Current Healthcare Issues

​Current Issues in Healthcare

By MARIA ARAMBULA Principles Health Science 9-8-2025

Agenda Monday, September 8, 2025
Tuesday, September 9, 2025

​Current Issues in Healthcare

Bell Ringer Exit Ticket
Lecture/Notes (students will need to write notes).
Check for understanding-
Think, Pair, Share
Guided Practice
Individual Practice
Activities

• I will use words like deductible, copayments, coinsurance, premiums, out-of-pocket maximum, affordability, accessibility, ACA, and insurance plans to explain healthcare decisions.

• I will practice speaking and writing these terms when discussing healthcare situations.

​Language Objective

• I can explain how cost and access to healthcare affect people’s health.

• I can identify important parts of the Affordable Care Act (ACA).

• I can give examples of health insurance plans people can choose.

​Learning Objective

Objectives

Bell Ringer (5 minutes) Answer the question on Google Classroom.

• Scenario: Maria needs to see a doctor but doesn’t have money saved. What problems could happen if she waits?

• Students write 1–2 sentences.

TERMS you will need to know.
Affordability HMOs
Accessibility PPOs
Premiums
Deductibles
Copayment
Coinsurance
Out-of-pocket maximum
DRG's

Introduce key terms

• Deductible → money you pay before insurance starts helping You have to pay the first $500 of your medical bills each year before your insurance starts helping.
  Example: If you get sick and your hospital bill is $1,000, you pay $500 first (your deductible), and insurance helps cover the rest.

• Copayment → small payment you pay at doctor visits

  The monthly payment you make to keep your insurance active, even if you don’t go to the doctor.
  Example: You pay $150 every month for your health insurance, just like a subscription.

• Coinsurance → percentage you pay for care

  A set fee you pay each time you visit the doctor or pick up medicine.
  Example: You pay $25 every time you go to the doctor’s office.

• Premium → monthly payment for insurance

  The monthly payment you make to keep your insurance active, even if you don’t go to the doctor.
  Example: You pay $150 every month for your health insurance, just like a subscription.

• Out-of-pocket maximum → most you’ll pay per year

• Affordability → can a person pay for care

• Accessibility → can a person get care easily

• ACA → law that helps people get health insurance

• Insurance plans → ways to pay for healthcare

Out-of-Pocket Maximum:
The most you’ll pay in a year for covered healthcare costs. After you hit that number, insurance pays 100%.
Example: If your out-of-pocket max is $6,000, once you’ve paid that much, you don’t pay anything else for the rest of the year.

Health Insurance:
A plan that helps pay for doctor visits, medicine, and hospital stays.
Example: With insurance, you might only pay $25 for a doctor visit instead of the full $150 bill.

• Affordable Care Act (ACA):
  A U.S. law that made health insurance easier to get and required insurance to cover important services.
  Example: Because of the ACA, a student can stay on their parents’ insurance until age 26.

• Affordability:
  How much people can afford the cost of healthcare.
  Example: A person with a low-paying job might struggle if premiums cost $500 a month—that’s not affordable for them.

• Accessibility:
  How easy it is for people to get healthcare services.
  Example: If someone lives in a small town with no hospital nearby, they might have to drive 2 hours to see a doctor. That’s poor accessibility.

​Current Issues in Healthcare

Challenges of Healthcare today are affordability and accessibility.
People in the United States are having a hard time paying for health insurance and obtaining access to healthcare.
What does this mean?
People are at risk for dying earlier due to lack of medical care.
Efforts are being made to address these important healthcare issues.

Poll

People in the United States can afford health insurance and have easy access to healthcare.

• True

• False

Employers and workers are fining it more and more difficult to afford health insurance, with premiums rising by more than 100 percent in the past decade.

Healthcare costs in the United States have been rising for several years.
Healthcare costs rising faster than the rate of inflation and faster than the growth in national income.

Affordability

affordability continued

Why are healthcare costs rising so rapidly? So many factors influence this trend.
Factors
Cost of newly developed healthcare technologies.
Research and development costs of medications and new medical technologies increase the cost of newly developed treatments.
Demand for newer, more expensive treatments and procedures overall spending increases.
Americans are living longer as a result of better treatments for chronic illnesses.

​Affordability continued

more medical care for more years of life, increases their total healthcare costs.
Poor lifestyle choices as a factor in rising healthcare costs.

​Accessible Healthcare

Cost of health insurance and out-of-pocket costs not paid by insurance creates a barrier to accessing healthcare.
Cost of health insurance increases, some employers increase the amount employees must pay to receive insurance, or simply stop offering health insurance.
Familys out of pocket greater than the amount spent on food, clothing or transportation,
American lacked basic health insurance and accessed care only in an emergency.
Shortage of primary care physicians, especially in rural areas.

​DRGs

Diagnosis-Related Groups (DRGs) are a system used to classify inpatient hospital stays based on factors such as: 

principal diagnosis, secondary diagnoses, surgical procedures, age, sex, and discharge status. 

​Purpose DRGs

DRGs were developed to:

• Provide a standardized way to classify hospital cases

• Estimate the average cost of treating patients with similar conditions

• Facilitate healthcare payment and reimbursement

• Improve the efficiency and quality of hospital care 

​Check for understanding 1

1. Vocabulary Recall

• What does premium mean in health insurance?

• What is a deductible?

• What does copayment mean?

Open Ended

Imagine a family can’t afford their monthly premiums. How might this affect their health?

Open Ended

What does affordability mean in healthcare?

Poll

What does accessibility mean? (check for understanding 2)

• they have to pay a lot before insurance helps, so they may skip visits

• how easy it is to get care, like having a doctor or hospital nearby.

• the most you pay in a year before insurance covers everything

• paying $25 when you see a doctor