Slides on heathcare, management and impact of socio-economic diversity

1. ManagementandImpactofSocio-economic
Diversity
Healthcare
1
PreparedbyMrK.WongandadaptedbyMsCarol

2. Management and Impact of Socio-
economic Diversity
2
Market-based
approach in USA
Shared
Responsibility
approach in
Singapore
Government-
financed approach

3. 1.Management& ImpactofSocio-economic
Diversity
i.Market-basedApproach
In this approach, the government gives citizens the freedom to decide how
much they wish to pay for healthcare and allows the market to determine the
provision of services to meet healthcare needs.
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4. 1.Management& ImpactofSocio-economic
Diversity
i.Market-basedApproach
a) Market-based approach in the USA
• There is no single national policy guiding healthcare system in USA
• Both public and private hospitals provide healthcare services to American
citizens
• The US government does not intervene in these systems
• Middle and higher socio-economic status groups obtain their medical
insurance as part of their employment package
• Medical insurance premiums are higher as insurance companies charge
higher in a market-based system to make profit.
• However, not everyone is able to afford medical insurance 4

5. Policy How and for whom does the policy
help?
Who are not covered under this policy?
Medicare  Americans above age 65
 Americans aged below 65 if they have
permanent kidney failure or disabilities
 Americans below the age of 65 who may not
have the financial ability to pay for healthcare
Medicaid  Available to Americans with limited
income or have disabilities
 Americans who may not fall within groups with
limited income but still may not have the
financial means to pay for their healthcare
EMTALA  All cases of emergency treatments in
hospitals
 Americans who have chronic diseases which
are not catastrophic and who have no access
to medical services under EMTALA
Who are not covered by these policies?
Low-income families who are disadvantaged by circumstances (e.g. joblessness, poor health, etc) but do not
qualify for Medicaid, or are unable to purchase highly priced insurance.
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6. 1.Management& ImpactofSocio-economic
Diversity
i.Market-basedApproach
b) Keeping healthcare affordable in the USA
• Americans have to cope with the healthcare costs on their own
• Americans of lower socio-economic status are more likely to be
affected due to high costs – which might lead them to not visit
doctor, take necessary treatments or follow-up care.
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7. 1.Management& ImpactofSocio-economic
Diversity
i.Market-basedApproach
c) Challenges faced by the healthcare system in the USA
Lower socio-economic status:
• Heath insurance premiums cost few thousand dollars per year.
• These premiums are deducted from their pay.
• Many low socio-economic status groups do not buy insurance as they
need to pay for their daily needs.
• Low-skilled workers are not given any healthcare insurance as small firms
find it a financial burden to provide one
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8. 1.Management& ImpactofSocio-economic
Diversity
i.Market-basedApproach
c) Challenges faced by the healthcare system in the USA
Insurance companies:
• Profit-making
• More motivated to insure the healthy and the employed
• Insuring the sick (in the past) or risky ones will incur more costs
• This leads to the situation of healthcare being denied to those who need it
most.
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9. 1.Management& ImpactofSocio-economic
Diversity
i.Market-basedApproach
c) Challenges faced by the healthcare system in the USA
ObamaCare 2014:
• There is possibility of lower socio-economic status groups to receive more
help
• Low to moderate income are now eligible for financial assistance in
obtaining insurance coverage
• Benefits Americans from a wider range of income levels
• Alleviate challenges posed by market-based approach 9

10. 10
Thinking Cap: Why do you think these
cartoons were published?

11. Video:
Title: Why Is Healthcare So Expensive in the United States?
URL: https://www.youtube.com/watch?v=Ro56CoQ7GoY
(Title: Why Is Healthcare So Expensive in the United States?)
Synopsis of Video:
To understand more about the healthcare system set up in the USA.
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12. BonusReading:
(Pleasereadthesepagesonlywhenyouhavecompleted
therestofthehandout)
Title: The future of free market healthcare
URL: http://blogs.reuters.com/great-debate/2013/02/20/the-future-of-free-market-healthcare/
Title: Obamacare in 2014
URL: http://www.businessinsider.sg/daily-show-steven-brill-obamacare-2014-1/#.Vhingd-qqko
Title: Compelling reasons for a market-driven healthcare system
URL: http://www.heritage.org/research/reports/2013/12/compelling-evidence-makes-the-case-for-
a-market-driven-health-care-system
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13. 1.Management& ImpactofSocio-economic
Diversity
ii.SharedResponsibilityApproach
• The government intervenes through the provision of basic healthcare
services and shares the costs of some aspects of healthcare.
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14. 1.Management& ImpactofSocio-economic
Diversity
ii.SharedResponsibilityApproach
a) Shared responsibility approach in Singapore
• Public and private healthcare service providers
Primary Care  polyclinics (public) & general practitioners (private)
Hospitals  e.g. SGH (public) & Mount Alvernia (private)
• Voluntary organisations
E.g. community hospitals, nursing homes, hospice cares
• Financing is guided by a combination of personal & collective
responsibility and government provision.
E.g. CPF & Medisave
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15. 1.Management& ImpactofSocio-economic
Diversity
ii.SharedResponsibilityApproach
b) Keeping healthcare affordable in Singapore
• Healthcare subsidies
• Medisave
• Medishield Life/ ElderShield
• Medifund
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16. 16

17. 1.Management& ImpactofSocio-economic
Diversity
ii.SharedResponsibilityApproach
c) Challenges faced by the healthcare system in Singapore
Managing the growing demand for healthcare:
• Singapore’s population is growing and the ageing population is growing 
healthcare services & capacity of infrastructure will need to grow in
tandem
• Also, with increasing life expectancy and more sedentary lifestyles, there
will be a greater need of treatment for chronic diseases
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18. 1.Management& ImpactofSocio-economic
Diversity
ii.SharedResponsibilityApproach
c) Challenges faced by the healthcare system in Singapore
Rising healthcare costs:
• Singaporeans are not spared from the effects of global healthcare inflation.
• A concerted effort from everyone is needed to manage this high costs.
• To continually review the system to ensure that healthcare needs continue
to be sufficiently met in the context of rising costs and expectations of
citizens.
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19. Video:
Title: Affordable Healthcare for All
URL: https://www.youtube.com/watch?v=V2akdRnUKxI
Synopsis of Video:
The video explores the different components of financing healthcare and how
personal responsibility is important in managing the costs of healthcare.
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20. Video:
Title: How much does the Singapore Government spend on Healthcare?
URL: https://www.youtube.com/watch?v=bDOkKQ-_89Y
Synopsis of Video:
This video shows what the components of healthcare financing for
Singaporeans are in which the government takes an active role in providing.
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21. 1.Management& ImpactofSocio-economic
Diversity
iii.Government-financedApproach
The government provides substantial subsidies and services for
most of the healthcare needs of its citizens.
a) Healthcare system and financing in Sweden
• The fundamental belief is that all citizens should have access to
healthcare services regardless of background or socio-economic status.
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22. Sweden’s Social Welfare System Up Close
There is free day-care offered from age 1, and a free primary and secondary
school system that promotes democratic values. School lunches are free for all
students. University and post-graduate studies are free. Healthcare and dental
coverage is high quality and universal, and patients choose their doctors. A public
pension system reserves a portion of your income for retirement. There is an
efficient public transportation system of metros, streetcars, buses and commuter
trains… The country only spends 1.2% of its GDP on national defence, allowing
more funds to be spent on social welfare. Sweden pays for its social welfare
system through one of the highest tax rates in the world. The people we talked to
saw paying in as part of their self-interest. Everyone pays in; and everyone gets
back.
http://www.gmfus.org/blog/2013/12/18/swedens-social-welfare-system-close
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23. Bonus Readings:Read these duringyour
free time
For more information about Sweden’s healthcare system, refer to the following
resources:
• https://sweden.se/society/health-care-in-sweden/
• http://www.thelocal.se/20130327/46910
• http://www.commonwealthfund.org/~/media/files/resources/2008/health-care-
system-profiles/sweden_country_profile_2008-pdf.pdf
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24. 1.Management& ImpactofSocio-economic
Diversity
iii.Government-financedApproach
b) Keeping healthcare affordable in Sweden
Policy 1: National ceiling for out-of-pocket payments
Policy 2: Costs of prescriptions
Policy 3: Child protection
Policy 4: Freedom to choose private insurance
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25. 1.Management& ImpactofSocio-economic
Diversity
iii.Government-financedApproach
b) Keeping healthcare affordable in Sweden
Policy 1: National ceiling for out-of-pocket payments
Section of society that would benefit most:
For lower income families and those with chronic illnesses
Explanation:
They would not be subjected to ever increasing amounts of money
to be paid for a long term illness.
Policy 2: Costs of prescriptions
Section of society that would benefit most:
For lower income groups and those with chronic illnesses
Explanation:
They would not be subjected to ever increasing amounts of money
to be paid for a long term illness.
Policy 3: Child protection
Section of society that would benefit most:
Large families with many children, and/or lower income families
Explanation:
They would not be subjected to ever increasing amounts of money
to be paid for a long term illness.
Policy 4: Freedom to choose private insurance
Section of society that would benefit most:
Middle to higher income groups, groups with chronic and catastrophic
illnesses
Explanation:
They would have the flexibility to choose more specific plans for their
medical needs
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26. 1.Management& ImpactofSocio-economic
Diversity
iii.Government-financedApproach
c) Challenges faced by the healthcare system in Sweden
High taxation for low healthcare costs:
• Despite the willingness of most Swedes to pay high taxes to sustain the
government-financed system, the ageing population means that the tax
burden will increasingly fall on a smaller group of working citizens.
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27. 1.Management& ImpactofSocio-economic
Diversity
iii.Government-financedApproach
c) Challenges faced by the healthcare system in Sweden
Growing number of people needing healthcare:
• Their once homogenous society is becoming more diverse due to
immigrants
• Besides immigrants, citizens of EU member have access to Sweden
healthcare  they consume healthcare without paying taxes
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28. Video:
Title: Immigration is killing Sweden’s welfare state
URL: https://www.youtube.com/watch?v=UoUjJKXZjRY
Synopsis of Video:
This video is a newscast that shows who these new immigrants are, the
constraints on the system of healthcare provision in Sweden, etc.
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