Module 1

______ is a measure used to compare the U.S national health expenditures with other countries

*GDP (gross domestic product) per capita* GDP: the total measure of aggregate economic production for a country Per capita: what we would spend per person IF we divided our total health care spending across the population

General characteristics of the U.S healthcare system: 4) Technology driven and focusing on Medical care

- Invested to create a hospital system to take care of SICK PEOPLE, NOT necessarily to keep people healthy

Central governing agency in other countries...

- Most have a "global budget" where the country decides the entire amount it will spend on health care during a fiscal year - Central governing agency? MORE control over health care costs and insurance.

What are the 4 Characteristics of the U.S Healthcare system?

- No central governing agency - Healthcare is distributed VIA the private (imperfect) market - Fusion of Market and Social Justice - Technology driven and focusing on medical care

What are the four models of healthcare systems?

- Out of pocket model - National health insurance (Canada) - National health service (Great Britain) - Socialized Health Insurance (Germany)

The U.S has a hospital centric healthcare system. What does this lead to?

- U.S has a lot of expensive diagnostic equipments & elective procedures - The RESULTS of a hospital centric system is: high cost & unequal access to care!

National Health Service (NHS of Great Britain)

- gov't finances a tax-supported national insurance program AND manages the infrastructure for the delivery of care! -gov't operates most of the medical institutions while the infrastructure is privately OWNED - publicly funded, provides universal health insurance, SOCIAL justice (everyone deserves health care)

National Health Insurance (Canada)

- government finances healthcare through general taxes BUT private providers deliver the actual care - Canadian territories= central governing agency, organize and deliver health services, OVERSEE healthcare providers GOALS: available to all, full coverage, equal access, portable within the country, publicly administered

General characteristics of the U.S healthcare system: 2) Health care is distributed VIA the private (Imperfect) Market

- government simply provides resources to support or improve the PRIVATE SECTOR ability to provide and distribute health care - Exceptions: Medicare(old), Medicaid(poor), Veterans

How does Great Britain compare to the U.S?

- greater integration and accountability due to a central governing agency - less medical technology

Out of Pocket healthcare system

- mainly in non-industrialized countries - NOT subsided by government or employment - Money? You can purchase health insurance. Poor? Sorry.

How does Canada compare to the U.S?

- spends 25% LESS on hospital-related care - this is partially bc Canada's medical technology infrastructure is SMALLER than U.S

How does Germany's healthcare system compare to U.S?

- spends 75% less on hospital based care - focuses more on health promotion - weaker medical technology however!

John Snows map of London

- went around the neighborhood and highlighted the areas in which MOST people were dying

Iron Triangle of Health: Access

Access to care= the ability to obtain needed, affordable, convenient, acceptable, and effective healthcare services in a timely manner

Association and Causation relative to health care

Association: relationship between two or MORE factors ex: overweight people having heart attacks Causation: changes in one factor CAUSES changes in another

Iron Triangle of Health: Costs

Consumer: price of healthcare services & cost of care Provider: staff salaries, costs for building/equipment, rental space, purchase of supplies, ext.

Socialized Health Insurance System (Germany)

Has a universal, multi-player, health care system with TWO main types of insurance -Standard Health Insurance- provided by competing, not-for-profit health insurance funds called "sickness funds" - Private Insurance- wealthy usually select private insurance and opt out of sickness funds employees/employees finance standard health insurance through government-mandated contributions (income tax) IF they are receiving health insurance

General characteristics of the U.S healthcare system: 3) Fusion of Market and Social Justice

Market Justice: responsibility for the fair/equal distribution of healthcare on MARKET FORCES in free economy Social Justice: emphasizes the well-being of the community OVER the individual Ex of Fusion: The distribution of private insurance. 1940s U.S decided to offer health insurance through employment. To encourage employers to offer insurance, federal government provided tax subsidies (basically giving employers a tax break for providing employer-insurance)!

Iron Triangle of Health: Quality

Structure, Process, and Outcomes -Structure: is the FOUNDATION of quality health care. Resource inputs. Does the healthcare system have sufficient workforce, provider organizations, and technology? -Process: the actual delivery of care. EX: correct diagnostic tests, correct prescriptions, adequate waiting time. -Outcome: the effects or FINAL results obtained from healthcare delivery

T or F: Most Western European countries have National Health Insurance or health systems that provide universal access of healthcare services to ALL CITIZENS.

T! - everyone gets insured -managed by government

T or F: U.S healthcare system is "mixed" or "pluralistic".

True! We have elements of all four healthcare systems in ours! -National Health program (Veterans) - Socialized health insurance (Medicare) - National health insurance (Medicaid) - Out of pocket (Individual insurance)

U.S vs. Western Countries

U.S: narrow biomedical definition, designed for younger/middle life care, Western Countries: broader frameworks, designed for care over the lifespan

General characteristics of the U.S healthcare system: 1) NO central governing agency

Unlike other countries, the U.S has NO central governing agency! - NO central agency that authorizes the financing, payment, and delivery of healthcare to residents! - U.S is pluralistic: depends more on the private sector for insurance. - SOME countries have National Health Insurance. We DO not.

Pre-Modern Health Frameworks

external forces: bad air! internal forces: imbalance of bodily fluids

The Iron Triangle of Health

the interaction of the COST, ability to ACCESS, and the QUALITY of health care -cost, access, and quality - You can not affect one aspect without affecting the other aspects! - Healthcare=tradeoffs!