Hth 354 Test 1

Front 1

health care objections

Back 1

1. ALL citizens receive health care services

2. services are cost-effective and of quality

Front 2

payment/finance options

Back 2

-employment based insurance (majority)

-private health insurance

-government programs

Front 3

10 characteristics of US Health Care System

Back 3

1. multiple payers

2. selective services

3.third-party insurers are intermediates

4. imperfect market

5. no central agency that governs insurers

6. legal risks lead to defensive medicine

7. new technology

8. quality

9. power balance

10. continuum of service

Front 4

multiple payers

Back 4

too many providers

Front 5

selective service based minimum

Back 5

not everyone gets covered for everything

Front 6

third-party insurer are intermediates

Back 6

-you can get it, but they don't need to cover it

-whatevers most cost efficient for them

Front 7

imperfect market

Back 7

-cant evaluate different insurers

-information not upfront (can't "shop")

Front 8

no central agency that governs the system

Back 8

-state licensing boards, etc.

- no laws

Front 9

legal risks lead to defensive medicine

Back 9

-malpractice insurance is so high

-physicians over-run tests to cover themselves, running up your bill

Front 10

new technology

Back 10

-new best thing is expensive

-research & development (payed for by insurance)

-more caught up in "toys" than practice

Front 11

quality

Back 11

-how do we improve our system & methods

-chronic disease prevention (our job, not insurance)

-preventable with diet, exercise, sleep, stress management, no smoking

Front 12

power balance

Back 12

-no one entity controls, many different providers

-multiple insurers, no one is in control,but they still have power

Front 13

continuum of service

Back 13

-preventative; education, vaccination (individuals job)

-nothing to sell, no reinburstment (assume people know)

-restorative; get you back to former self

-curative; cure self from disease

* first needs more attention, latter two are billable

Front 14

quad-function model

Back 14

1. financing

2. insurance

3. delivery

4. payment

Front 15

financing

Back 15

either buying health insurance, pay H.C. services

-employee, gov't or self

Front 16

insurance

Back 16

-protect against catastrophic risk

-different packages available to you

Front 17

delivery

Back 17

-providers of healthcare

-physicians, hospitals, nursing homes, diagnostic centers

-primarily paid by insurance companies

Front 18

payment

Back 18

-out of pocket, reimbursement, co-pay/cost sharing premiums, deductible

Front 19

4 factors that affect access to healthcare

Back 19

1. ability to pay

2. availability of services

3. payment options

4. barriers to care

Front 20

ability to pay

Back 20

-do you have health insurance?

-what kind?

-how will you pay?

Front 21

availability of services

Back 21

-where do you live and whats available

-whether or not you can access health care system

Front 22

payment options

Back 22

-many providers don't accept Medicare & Medicaid

-poor people are usually more sick

-poor are discriminated against

Front 23

barriers to care

Back 23

-transportation, culture, language

-discriminate against those that don't know "our ways" (expected to know how to read ex. money)

-disability

Front 24

health care systems of other countries

Back 24

1. national health insurance

2. national health care system

3. socialized health insurance

Front 25

National Health Insurance

Back 25

-collect general taxes

-have private providers still

-ex. Canada (single payer system)

Front 26

National Health Care System

Back 26

-gov't controlled

-supported by taxes

-providers are gov't employees

-everyone has H.C.

-ex. Great Britian

Front 27

Socialized Health Insurance

Back 27

-gov't mandated and to employers & employees

-private providers

-non-profit insurance

-fined if you don't have insurance

-ex. Germany

Front 28

what is health?

Back 28

-used to be anyone free of disease

-Health care is based on medical model

Front 29

medical model

Back 29

-people only use medical system when sick

-if youre well, why go to the doctor?

- ACA requires checkups

-leaves our prevention, saying it's not as important as diagnosis & treatment

-physicians not trained for prevention

Front 30

illness v disease

Back 30

i feel sick v. i have been diagnosed

Front 31

epidemiology triangle

Back 31

agent, host and environment working together

Front 32

risk factors

Back 32

behavior and hereditary

Front 33

behavioral

Back 33

-diet, exercise, stress, sleep, smoking

-behavior modification is more easily said than done

Front 34

hereditary

Back 34

-less so than behavior, but still prevalent

Front 35

prevention

Back 35

-primary

-secondary

-tertiary

Front 36

primary

Back 36

-prevent a health incident from occurring

-ex. seatbelt, vaccine, education, skills, condom

Front 37

secondary

Back 37

-early detection and treatment of disease

-ex. screenings

Front 38

tertiary

Back 38

-intervention to prevent further complications

-health issue already present, learning how to live with it

Front 39

public health

Back 39

-what is good for population, not individual

ex. public water, isolation

-current information/research about disease AND prevention applied to the people

-3 roles (prevention, health promotion/education, and health protection_

Front 40

public health prevention

Back 40

vaccines for infectious diseases

Front 41

health promotion and education

Back 41

-applied to all people

-sex education, tobacco use, DARE

-really where public health works (3-in-1_

Front 42

health protection

Back 42

-water quality, air quality, seatbelt, occupational health, bio terrorism

Front 43

health determinants

Back 43

~20% genetics

~50% behaviors (can change but hard to do)

~10% medical (where we focus but its only 10)

~20% environment (income and convenience determine)

-structural determinants of health

-how society is structured

-i.e. politics, laws, governance

-where waste management goes in towns

Front 44

Blum's forcefields

Back 44

-environment; put more emphases here

-physical: what you actually do day to day

-cultural: who is around you

-social: who you respect

-economic: social-economic & and what comes with it

-medical care service

-lifestyle

heredity

Front 45

medical care service

Back 45

-delivery

-access

Front 46

lifestyle (behaniors)

Back 46

-attitudes about health

ex. diet and food

Front 47

heredity

Back 47

genetic make up

Front 48

American's beliefs and values

Back 48

1. concern

2. entrepreneurial

3. capitalism

4. science

5. distrust

Front 49

concern for the underprivileged

Back 49

-poor, elderly, and disabled

Front 50

entrepreneurial spirit

Back 50

-self determination, motivation

-you should work for life you want

-not equal opportunities however

Front 51

capitalism

Back 51

-ability to shop around between competeters

Front 52

science

Back 52

-true whether we believe it or not

-technological advances

-make things more expensive

Front 53

distrust of gov't

Back 53

-elected officials

-responsibility is on us

-voting process

Front 54

market justice

Back 54

-health care is an economic good

-pay for what you can afford (income determines)

-production determined by supply & demand

-rather than gov't interference

-access is a reward (not right)

-assumes free market in place

-no gov't interference

Front 55

social justice

Back 55

-equatable distribution

-everyone has access

-solicitate responsibility

-help out those who can't pay

-obligation of society

-how do we pay? Do we cover everything?

Front 56

Health status

Front 57

morbidity

Front 58

mortality

Front 59

longevity

Front 60

ADL

Front 61

7 Key Factors of transformation in the Post-Industrial Error

Back 61

1. urbanization

2. science & technology

3. institutionalization

4. dependency

5. licensing

6. educational reform

7.autonomy & organization

Front 62

urbanization

Back 62

-increased reliance on specialized skills and paid professionals

Front 63

science & technology

Back 63

-acceptance and use of science in medicine

-got away from herbal remedies

Front 64

institutionalization

Back 64

-evolution of medical technology and professionalization of medical staff

-hospitals changed from a place to go to die to a place to go for treatment

Front 65

dependency

Back 65

-patients depend on the medical profession's judgement and decision

-requires physicians intervention

-physicians took responsibility for health

Front 66

licensing

Back 66

-couldn't just apprentice, needed certification

Front 67

educational reform

Back 67

-standardized curriculum that they could control

Front 68

autonomy & organization

Back 68

-physicians ability to remain free of control from hospitals & insurance companies

-AMA is very powerful

Front 69

public health development

Back 69

-developed along side physicians

-did everything physicians didn't want

-gov't financed

-monitor:

-air and water quality

-waste management

-vaccinations

-epidemiology

-statistics

Front 70

forces that created need for health insurance

Back 70

1) technology

2) social

3) economic

Front 71

technology

Back 71

better treatments, more expensive

Front 72

social

Back 72

growing demand

Front 73

economic

Back 73

people cant afford it

Front 74

proposing health care plans have been shaped by:

Back 74

-politics

-institutional dissimilarities

-ideological differences

-tax aversion

Front 75

politics

Back 75

-democratic nation

-dont want to take ideas from "foes"

-1960's fight for Medicare & Medicaid

-Medicare: 65+, federally funded

-Mediaid: shared by fed & state, so states determine eligibility standards

Front 76

institutional dissimilarities

Back 76

-private hospitals (not gov't owned)

-too decentralized to adopt another nations H.C. model

Front 77

ideological differences

Back 77

-stand on our own feet

-principles of market justice

-middle class pays for everything

Front 78

tax aversion

Back 78

-expanding health insurance coverage would mean higher taxes for middle class

Front 79

corporate era

Back 79

1) corporatization

2)information revolution

3) globalization

Front 80

corporatization

Back 80

-physician consolidating into large organizations

-cost efficient

-reimbursement changes

-ex.happening in Harrisonburg w/ clinicals

-creating monopoly

-eroding private practices

-physicians now on salary of hospital

-managed care; dictates usage, practice guidelines (time), less personal

Front 81

information revolution

Back 81

-telecommunications: telemedicince, advancements through technology and informationsharing

-bright side of corporate era

-Ehealth: accessable information easily found online

Front 82

globalization

Back 82

-global information exchange

-global profession and exchanges

-outsourcing, imporatation

-medical tourism

-physicains migration

Front 83

medical tourism

Back 83

getting treatment elsewhere

Front 84

physicians migration

Back 84

-everyone wants to come to the U.S.

-most not medically equivalent

Front 85

reform

Back 85

-sCHIP: state childrens health care insurance plan

-medicare prescription drug act

-affordable care act

Front 86

sCHIP

Back 86

-state childrens healthcare insurance plan

-gap between medicaid and private insurance

Front 87

Medicare Prescription Drug Act, part D

Back 87

-help medicare patients with payment for prescriptions

Front 88

affordable care act

Back 88

-expands access to health care

-pre-diagnosed no longer discriminated against