The US Healthcare Systemand the Roemer Model.ppt

The US Healthcare Systemand the Roemer Model Lecture 2 Tracey Lynn Koehlmoos, PhD, MHA HSCI 609 Comparative International Health Systems Organization of  the US Health Services System Ever shifting mix of public/government sector, private sector and voluntary services. 16% of GDP spent on health services (2005) The US government now: Major payer for care: Medicare, Medicaid Provider of healthcare for special populations like Tricare, Indian Health Services, VA Major supporter of education and training of many types of care providers Introduction to the Roemer Model Developed by Milton I. Roemer, MD, MPH WHO, UCLA School of Public Health Pioneer in international health systems research Roemer Model of Health Services System (1984) allows for clear understanding of health systems Clear understanding = Meaningful comparisons Roemer Model Five Parts to the Model Organization of the Program Management of Health Services System Economic Support of Health Services Production of Health Services Resources Delivery of Health Services Part 1: Organization Ministry of Health—all levels Other Public Agencies Voluntary Agencies Enterprises Private Market Part 2: Management Planning Administration Regulation Legislation Part 3: Economic Support Personal Households Charity Insurance (voluntary) Social Security Governmental Revenues Foreign Aid Part 4: Production of Resources Manpower Facilities Commodities (drugs, DME, equipment, etc.) Knowledge Part 5: Delivery of Services Primary Care—Prevention Primary Care—Treatment Secondary Medical Care Tertiary Medical Care Care of Special Disorders and Populations Applying Roemer at Home Part I: Organization of Health Services: US health system is DECENTRALIZED Department of Health and Human Services (DHHS) instead of MoH DHHS regulates and finances many health services Services delivery primarily occurs in private sector Part I: Organization Public Health at the national level Centers for Disease Control and Prevention Food and Dru