Obamas Healthcare Reform Bill And Its Impact On The U.s. Healthcare Market --- Aarkstore Enterprise
REPORT DESCRIPTION
REPORT DESCRIPTION
According to World Health Organization, the U.S. healthcare system ranks 37th among the healthcare systems of 200 countries. The U.S. healthcare spending is considered as one of the highest in the world as healthcare expenditure in the country accounts to 17.5% of its GDP (2009) as compared to an average of 8% to 9% in the Organization for Economic Co-operation and Development (OECD) countries. However, the rising healthcare costs and increasing health premium rates, along with high number of uninsured people (about 47 million, i.e., approximately 16% of the total population) are among the significant factors contributing to the need for healthcare reforms in the U.S. Healthcare reforms in the country are looked upon as an initiative toward provision of affordable health coverage for all Americans, and improvement in quality and efficiency of healthcare.
President Obama signed the health reform into law in March 2010 to address the inefficiencies of the existing healthcare structure and to decrease the number of uninsured people in the U.S. The health reform bill outlines several provisions such as universal health coverage, cost containment, increase in insurance market competition, excise tax on medical device manufacturers, and lower drug costs for Medicaid and Medicare. Thus, the provisions in the health reforms directly impact the U.S. healthcare industry and its stakeholders
Table of Contents :
1 INTRODUCTION
1.1 KEY TAKE-AWAYS
1.2 REPORT DESCRIPTION
1.3 STAKEHOLDERS
1.4 RESEARCH METHODOLOGY
2 U.S. HEALTHCARE INDUSTRY OVERVIEW
2.1 OVERVIEW OF HEALTHCARE SYSTEM IN U.S.
2.2 HEALTHCARE REFORMS IN THE U.S.
2.2.1 AGENDA OF OBAMAS HEALTHCARE REFORMS
2.2.2 CHALLENGES FOR OBAMAS HEALTHCARE REFORMS
2.2.3 IMPACT OF OBAMAS HEALTHCARE REFORMS ON THE HEALTHCARE INDUSTRY
2.2.3.1 Impact on Health Insurance Industry
2.2.3.2 Impact of on Pharmaceutical and Medical Devices Industries
2.2.3.3 Empowerment of Healthcare consumers and its impact on U.S. economy
3 U.S. HEALTHCARE SYSTEM
3.1 HEALTHCARE STRUCTURE IN THE U.S.
3.1.1 REIMBURSEMENT AND FINANCING.
3.1.1.1 Public health insurance
3.1.1.1.1 Medicare.
3.1.1.1.2 Medicaid
3.1.1.1.3 Other public systems.
3.1.1.2 Private health insurance
3.1.1.2.1 Employer-sponsored insurance.
3.1.1.2.2 Private non-group insurance (individual market).
3.1.1.2.3 Private group insurance (cooperative)
3.1.2 REGULATORY ENVIRONMENT
3.1.2.1 Healthcare laws
3.1.2.2 Regulating bodies
3.1.2.2.1 The Center for Devices and Radiological Health (CDRH)
3.1.2.2.2 U.S. Food and Drug Administration (FDA)
3.2 HEALTHCARE EXPENDITURE.
3.2.1 TOTAL HEALTHCARE EXPENDITURE.
3.2.2 PER CAPITA HEALTHCARE EXPENDITURE.
3.2.3 HEALTHCARE BUDGET AND HEALTH REFORMS
3.2.4 OBAMAS STIMULUS PACKAGE FOR HEALTHCARE SECTOR
3.3 NEED FOR HEALTHCARE REFORMS
3.3.1 RISING HEALTHCARE COSTS.
3.3.2 UNAFFORDABLE HEALTH INSURANCE.
3.3.3 UNEVEN HEALTH COVERAGE.
3.3.4 LACK OF QUALITY HEALTHCARE
4 OBAMAS HEALTHCARE REFORMS
4.1 OBAMAS PROPOSED STRATEGIES FOR HEALTHCARE REFORMS.
4.1.1 INCREASING AFFORDABILITY AND ACCESSIBILITY OF HEALTHCARE
4.1.2 IMPROVING PUBLIC HEALTH
4.1.3 LOWER HEALTHCARE COSTS
4.1.4 IMPROVING QUALITY OF HEALTHCARE.
4.2 OBAMAS INITIATIVES IN HEALTHCARE
4.2.1 OBAMAS HEALTHCARE REFORMS
4.2.1.1 Patient Protection and Affordable Care Act, 2009
4.2.1.2 Health Care and Education Reconciliation Act 2010.
4.2.1.3 Healthcare Reforms Implementation Timeline
4.2.2 OTHER HEALTH INITIATIVES
4.2.2.1 Childrens Health Insurance Program Reauthorization Act, 2009 (CHIPRA)
4.2.2.2 American Recovery and Reinvestment Act, 2009
5 IMPACT OF OBAMAS HEALTH REFORM PROVISIONS ON THE U.S. HEALTHCARE INDUSTRY
5.1 IMPACT ON MEDICAL DEVICES INDUSTRY
5.1.1 EXCISE TAX
5.1.2 INCREASED FDA COMPLIANCE
5.1.3 INCREASED TRANSPARENCY THROUGH CER AND BAN ON SUNSHINE PROVISION.
5.1.4 INDIRECT IMPACTS
5.1.5 BUSINESS IMPLICATIONS FOR MEDICAL DEVICE MANUFACTURERS.
5.2 IMPACT ON PHARMACEUTICAL INDUSTRY
5.2.1 EXCISE TAX: A POTENTIAL NEGATIVE IMPACT
5.2.2 LOWER DRUG PRICES THROUGH MEDICARE AND MEDICAID
5.2.3 REBATES FOR NEW FORMULATIONS OF BRANDED DRUGS
5.2.4 INCREASE INSPECTION AND COMPLIANCE COSTS
5.2.5 12-YEAR EXCLUSIVITY FOR BIOLOGICS AND NEW REGULATORY PATHWAY FOR BIOSIMILARS.
5.2.6 COVERAGE OF CLINICAL TRIAL COSTS
5.2.7 BUSINESS IMPLICATIONS FOR PHARMA/ BIOTECH INDUSTRY
5.3 IMPACT ON INSURANCE INDUSTRY
5.3.1 MEDICAL LOSS RATIO (MLR)
5.3.2 MANDATORY COVERAGE PROVISIONS
5.3.2.1 Guaranteed eligibility
5.3.2.2 Ban on annual and lifetime limits
5.3.2.3 Mandatory preventive care and immunizations without cost sharing
5.3.3 ANNUAL FEES AND TAX IMPLICATIONS
5.3.4 HEALTH INSURANCE EXCHANGE
5.3.5 IMPROVEMENT IN CHILD COVERAGE.
5.3.6 COST CONTAINMENT PROVISIONS
5.3.7 EMPLOYER PLAY-OR-PAY POLICY
5.3.8 BUSINESS IMPLICATIONS FOR INSURANCE INDUSTRY
5.4 IMPACT ON OTHER STAKEHOLDERS (BENEFICIARIES AND HOSPITALS)
5.4.1 IMPACT OF HEALTHCARE REFORMS ON BENEFICIARIES.
5.4.2 IMPACT OF HEALTHCARE REFORMS ON HOSPITALS
6 ECONOMIC IMPACT OF OBAMAS HEALTHCARE REFORMS.
6.1 ECONOMIC IMPACT
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