Chapter 1 Notes & Slides Flashcards
Blue Cross
A health insurance program that primarily covers hospital services initially for teachers.
Blue Shield
A health insurance program that primarily covers physician and medical services.
Charitable hospitals
Hospitals that provide healthcare services to underserved or indigent populations often as part of their charitable mission.
Children’s Health Insurance Program (CHIP)
A federal-state program that provides healthcare coverage to low-income children and pregnant women
Children’s Health Insurance Program Reauthorization Act
Legislation that reauthorized and expanded the CHIP program, increasing access to healthcare for children.
Chronic disease
A long-lasting medical condition that requires ongoing management and care.
Comprehensive health care
Healthcare that includes a wide range of services to address all aspects of a person’s health.
Dispensary
A facility where medications and medical supplies are prepared, dispensed, and distributed.
Flexner report
A landmark report that led to improvements in medical education and the standardization of medical training.
Health Insurance Portability and Accountability Act (HIPAA)
Legislation that protects the privacy and security of individuals’ healthcare information.
Health Maintenance Organization Act (HMO Act)
Legislation that promoted the establishment of Health Maintenance Organizations to provide managed healthcare.
Heroic medical therapy
Aggressive and often experimental medical treatments used in the past, sometimes with harmful effects.
Hill-Burton Act (National Hospital Survey and Construction Act)
Legislation that funded the construction of hospitals and healthcare facilities, especially in underserved areas.
Humoralism
An ancient medical theory that believed health was determined by the balance of bodily fluids or humors.
Incremental healthcare reform
The gradual and phased approach to making changes and improvements in healthcare systems.
Infectious disease
Illnesses caused by pathogenic microorganisms, such as bacteria, viruses, or parasites.
Medical home
A primary care model that provides comprehensive, coordinated, and patient-centered care.
Medicare
A federal health insurance program primarily for seniors and certain disabled individuals.
Medicare Part D
A Medicare program that provides prescription drug coverage.
Medicare Prescription Drug, Improvement, and Modernization Act
Legislation that established Medicare Part D and made other changes to the Medicare program.
Medicaid
A joint federal and state program that provides health coverage for low-income individuals and families.
Medication therapy management
A service that helps individuals manage their medications for better health outcomes.
Orthodox physicians
Conventional or mainstream medical practitioners.
Patent medicines
Historical term for unregulated, often ineffective, and sometimes dangerous medical remedies.
Quack medicines
Patient-centered care
Healthcare that prioritizes the needs and preferences of the patient.
Patient Protection and Affordable Care Act (ACA)
Landmark healthcare reform legislation aimed at improving access to healthcare and controlling costs.
Pharmaceutical care
The practice of pharmacists providing patient-focused medication therapy management.
Quackery
The promotion of medical treatments or products that lack scientific support and may be fraudulent.
Sectarians
Individuals or groups practicing alternative or non-mainstream forms of healthcare.
Self-dosing
The practice of individuals determining their own medication dosages without medical guidance.
Social healers
Individuals or groups focused on addressing social determinants of health to improve overall well-being.
Paradoxes of the U.S. Health Care System
Despite having the highest healthcare standards, advanced technology, and the highest per capita expenditure (approximately 17% of GDP), the U.S. healthcare system faces issues such as fragmentation, a high rate of medical errors, socioeconomic and racial disparities in outcomes, and inadequate health insurance coverage for all.
High rate of medical errors (44-98K deaths/year), socioeconomic and racial disparities in outcomes, and incomplete health insurance coverage for all.
Health Values, Therapeutics, and Practitioners in 19th-Century America
In 19th-century America, healthcare was influenced by Galen’s humoralism, emphasizing the body’s interconnected balance. Health practitioners adhered to humoralism, treating disease as an imbalance. Drugs were seen as adjusting the body’s equilibrium.
Types of 19th-Century Practitioners
In the 19th century, there were two types of practitioners - orthodox physicians (allopathic or regulars) who had some medical education and used depletive or strengthening measures, and sectarians (irregulars) who practiced alternative methods without formal training.
Fee-for-Service in 19th-Century Healthcare
In the 19th century, both orthodox physicians and sectarian practitioners often required payment at the time of service, following a fee-for-service model. Many Americans, especially those of lower economic classes, initially relied on home remedies to avoid these costs.
Changes in Healthcare at the Turn of the 20th Century
At the turn of the 20th century, healthcare underwent significant changes, including reforms in medical education inspired by the Flexner report of 1910. These reforms aimed to raise accreditation standards, admission criteria, and standardized curricula for medical schools.
Golden Age of Medicine and Transformation
The golden age of medicine occurred in the early 20th century, but it was replaced by transformations in the late 20th and early 21st centuries, including shifts in healthcare delivery, patient care, and professionalization.
Professionalization of Medicine and Pharmacy
In the late 19th and 20th centuries, both medicine and pharmacy pursued professionalization, setting higher standards, educational requirements, and codes of ethics. These professions continued to define themselves in the 21st century.
Factors Influencing Decline of Infectious Diseases
Improved public health practices, lifestyles (diet, housing, personal hygiene), and advancements in medical practice played key roles in reducing infectious diseases and increasing life expectancy at the turn of the 20th century.
Government Policies Affecting Healthcare (20th-21st Century)
Over the 20th and early 21st centuries, government policies have significantly shaped healthcare delivery, including the implementation of public and private health insurance systems, regulation of providers, and healthcare financing.
Key Healthcare Policies and Acts
Key healthcare policies and acts include the implementation of Medicare and Medicaid in the 1960s, the Health Maintenance Organization Act of 1973, the Health Insurance Portability and Accountability Act of 1996, the Children’s Health Insurance Program of 1997, and the Patient Protection and Affordable Care Act of 2010.
Medicare Part D Drug Plan
The Medicare Part D Drug Plan provides prescription drug coverage to Medicare beneficiaries. It offers benefits by helping seniors afford medications but also has costs, including premiums, deductibles, and potential coverage gaps.
Problems with Incremental Healthcare Reform
: Incremental healthcare reform faces challenges like resistance to change, complexity, and fragmented improvements, hindering its effectiveness in addressing comprehensive healthcare system issues.
Patient Protection and Affordable Care Act (ACA)
The ACA is a significant healthcare reform law that aims to expand coverage, control costs, and improve care quality. It includes provisions like insurance exchanges, Medicaid expansion, and consumer protections.
Affordable Care Act provisions
Provisions include:
– Most individuals required to have health insurance beginning in
2014
– Health Insurers prohibited from imposing lifetime limits on
coverage and prohibited from rescinding coverage, except in
cases of fraud
– Young adults allowed to remain on parent’s health insurance up
to age 26
Health Maintenance Organization Act (HMO Act)
Enacted in 1973, the HMO Act required employers with over 25 employees to offer HMO options in their health plans. By 1995, over half of the U.S. population was covered by HMOs or less-structured PPOs.
State Children’s Health Insurance Plan (S-CHIP)
Established in 1997, S-CHIP provides health insurance coverage for children in low-income families who do not qualify for Medicaid but cannot afford private insurance.
Medicare Prescription Drug Improvement and Modernization Act (MMA)
In 2003, MMA created Medicare Part D, providing prescription drug coverage to Medicare beneficiaries.
Incremental Health Reform
Incremental healthcare reform involves gradual changes and improvements to the healthcare system. Examples include employer mandates, expanding eligibility for Medicare and Medicaid, and initiatives like Health Savings Accounts.
Comprehensive Health Reform
Comprehensive health reform seeks to achieve universal healthcare coverage. It includes approaches like single-payer systems (government-run healthcare) and health care vouchers, promoting choice and competition.
