Medical students: Test your knowledge of health care financing

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Turning into an impressive doctor requires extra than simply empathy, training, good communication expertise and sound medical judgment. It additionally calls for perception into how well being care is financed so you’ll be able to perceive and adapt to the challenges sufferers face in accessing care and make sure you get compensated pretty on your work.

Content material associated to well being methods science—an understanding of how care is delivered, how well being professionals work collectively to ship that care, and the way the well being system can enhance affected person care and well being care supply—has turn out to be extra frequent on the USA Medical Licensing Examination (USMLE). The Nationwide Board of Medical Examiners contains the subjects in its USMLE Content material Define and affords a devoted well being methods science topic examination.

To assist medical college students, the AMA Accelerating Change in Medical Training Consortium has collaborated with the “InsideTheBoards” podcast to create a well being methods science (HSS) podcast collection. Every episode of the HSS collection affords on-the-go studying by breaking down apply examination questions with professional company.

A current episode contains a dialog with a doctor and a medical scholar about well being care economics, specializing in the historical past of medical insurance within the U.S. and its implications for sufferers and physicians.

Extra People get their medical insurance via employer-based plans than another supply, but likely don’t know why that is.

“Previous to World Conflict II, solely a fraction of medical insurance was supplied via employers,” mentioned Richard Lu, a third-year medical scholar at Harvard Medical Faculty.

However with the conflict got here inflation, and after Congress handed the Stabilization Act of 1942, the president froze wages and salaries for all staff. In lieu of upper salaries, employers started providing medical insurance as a fringe profit to draw and retain staff.

“After the wage freezes, that quantity skyrocketed and it grew to become entrenched in a path-dependent form of method, the place insurance coverage grew to become one thing that individuals labored for,” Lu mentioned. “And this concept—this notion of insurance coverage as being earned via employment and supplied by your employer—form of caught from then on.”

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Tying insurance coverage to employment presents apparent obstacles to making sure all people can see a physician when they should see one. However employer-based protection—in addition to some public medical insurance applications, similar to Medicaid, a joint federal and state program for individuals with restricted revenue and sources—even has downsides for individuals who get it.

“My insurance coverage is state-based,” mentioned Ned Palmer, MD, MPH, an attending doctor at Boston Kids’s Hospital and Harvard Medical Faculty. “And in order quickly as I go away Massachusetts, I wrestle to seek out well being care that my insurance coverage would cowl,” that means sufferers can then be on the hook for big out-of-pocket prices if they should entry care.

However one doesn’t have to journey out of state to get hit with unaffordable out-of-pocket prices with employer-based plans. Take copays, for instance.

“Twenty {dollars} doesn’t suggest the identical factor to all people,” added Dr. Palmer, additionally chief technique officer of Panacea Monetary, which is a sponsor of the “InsideTheBoards” podcast. “Twenty {dollars} is a set quantity, and $20 to any individual who’s making a $200 every week, as an example, may be very completely different than any individual who’s making $2,000 every week. And so … the identical pricing construction finally ends up differentially affecting those that are decrease wage and decrease revenue. It creates a a lot greater barrier to entry.”

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The podcast’s company additionally mentioned how insurers within the U.S. are shifting from fee-for-service to value-based cost and broke down the important thing parts of doctor compensation packages.

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