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