Before the passage of the Affordable Care Act, approximately 15% of Americans did not have health insurance.

Continue watching to see the breakdown. 43 million uninsured non-illegal If Obama tries to provide the universal coverage, when 85% of people is insured, and needs at least 51% of the votes dilemma. When might an insured person worry about becoming uninsured: in a recession. What proportion of the uninsured can afford health insurance? FPL: Federal Poverty Level How much insurance for a family of four? ~ $15k per year 36% of people who <100% FPL is uninsured 5% of people who >400% FPL is uninsured. So uninsurance is not restricted to the poor but dominant in the poor. What does the typical uninsured American look like? White, working adult, without children The most common "type" of uninsured in America is a non-elderly, working adult. (Adults aged 65 and over are covered by Medicare.) However, the rate (i.e. proportion) of uninsurance is greater for blacks and Hispanics than for whites, and for low-income Americans than for medium- and high-income Americans. The typical uninsured American: White: 46% are non-Hispanic whites Working: more than are in working families Young adults: 19-29 years old make up 32% US citizens: 81% are US citizens Characteristics of the Uninsured: family work status: 1 or more full-time workers 61% parttime workers: 16% No worker: 23% Most of the uninsured is somewhat gainfully employed How long do most people stay uninsured? 3 years Over half of the uninsured stay uninsured for more than three years

at a time. Another fifth stay uninsured for between one and three years. This is an important policy issue, since it means that people who go without insurance do so for long periods of time. We will see in a few minutes that being uninsured deteriorates access to health care, as well as health outcomes, compared to being privately insured. half of the people, it is a long term problem (stuck with employers who do not provide coverage) The proportion of the population that is uninsured is substantially higher in the South (mostly red states) than elsewhere. The Northeast has the lowest proportion of uninsured. State has a variety of very creative mechanisms to discourage people for signing on to benefits that they are legally entitle to. Medicaid is the biggest one that they put a lot of barriers because it is expensive for them. Another reason, if you are a welfare right group or a group that really cares about this population and you want to get them insured, it could be somewhat difficult to get them onto the roles because they are concerned about stigmatized Medicare. Medicare are not stigmatized, every one gets it, rich and poor. Americans belief: tomorrow is gonna be better. I am not going through the hassle signing up for Medicaid, I am going to get a job in a month. Most children got coverage through employment of Mom and Dad. About 40% get coverage to Medicaid or CHIP. How does being uninsured affect health outcomes? Breast cancer in women: 89% 5-year survival with insurance 76% 5-year survival with Medicaid or without insurance That is 13% difference!
Lecture 3: In 2010, the US spent 2.6 trillion dollars on Health Care. (~Frances GDP, #5 economy in the world) By how many billions of dollars did health care spending rise between 2009 and 2010? 100 billions Almost every year, growth in health care cost is 2.45% higher than the growth in GDP

The US spends 1.5 times as much on health care as Norway, the next highest-spending country. It is a common misperception that our high medical spending is composed largely of spending on prescription drugs. In fact, only about 10% of health care costs go to prescription drugs. The Congressional Budget Office estimates that less than 1% of the growth in health care costs is due to medical malpractice. We will return to this issue next week. Causes of Health Care Cost Growth: Technology 38 65% (switching from old to new technology)

Who pays the largest portion of the cost of health care in the US?
Of these four categories, households pay the largest proportion of health care costs in the US (28%), with the federal government a close second (27%). Note that each of these categories pays a larger share of costs than private business.

What proportion of the increase in health care costs is due to the aging of the population?
In spite of all the media attention, the proportion of the growth in health care costs attributable to the aging of the population is only 2%. It is true that the elderly account for a disproportionate share of health care spending, but this is not the same as growth in health care costs. The average annual health insurance premium for a family is approximately $15,000.
What is the probability that a 60-year-old surgeon has been sued for malpractice at least

once in his/her career? 100% Which medical specialty is sued the most frequently? Neurosurgeons have the

highest rate of malpractice claims against them of any medical specialty. The top five most sued medical specialties are all surgical specialties. Since 1990, is the frequency of medical malpractice claims..? Too complex of a trend to categorize For low-risk specialties, the frequency of medical malpractice claims has been decreasing over the past two decades. For high-risk specialties, it has fluctuated without a clear trend. Approximately how often are practitioners sued when they are negligent? 0-5% of the time 98% of adverse events due to negligence did not lead to a malpractice claim. Only 1.5% of incidences of malpractice lead to a malpractice suit. Malpractice premiums, settlements, and administrative costs are approximately $35 billion, about 2% of total health care costs.