Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
88 Cards in this Set
- Front
- Back
|
health care objections |
1. ALL citizens receive health care services 2. services are cost-effective and of quality |
|
|
payment/finance options |
-employment based insurance (majority) -private health insurance -government programs |
|
|
10 characteristics of US Health Care System |
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 |
|
|
multiple payers |
too many providers |
|
|
selective service based minimum |
not everyone gets covered for everything |
|
|
third-party insurer are intermediates |
-you can get it, but they don't need to cover it -whatevers most cost efficient for them |
|
|
imperfect market |
-cant evaluate different insurers -information not upfront (can't "shop") |
|
|
no central agency that governs the system |
-state licensing boards, etc. - no laws |
|
|
legal risks lead to defensive medicine |
-malpractice insurance is so high -physicians over-run tests to cover themselves, running up your bill |
|
|
new technology |
-new best thing is expensive -research & development (payed for by insurance) -more caught up in "toys" than practice |
|
|
quality |
-how do we improve our system & methods -chronic disease prevention (our job, not insurance) -preventable with diet, exercise, sleep, stress management, no smoking |
|
|
power balance |
-no one entity controls, many different providers -multiple insurers, no one is in control,but they still have power |
|
|
continuum of service |
-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 |
|
|
quad-function model |
1. financing 2. insurance 3. delivery 4. payment |
|
|
financing |
either buying health insurance, pay H.C. services -employee, gov't or self |
|
|
insurance |
-protect against catastrophic risk -different packages available to you |
|
|
delivery |
-providers of healthcare -physicians, hospitals, nursing homes, diagnostic centers -primarily paid by insurance companies |
|
|
payment |
-out of pocket, reimbursement, co-pay/cost sharing premiums, deductible |
|
|
4 factors that affect access to healthcare |
1. ability to pay 2. availability of services 3. payment options 4. barriers to care |
|
|
ability to pay |
-do you have health insurance? -what kind? -how will you pay? |
|
|
availability of services |
-where do you live and whats available -whether or not you can access health care system |
|
|
payment options |
-many providers don't accept Medicare & Medicaid -poor people are usually more sick -poor are discriminated against |
|
|
barriers to care |
-transportation, culture, language -discriminate against those that don't know "our ways" (expected to know how to read ex. money) -disability |
|
|
health care systems of other countries |
1. national health insurance 2. national health care system 3. socialized health insurance |
|
|
National Health Insurance |
-collect general taxes -have private providers still -ex. Canada (single payer system) |
|
|
National Health Care System |
-gov't controlled -supported by taxes -providers are gov't employees -everyone has H.C. -ex. Great Britian |
|
|
Socialized Health Insurance |
-gov't mandated and to employers & employees -private providers -non-profit insurance -fined if you don't have insurance -ex. Germany |
|
|
what is health? |
-used to be anyone free of disease -Health care is based on medical model |
|
|
medical model |
-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 |
|
|
illness v disease |
i feel sick v. i have been diagnosed |
|
|
epidemiology triangle |
agent, host and environment working together |
|
|
risk factors |
behavior and hereditary |
|
|
behavioral |
-diet, exercise, stress, sleep, smoking -behavior modification is more easily said than done |
|
|
hereditary |
-less so than behavior, but still prevalent |
|
|
prevention |
-primary -secondary -tertiary |
|
|
primary |
-prevent a health incident from occurring -ex. seatbelt, vaccine, education, skills, condom |
|
|
secondary |
-early detection and treatment of disease -ex. screenings |
|
|
tertiary |
-intervention to prevent further complications -health issue already present, learning how to live with it |
|
|
public health |
-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_ |
|
|
public health prevention |
vaccines for infectious diseases |
|
|
health promotion and education |
-applied to all people -sex education, tobacco use, DARE -really where public health works (3-in-1_ |
|
|
health protection |
-water quality, air quality, seatbelt, occupational health, bio terrorism |
|
|
health determinants |
~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 |
|
|
Blum's forcefields |
-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 |
|
|
medical care service |
-delivery -access |
|
|
lifestyle (behaniors) |
-attitudes about health ex. diet and food |
|
|
heredity |
genetic make up |
|
|
American's beliefs and values |
1. concern 2. entrepreneurial 3. capitalism 4. science 5. distrust |
|
|
concern for the underprivileged |
-poor, elderly, and disabled |
|
|
entrepreneurial spirit |
-self determination, motivation -you should work for life you want -not equal opportunities however |
|
|
capitalism |
-ability to shop around between competeters |
|
|
science |
-true whether we believe it or not -technological advances -make things more expensive |
|
|
distrust of gov't |
-elected officials -responsibility is on us -voting process |
|
|
market justice |
-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 |
|
|
social justice |
-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? |
|
|
Health status |
|
|
|
morbidity |
|
|
|
mortality |
|
|
|
longevity |
|
|
|
ADL |
|
|
|
7 Key Factors of transformation in the Post-Industrial Error |
1. urbanization 2. science & technology 3. institutionalization 4. dependency 5. licensing 6. educational reform 7.autonomy & organization |
|
|
urbanization |
-increased reliance on specialized skills and paid professionals |
|
|
science & technology |
-acceptance and use of science in medicine -got away from herbal remedies |
|
|
institutionalization |
-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 |
|
|
dependency |
-patients depend on the medical profession's judgement and decision -requires physicians intervention -physicians took responsibility for health |
|
|
licensing |
-couldn't just apprentice, needed certification |
|
|
educational reform |
-standardized curriculum that they could control |
|
|
autonomy & organization |
-physicians ability to remain free of control from hospitals & insurance companies -AMA is very powerful |
|
|
public health development |
-developed along side physicians -did everything physicians didn't want -gov't financed -monitor: -air and water quality -waste management -vaccinations -epidemiology -statistics |
|
|
forces that created need for health insurance |
1) technology 2) social 3) economic |
|
|
technology |
better treatments, more expensive |
|
|
social |
growing demand |
|
|
economic |
people cant afford it |
|
|
proposing health care plans have been shaped by: |
-politics -institutional dissimilarities -ideological differences -tax aversion |
|
|
politics |
-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 |
|
|
institutional dissimilarities |
-private hospitals (not gov't owned) -too decentralized to adopt another nations H.C. model |
|
|
ideological differences |
-stand on our own feet -principles of market justice -middle class pays for everything |
|
|
tax aversion |
-expanding health insurance coverage would mean higher taxes for middle class |
|
|
corporate era |
1) corporatization 2)information revolution 3) globalization |
|
|
corporatization |
-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 |
|
|
information revolution |
-telecommunications: telemedicince, advancements through technology and informationsharing -bright side of corporate era -Ehealth: accessable information easily found online |
|
|
globalization |
-global information exchange -global profession and exchanges -outsourcing, imporatation -medical tourism -physicains migration |
|
|
medical tourism |
getting treatment elsewhere |
|
|
physicians migration |
-everyone wants to come to the U.S. -most not medically equivalent |
|
|
reform |
-sCHIP: state childrens health care insurance plan -medicare prescription drug act -affordable care act |
|
|
sCHIP |
-state childrens healthcare insurance plan -gap between medicaid and private insurance |
|
|
Medicare Prescription Drug Act, part D |
-help medicare patients with payment for prescriptions |
|
|
affordable care act |
-expands access to health care -pre-diagnosed no longer discriminated against |
