Health Care Economics
“It was the best of times it was the worst of times.” How prophetic was Charles Dickens when applied to health care in America today.1 We are currently experiencing unprecedented technologic and therapeutic advancements; however, these come at a tremendous price. Health care expenditures have increased by double digits for the past decade, physician reimbursement has decreased by over the past 10-years, and hospitals have closed and health care systems have filed for bankruptcy.2 Furthermore, in 2009, national health care expenditures are projected to have reached $2.5 trillion, an increase of 5.7%, up from the 4.4% increase seen in 2008, while the overall economy, as measured by gross domestic product (GDP) is still in recession, and anticipated to have fallen 1.1% (Table 51-1). From 2009 to 2019 the average annual health care spending growth is projected to grow at a rate of 6.0%, well outpacing the expected average annual growth in the overall economy (4.4%). By 2019, national health spending is expected to reach $4.5 trillion and comprise 19.3% of GDP3 (Figure 51-1).4 It is in this environment that President Barak Obama has attempted potentially sweeping changes in the health care landscape. At the time of writing this book, health care reform has passed the democratically controlled congress. However with the republicans regaining control in the 2010 midterm elections renewed partisan opposition to health care reform has occurred.
KeywordsHealth Care Reform Skilled Nursing Facility Medicare Part Prospective Payment System Private Payer
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