Date: 6/13/22
Name of podcast: Dr. Patient
Episode title and number: 10 Pushback, Part 2

Episode summary:
How did we get to where we are today, where health insurance companies dictate how medicine should be practiced between a doctor and their patient? This episode reviews the origins of Medicare, and reviews Medicare For All as an alternative to the over-privatization of current Medicare plans. This is yet another way that physicians (and patients) can pushback on a dysfunctional system.

Guest(s):
Dr. Susan Rogers, President of Physicians for National Health Program

Key Terms:
Medicare – federal insurance for people 65 and older, some younger people with disabilities
Medicare Parts A, B, C, D – A provides inpatient/hospital care, B is for outpatient coverage, C offers an alternative way to get your benefits, D provides prescription drug coverage
Medicare For All – a single payer, national health insurance program concept; would provide everyone in the US with comprehensive health care coverage
Medicare Advantage – Part C plans; private companies provide the care
Fee For Service, FFS – system of health insurance payment where a doctor or other health care provider is paid a fee for each service rendered
Single Payor System – health care system where one entity (a single payer) collects all health care fees and pays for all health care costs
Affordable Care Act, ACA – legislation from 2010 that provided more affordable health insurance to more people, expanded the Medicaid program and supports innovative medical care delivery methods to reduce costs. Also called “Obamacare”
Direct Contracting Entity, DCE – Private 3rd parties that provide an alternative payment model for healthcare. They act as the intermediatry between the government and the beneficiary
Capitation – the payment of a fee to a doctor per patient; often is about $10k per year per patient whether the doctor sees that patient 1 time or 20 times during the year

References:
1. Physicians for National Health Program - https://pnhp.org
2. How do Medicare Advantage Plans work? - https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf
3. Social Determinants of Health - https://www.healthcaredive.com/trendline/social-determinants-of-health/93/?utm_source=HD&utm_medium=Library&utm_campaign=KomodoHealth&utm_term=Healthcare%20Dive
4. US Health Insurance System (overview) - https://visaguide.world/international-health-insurance/us/
5. A Brief history of Medicare in America - https://www.medicareresources.org/basic-medicare-information/brief-history-of-medicare/
6. History of Health Insurance in the United States - https://account.ache.org/iweb/upload/Morrisey2253_Chapter_1-3b5f4e08.pdf
7. Medicare and the Affordable Care Act - https://www.medicareresources.org/basic-medicare-information/health-reform-and-medicare/
8. There goes your Medicare: The trouble with DCEs - https://www.medicareresources.org/basic-medicare-information/health-reform-and-medicare/
9. Single-Payer Healthcare vs. Universal Coverage - https://www.verywellhealth.com/difference-between-universal-coverage-and-single-payer-system-1738546