfall
for excess on other patients)

88. problems

89. problems
• Number of workers paying
contributions compared to
claimants falling
• Cost of treatments increasing

90. Medicaid

91. Medicaid
• Joint state and federal funded entitlement programme

92. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities

93. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part

94. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part
• Average expenditure 22% of state spending

95. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part
• Average expenditure 22% of state spending
• Covers 42.9 million Americans

96. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part
• Average expenditure 22% of state spending
• Covers 42.9 million Americans
• 37% of Childbirths

97. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part
• Average expenditure 22% of state spending
• Covers 42.9 million Americans
• 37% of Childbirths
• 60% of nursing home care

98. Eligibility

99. Eligibility
• Varies from state to state

100. Eligibility
• Varies from state to state
• Low income plus

101. Eligibility
• Varies from state to state
• Low income plus
• Age

102. Eligibility
• Varies from state to state
• Low income plus
• Age
• Pregnancy

103. Eligibility
• Varies from state to state
• Low income plus
• Age
• Pregnancy
• Blindness

104. Eligibility
• Varies from state to state
• Low income plus
• Age
• Pregnancy
• Blindness
• Disability