미국이 엄청 춥다고 합니다. 체감온도가 영하 60도나 되는 도시들도 속속 생겨나고 있다는 군요...수염 많은 분들은 고드름이 매달릴 정도라니...가히 빙하기에 비유할 만합니다.
(이분...집 근처의 눈 치우다가 자기 수염에 고드름이 생기는 줄도 몰랐다고 하십니다.)
2013년의 미국의료이용 역시 빙하기였습니다. 미국시간 1월 6일 언론에 의료이용에 관한 정부산하연구원 자료가 발표되었습니다. 미국정부는 의료비용 감소 및 국민 의료이용 증가를 목표로 '오바마케어'를 밀고 있는데요...가뜩이나 경제가 시원찮은 마당에(회복세로 돌아섰다는 지표들이 보이긴 합니다만) 사활을 걸고 있는 정책 중의 하나인 오바마 케어가 얼마나 효과적이었는지를 볼 수 있는 리포트이기도 합니다. 그리고 한국에도 시사하는 바가 있다고 봐요^^ 오바마가 헬스케어 정책을 만들 때 한국의 제도역시 많이 참고했다고 합니다...읽어보시죠.
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Health Care Spending Slows To Historically Low Rate
For the first time in more than a decade, health care spending grew more slowly than the U.S. economy from 2010 to 2012, according to a new report by government auditors.
Total U.S. health care spending was $2.79 trillion in 2012, up 3.7 percent from the previous year -- that amounts to 17.2 percent of the national economy, the Office of the Actuary at the Centers for Medicare and Medicaid Services conclude in a report published by the journal Health Affairs. It's the first time since 1997 that health expenditures didn't outpace the gross domestic product.
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의료에 지출된 돈이 역사적으로 낮은 시점이다.
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The historic slowdown in the growth of health care spending since 2009 -- the lowest rate since the federal government began tracking the data in 1960 -- has sparked a debate about its causes. President Barack Obama partially credits elements of the Affordable Care Act, such as reduced fees for hospital services, for reduced inflation in national expenditures, but there's no consensus among experts. The actuaries at the Centers for Medicare and Medicaid Services are among those who believe the phenomenon is nothing more than a repeat of normal patterns that occur during and after economic recessions like the one that began in 2007.
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오바마는 의료비용의 감소가 오바마케어(ACA)라고 하지만, 전문가들 사이에 의견이 일치하진 않는다.
- 사실 오바마케어로 1인당 의료비용은 감소할 수 있겠지만, 의료혜택을 받는 사람들의 수가 늘어나고 감소한 의료가격으로 인해 수요가 증가하기 때문에 이 모든 효과의 합은...예상할 때는 다 더해봐야 하고 실제론 어떤 일이 일어날지는 사실 해봐야 알겠죠.
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"The trends that we've seen in the last few years are consistent with the historical relationship that we've seen between health spending and overall economic growth," said Aaron Catlin, the deputy director of the National Health Statistics Group within the actuary's office, during a press briefing Monday prior to the report's release.
Expenditures on health care, including everything from hospital procedures to prescription medicines, rose less than 4 percent a year from 2009 through 2012, after growing by an average of more than 7 percent from 2000 through 2008 and by double digits in the previous decade.
In November, the White House issued a report highlighting slower health care spending growth and emphasizing that some categories of spending, especially by Medicare, aren't related to the economic cycle because those benefits aren't affected by job loss or other phenomena. The health care reform law reduced Medicare payment rates to hospitals and instituted other measures aimed at cutting spending and improving health, such as barring payments to hospitals when they re-treat patients for the same condition within 30 days.
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미국정부는 이런 정보들을 자기한테 유리하게 해석하고 있네요. 논외로 1달내 재치료시 환자한테서 돈 받지 않는다는 건 지혜로운 원칙인 것 같다는 생각이 듭니다.
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From 2010, when Obama signed the Affordable Care Act, until the end of 2012, however, the actuaries could discern only a meager impact from the law on national health care spending, said Anne Martin, an economist at the Office of the Actuary, during the press briefing. During that period, the law increased U.S. health expenditures by no more than 0.1 percent, she said.
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하지만 계리사(actuary...맞는지 확신이 없습니다)들은 ACA에 의한 영향은 매우 미미하다...경기 사이클 때문에 생긴 의료이용 감소라고 생각한다...
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빨간색이 의료이용(비용)
파란건 GDP
보라색은 GDP에서 의료비용이 차지하는 비율입니다
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"While our historical data cannot parse out the spending that was directly the result of the ACA, the projections model showed that there was minimal impact from the Affordable Care Act on aggregate national health expenditure trends from 2010 through 2012," Martin said.
A 2012 report by the Office of the Actuary projected that expanding coverage to tens of millions of individuals via the Affordable Care Act would increase national health spending by one-tenth of a percentage point each year through 2021, compared to what expenditures would have been absent the law.
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앞으로도 오바마케어가 의료비용이 미치는 영향은 미미할 것이다....결정적인 한방이로군요.
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The new actuaries' report attributes recent levels of annual growth mainly to individuals who lost jobs, or at least lost their health insurance, during the recession and the sluggish recovery. "The period of stability is consistent with the historical experience when the share of GDP tends to stabilize after an overall economic recession, usually two to three years," Catlin said.
In 2012, the low rate of growth was a combination of decreases in some areas and increases in others. Spending on Medicare private health insurance premiums, prescriptions drugs and nursing-home care rose more slowly than during the previous year. Hospital, physician, Medicaid and consumers' out-of-pocket costs accelerated in 2012 compared to 2011.
The uptick in spending growth on hospital care and visits to physicians, urgent care centers and other clinics was driven by patients receiving more, and more intensive, services, rather than by price increases, according to the report. Medical prices grew 1.7 percent in 2012, down from a growth of 2.4 percent in 2011. The increase in the use of health care services was partly based on more individuals having health insurance as a result of the economic recovery, the report suggests.
In September, the Centers for Medicare and Medicaid Services issued a report projecting that health care spending growth would remain below 4 percent in 2013 but would accelerate in later years. This year, as the Affordable Care Act expands health coverage to the uninsured, the spending increase will surpass 6 percent for the first time since 2007 and the law will account for 1.6 percentage points of that rise, that report predicts.
* 기사를 읽고보니 경기변동이 한국의 의료비에 미치는 영향이 매우 궁금하네요...우연의 일치인진 몰라도 보건복지부에서도 경기변동이 의료이용에 미치는 영향에 대해 연구한 결과가 발표되었더군요. 뉴스기사엔 전,월세가 의료이용에 미치는 영향이 매우컸다고 합니다~!
http://www.huffingtonpost.com/2014/01/06/health-care-spending_n_4549383.html
