Health care test one
Market justice assumptions
- Healthcare is an economic good governed by free market - society is better served when individuals pursue their own interests - people are willing to purchase health care - the market is more efficient than the government
social justice assumptions
- Healthcare should be based on need rather than cost - there is shared responsibility for health - the wellbeing of the community is superior to that of the individual - the government, rather than the market can more equitably distribute healthcare
Market justice
- Proposes that market forces in a free economy can best achieve a fair distribution of health care - based on peoples willingness and ability to pay - Healthcare is an economic good that is earned
Hospitals
- became the central core and symbol of healthcare
Market justice implications
- demand-side rationing - individual responsibility for health - limited obligation to society as a whole - private solutions to social problems
Workers compensation
- first broad coverage health insurance - originally designed to make cash payments to workers for lost wages - later covered medical expenses and death benefits for survivors
preindustrial medical practice
- medical procedures were primitive - physicians did not possess technical expertise but relied on experience and folk remedy - anyone could practice as a physician - little prestige/ income - no insurance - barbers did blood letting
Social justice
- proposes that the equitable distribution of healthcare is a societal responsibility that is best overseen by the government - distributed based on need, not ability to pay - healthcare is a social good that should be collectively finances and available to all
social justice implications
- supply side rationing - collective responsibility for heath - strong obligation to society as a whole - public solutions to social problems
Post industrial medical profession
- transformation occured in the growth of urbanization after the civil war - increases reliance on paid professionals - concentration of medical practices in cities and towns - office based practices formed
Preindustrial medical training
- viewed as trade rather than profession - training was approved through individual apprenticeships - medical education was not standardized - not rigorous - lacking in science
Post industrial america
-period of growth and development of medical profession - creation of private and public healthcare - education standards were formalized in schools
Healthy people 20/20 goals
1) attain high quality, longer lives free of preventable disease and disability 2) Achieve health equity and eliminate health disparities 3) Create social and physical environments that promote good health 4) promote quality of life, healthy development, and healthy behaviors
Characteristics of the US health care system
1. No central governing agency 2. Partial access 3. Imperfect market conditions 4. Third party insurers or payers 5. Multiple payers 6. Balance of power 7. Legal risks 8. High technology 9. continuum of services 10. Quest for quality
Multi-payer system
A hc system that has multiple sources of income. Like insurance companies, private plans, and public programs
Illness
A persons own evaluation of how he or she feels
Insurance
A pool of money that protects people against risks
Managed care
A system of healthcare delivery that achieves efficiencies by integrating basic functions of health care delivery and manages utilization of services and determines prices
Health care delivery
Aka health services delivery - Provision of healthcare services to patients - Includes the components of healthcare system and the processes that enable people to receive healthcare
AMA
American medical association
Financing
How and by who healthcare is paid for
Out of pocket safety net providers ER treatment
How do the uninsured pay for healthcare?
Payment
How providers are reimbursed for their services
Veterans affairs
Insurance for disabled/ low income veterans
No
Is the US Healthcare system a true free market?
yes
Is the US really invested in technology
Public healthcare
Military Medicare Medicaid Children's health Insurance program
Equilibrium point
The intersection of supply and demand curves
prevalence
Total # of people with the disease
Holistic health model
Treats the individual as a whole person and may involve alternative therapies Emphasizes physical, mental, social, and spiritual well being
True
True or False? Health insurance premiums have increased more rapidly than inflation or wages.
True
True or False? High costs of health care is a common reason for bankruptcy in the U.S.
False
True or False? Most employers do not offer health insurance as an employment-based benefit.
True
True or False? People who speak a native language other than English are more likely to be uninsured
True
True or False? The U.S. is the only industrialized nation in the world that doesn't offer universal health care.
False
True or False? The average family pays about $2,000 per year for health insurance coverage through an employer.
False
True or False? The majority of our population is uninsured.
False
True or False?Americans have the highest life expectancy in the world.
False
True or false? The U.S. has one of the lowest infant mortality rates in the world.
True
True or false? The U.S. spends more on health care than any other industrialized nation.
Japan
What country has the highest life expectancy?
expanding access while controlling costs and maintaining quality
What is a major challenge of U.S. healthcare delivery?
TRICARE
What is the insurance called for military personnel?
Holistic model
What is the most complete understanding of health?
Managed care
What is the most dominant HC delivery system in the US?
Individual plans
What is the most expensive type of healthcare?
Biopsychosocial
What is the most ideal health model
Environment
What is the most important health determinant \
Medical model
What model of health governs US health care?
Workers compensation
What was a trial for government sponsored health insurance
Defensive medicine
When physicians order unnecessary procedures or antibiotics to prevent lawsuits
Employers
Where is the major source of healthcare delivery coming from?
Monaco and Japan
Which countries has the lowest infant mortality rate?
the government and private insurers
Who uses managed care?
People are living longer, there is better detection, and change in lifestyle factors
Why has the rate of chronic illnesses increased?
Employers don't offer insurance because they have a company of less than 50 people They can't afford the premiums
Why may employees not have insurance even if they are employed?
Biopsychosocial Model of health
a complete state of physical, mental, and social well being
Medical model of health
absence of illness and disease
life expectancy
average # of years expected to live
Mortality rate
death rate
Disease
determined by a professional evaluation and requires intervention
chronic
over long period of time, 3 months or longer can't cure it usually crones disease, diabetes, obesity
Leading health factors
physical activity, obesity, tobacco, substance abuse, sex, mental, violence, environment, immunization, health care
Key system players
physicians, administrators, the government THEY ALL have competing interests
dispensaries
provided outpatient charity care
Universal health care
provides basic health care for all persons with protection from financial hardship.
Medicare
provides healthcare for people 65+
Medicaid
provides healthcare for the poor
Delivery
provision of health service, A service being delivered such as a surgery, appointment, etc.
- pest houses
quarentined people who had contagious diseases
The Emergency medical treatment and labor act of 1986
requires emergency departments to treat people regardless of their ability to pay Fills up ER for non emergency reasons ER is the most expensive type of treatment
acute
short term, limiting cold, flu, infections
demand side rationing
the ability to pay is what rations health care
supply side rationing
the government rations healthcare
Restorative services
therapy, restoring function
almshouses
took care of the poor and needy, funded by the local government
incidence
total # of cases diagnosed in a year
Preventive services
vaccines, physicals, screenings
Advancements in medical care
what created the need to centralize expensive facilities and equipment in an institution?
Professionalism of nursing
what improve hospital care?
Chronic disease
what is the leading cause of death and disability in america
Post industrial
what time period did the healthcare system take shape
Harvard medical school
which school revolutionized medical education by extending the school year and adding clinicals?
John hopkins university
which university required that medical education be a graduate training program?
preindustrial medical institutions
- very few hospitals aka death houses - almshouses - dispensaries - pesthouses
They won't pay for anything unless its a referral It limits reimbursement to providers
Cons of managed care
Children' Health Insurance Program
covers low income kids More flexible qualifications Just children, not parents
Cultural beliefs and values in americA
- Strong belief in the advancement of science - Champion of capitalism - promotion of entrepreneurial spirit and health determination - follow principles of free enterprise and distrust of big government
Yes
Do at least half of americans have a chronic disease?
Yes
Does america spend a lot of money on the treatment of chronic conditions?
Yes
Does the use spend a lot on administrative costs?
Private healthcare
Employers Individual plans
Blum's model of health determinants
Environment Lifestyle and behavior heredity medical care
blue shield and blue cross merged
commercial insurance followed after______
Blue shield plans
created by the california medical association covered physician visits
Health disparities
differences in mortality and morbidity rates based on gender, culture, race, or economic reasons
Curative services
drugs, surgery, medicine
Blue cross plans
hospital insurance plans that began as a plan for teachers at baylor university and late became ______
morbidity rate
illness, sickness, chronic disease
Birthrate
number of births in a population