essentials of health policy and law - chapter 7: Social Determinants of Health and the Role of Health Law

benefits of MLPs

- interdisciplinary training and education -return on investment

history of mlp

-1960s: Jack Geiger and count gibson fforming community health center in Missisippi and Massachusetts -1980s: blending of medical and legal services for low-income populations facing HIV/AIDS -1990s: first formal MLP

Types of SDH

-access to high-quality educational opportunities -access to medical care services -access to social media and other technologies -availability of community-based resources and opportunities for recreational activities -availability of resources to meet daily needs -culture -language/literacy -public safety -residential segregation -social norms and attitudes (discrimination, racism, distrust of gov.) -socioeconomic conditions (ex. concentrated poverty and stressful conditions of poverty) -transportation options

medical-legal partnership

-bridge divide between poverty, health, and legal needs to focus on how to better help vulnerable populations -function as a patient care team comprised of physicians and legal professionals

Law as a Social Determinant of Health

-the law can be used to design and perpetuate social conditions that can have terrible physical, mental, and emotional effects on individuals and populations -the law can be used as a mechanism through which behaviors and prejudices are transformed into distributions of well-being among populations -laws can be determinative of health through their under-enforcement -laws can be determinative of health through their interpretation -final, the law can be used to structure direct responses to health-harming social needs that result from factors like impoverishment, illness, market failure, and individual behavior that harms others.

Moral hazard

In relation to health insurance, moral hazard results when an insured consumer uses more services than she would otherwise because part of the cost is covered by insurance

EMTALA

Individuals have a right to access emergency hospital services, the only truly universal legal right to healthcare. It was enacted by congress to prevent the practice of "patient dumping" of the poor and uninsured patients of private hospitals on public ones. It was also an effort to chip away no duty principle because congress created a corresponding legal duty of hospitals

Pareto optima

Is when an efficient distribution of resources occurs when the resource distribution cannot be changed to make someone better off without making someone else worse off.

Managed care

Managed care organizations provide a comprehensive, defined package of benefits to the purchaser/member for a pre-set fee. Managed care contains costs while providing necessary and high quality healthcare services. Services are offered to members through a network of providers, who all have a contractual relationship with managed care organizations.

Experience rating

One of the main methods of setting premiums, where insurance companies rely on making educated guesses about the risk each individual or group has of needing healthcare services. They rely on how much a beneficiary or group of beneficiaries spent on medical services in prior years to determine the amount of each premium for the coming year

Risk & Uncertainty

People choose to be insured because of risk and uncertainty; the world is full of risks and uncertainty about whether any certain events might affect an individual, and as a result of this, people buy insurance to protect themselves and/or families against the financial costs and consequences of unforeseen events. Health insurance protects the consumer from medical costs associated with both expensive and unforeseen events. Uncertainty and risk may lead to adverse selection, because unhealthy people over-select a particular plan

Gideon v. Wainwright (1963)

Supreme Court case in which the Court ruled that a defendant in a felony trial must be provided a lawyer free of charge if the defendant cannot afford one.

SDH

conditions in which people are born, grow, live, work and age

Civil Gideon

movement that has developed to explore strategies to provide legal counsel, as a matter of right and at public expense, to low-income persons in civil legal proceedings where basic human needs are at stake, such as those involving shelter, sustenance, safety, health