According to a 2009 study by the World Health Organization, the U.S. healthcare system ranks 37th among the healthcare systems of 200 countries. The U.S. healthcare expenditure is considered to be one of the highest in the world, accounting for 17.5% of its GDP in 2009, as compared to an average of 8% to 9% in countries of the Organization for Economic Co-operation and Development (OECD).
This has been a major factor necessitating healthcare reform, along with increasing healthcare costs and health premium rates, as well as the high number of the uninsured (about 47 million or approximately 16% of the total population).
President Obama signed the health reform into law in March 2010 to improve the quality and efficiency of healthcare, 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. The health reform provisions thus directly impact the U.S. healthcare industry and its stakeholders.
The report forecasts and analyzes the future impact of the health reforms on the U.S. healthcare industry. This covers direct as well as indirect impacts of the provisions on pharmaceutical, medical devices, and health insurance industries. Indirect impact refers to provisions that do not specifically apply to these industries. Each section offers a strategic analysis of the impact of Obama's health reforms on the U.S. healthcare structure.
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Key questions answered
* What is the structure of U.S. healthcare system and what are the pitfalls within the current system?
* What are the major provisions of the U.S. Healthcare reform?
* How would the provisions of healthcare reforms affect U.S. healthcare industry in near future?
* What will be the drivers and restraints for different stakeholders of the U.S. healthcare industry in the near future?
* What can be the possible business implications for the U.S healthcare industry and its stakeholders such as Pharmaceuticals, Medical device manufacturers and health insurance industry?
* What will be the impact of Healthcare reforms on the U.S. economy?
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Table of contents
1.1 Key Take-Aways
1.2 Report description
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 Obama's healthCAre reforms
2.2.2 challenges for Obama's healthCAre reforms
2.2.3 Impact of Obama's healthCare reforms on the healthcare industry
18.104.22.168 Impact on Health Insurance Industry
22.214.171.124 Impact of on Pharmaceutical and Medical Devices Industries
126.96.36.199 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
188.8.131.52 Public health insurance
184.108.40.206.3 Other public systems
220.127.116.11 Private health insurance
18.104.22.168.1 Employer-sponsored insurance
22.214.171.124.2 Private non-group insurance (individual market)
126.96.36.199.3 Private group insurance (cooperative)
3.1.2 Regulatory environment
188.8.131.52 Healthcare laws
184.108.40.206 Regulating bodies
220.127.116.11.1 The Center for Devices and Radiological Health (CDRH)
18.104.22.168.2 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 Obama's 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 Obama's HealthCare Reforms
4.1 Obama's 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 Obama's initiatives in healthcare
4.2.1 Obama's healthCare reformS
22.214.171.124 Patient Protection and Affordable Care Act, 2009
126.96.36.199 Health Care and Education Reconciliation Act 2010
188.8.131.52 Healthcare Reforms Implementation Timeline
4.2.2 Other health initiatives
184.108.40.206 Children's Health Insurance Program Reauthorization Act, 2009 (CHIPRA)
220.127.116.11 American Recovery and Reinvestment Act, 2009
5 Impact of Obama's 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
18.104.22.168 Guaranteed eligibility
22.214.171.124 Ban on annual and lifetime limits
126.96.36.199 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 Obama's healthcare reforms
6.1 Economic Impact
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