26. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity
27. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity
National Legislation- Federal
28. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity
Local Legislation- State National Legislation- Federal
29. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity
Local Legislation- State National Legislation- Federal
Influence of Religious
Right
30. Ideology and Culture
Libertarian Individualism Conservative
Ethnic and Cultural Origins National Identity
Local Legislation- State National Legislation- Federal
Influence of Religious
Separation of Religion and State
Right
31.
32. Obesity Trends* Among U.S. Adults
BRFSS, 1990, 1998, 2006
(*BMI ≥30, or about 30 lbs. overweight for 5’4” person)
1990 1998
2006
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System.
33. Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: Behavioral Risk Factor Surveillance System, CDC.
34. Diabetes
20.8 Million (7%) Americans are
diabetic
54 Million Americans are ‘pre diabetic’
American Indians (18%)
Non Hispanic Blacks (16%)
Hispanic/Latino (14%)
Non Hispanic Whites (8%)
56. Medicare
• Department of Health and Human Services
57. Medicare
• Department of Health and Human Services
• Social insurance covering 43 Million
Americans
58. Medicare
• Department of Health and Human Services
• Social insurance covering 43 Million
Americans
• 65+ US citizens or permanent legal resident
for 5 yrs
59. Medicare
• Department of Health and Human Services
• Social insurance covering 43 Million
Americans
• 65+ US citizens or permanent legal resident
for 5 yrs
• Or under 65 with permanent disability social
security benefit for more than 24 months
60. Medicare
• Department of Health and Human Services
• Social insurance covering 43 Million
Americans
• 65+ US citizens or permanent legal resident
for 5 yrs
• Or under 65 with permanent disability social
security benefit for more than 24 months
• End stage renal disease, renal failure,
65. Hospital care
• At least 3 days (midnights) not counting discharge
day
66. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)
67. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)
• Only “Skilled Care” covered for up to 100 days
68. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)
• Only “Skilled Care” covered for up to 100 days
• First 20 days full cost
69. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)
• Only “Skilled Care” covered for up to 100 days
• First 20 days full cost
• 80 days part payment (above $128)
70. Hospital care
• At least 3 days (midnights) not counting discharge
day
• Nursing home stay for conditions connected to
hospital stay (eg. Post surgery rehab)
• Only “Skilled Care” covered for up to 100 days
• First 20 days full cost
• 80 days part payment (above $128)
• After 100 days must have a gap of 60+ days before
eligible for more care support
72. Medicines and other out patient costs
• Optional cover
• Local and National Determinations of Cover
• Outpatient procedures
• Physician, nursing, x-ray, laboratory and other diagnostic tests
• Canes, walking and mobility aids,
• one pair of spectacle after cataract surgery
• Oxygen for home use
• Influenza and other vaccines
• Blood transfusions, renal dialysis
• Chemotherapy
• Immunosuppresive drugs for organ transplant patients
• Medications administered by a physician in the doctor’s office
74. Medicare +
• Additional or alternative private
medical insurance
• Equivalent to medicare but may
be variable in cover offered
• Co payment required for many
areas of health care
79. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day
80. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day
• 91- 150 days $512 per day
81. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day
• 91- 150 days $512 per day
• $128 per day for skilled nursing home
care 21- 100 days
82. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day
• 91- 150 days $512 per day
• $128 per day for skilled nursing home
care 21- 100 days
• Blood deductible for first 3 units of blood
unless replaced
83. Deductibles
• 1- 60 days hospital care $1,024
• 61- 90 days $256 per day
• 91- 150 days $512 per day
• $128 per day for skilled nursing home
care 21- 100 days
• Blood deductible for first 3 units of blood
unless replaced
86. Payments to providers
• Fixed amount per condition not
actual treatment costs
• “Upcoding” by Physician to cover
unexpected costs
87. Payments to providers
• Fixed amount per condition not
actual treatment costs
• “Upcoding” by Physician to cover
unexpected costs
• Hospitals can keep money not
spent on patient (cover shortfall
for excess on other patients)
91. Medicaid
• Joint state and federal funded entitlement programme
92. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
93. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part
94. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part
• Average expenditure 22% of state spending
95. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part
• Average expenditure 22% of state spending
• Covers 42.9 million Americans
96. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part
• Average expenditure 22% of state spending
• Covers 42.9 million Americans
• 37% of Childbirths
97. Medicaid
• Joint state and federal funded entitlement programme
• Low income parents, children, seniors and people with
disabilities
• State participation is voluntary but all states currently
take part
• Average expenditure 22% of state spending
• Covers 42.9 million Americans
• 37% of Childbirths
• 60% of nursing home care
100. Eligibility
• Varies from state to state
• Low income plus
101. Eligibility
• Varies from state to state
• Low income plus
• Age
102. Eligibility
• Varies from state to state
• Low income plus
• Age
• Pregnancy
103. Eligibility
• Varies from state to state
• Low income plus
• Age
• Pregnancy
• Blindness
104. Eligibility
• Varies from state to state
• Low income plus
• Age
• Pregnancy
• Blindness
• Disability
Editor's Notes
We have never had an epidemic like this that we have been able to track so thoroughly and see. As I told you, this is conservative.
About 60 million adults, or 30 percent of the adult population, are now obese, which represents a doubling of the rate since 1980.