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Laws and Public Policies and Health Care Delivery Systems in Other Countries
This class examines how the United States government impacts health care which in turn effects providers. This class will look at the Health Security Act originally proposed by President Clinton in 1993 and examine how the United States Congress may be moving more toward managed care. This class will analyze how "Any Willing Provider" and fraud and abuse and "Self Referral" type laws effect physicians and managed care organizations. Also, this class will explore how antitrust type laws effect physicians and managed care organizations. Healthcare systems in some other countries will also be explored.
Class 10 Topics: VARIOUS UNITED STATES LAWS AND PUBLIC POLICES/HEALTH CARE DELIVERY SYSTEMS IN OTHER COUNTRIES
B. Health Insurance Portability and Accountability Act of 1996 (HIPAA)
D. Employee Retirement Income Secuirty Act of 1974 (ERISA)
A. PATIENT PROTECTION AND PATIENT RIGHTS LAWS
B. ANY WILLING PROVIDER LAWS
VI. HEALTHCARE SYSTEMS IN OTHER COUNTRIES
A. GERMANY
B. CANADA
C. UNITED KINGDOM
D. POLICY SOLUTIONS
Key Objectives
1. Examine the effect market based competition compared to legislative regulations in managed care may have on physicians.
2. Synthesize laws that may effect physicians such as fraud and abuse and antitrust laws.
3. Examine what the United States can learn from other countries such as Britain, Germany, and Canada involving managed care in the health care delivery system.
Review
1. Analyze the effect market based competition compared to legislative regulations in managed care may have on physicians.
See: Ray Robinson, "Managed Care in the United States: A Dilemma for Evidence-Based Policy," Health Economics (2000): 1 - 7.
2. Describe the effect of fraud and abuse and antitrust type laws may have on physicians and managed care organizations.
See: Mark Lutes, J.D.,"Privacy and Security Compliance in the E-healthcare Marketplace," Healthcare Financial Management (March, 2000): 48 - 50.
3. Synthesize what the United States can learn from other countries such as Britain, Germany, and Canada involving managed care in the health care delivery system. Also, list three changes in European health care systems that parallel those in the United States.
See: Sean P. David, M.D., "Reflections From a Rotation in Cambridge, England," Family Medicine (May, 2000): 310 - 312.