Chapter 5: Healthcare

Question 1

Define Healthcare

Answer 1

Healthcarerefers to thediagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans

Healthcare istypically defined by unlimited demand and a limited supply, can be broadly grouped into 3 main categories

Question 2

Describe the 3 main categories of healthcare

Answer 2

primary care:
healthcare provided by health professionalswho havefirst contact for with patients
such care is relatively cheap
eg GP, physiotherapist

secondary care:
healthcare provided by healthcare professionals who generally do not have first contact with patients, usually on referral from a primary care healthcare professional
such care is usually relatively expensive,because it is provided over an extended period while a person is an in-patient
eg cardiologist, dermatologist

tertiary care:
specialized consultative healthcare, on referral from a primary or secondary care healthcare professional
such care is usually relatively expensive,because the resources used in the treatment are often costly
eg plastic surgery, heart surgery

Question 3

List the key providers of healthcare

Answer 3

doctors,
nurses,
hospitals,
support medical personnel (occupational therapist),
upstream service providers (manufacturers of pharmaceutical products)

Question 4

Why arePMI benefitsusuallyrestricted to secondary and tertiary care?

Answer 4

factors that reduce demand for primary carebenefits:
primary care is relatively cheap
sufficient public primary care

from insurer’s perspective:
primary care benefits likely to give rise to large number of small claims
leading to increased administration costs, which may lead to unattractive premiums being charged

factors that increase demand for secondary care benefits:
secondary care is relatively expensive
public secondary care often does not give the patient complete choice over the care provided,often subject towaiting lists

factors that increase demand for tertiary care benefits:
tertiary care is relatively expensive
likely to berationedin public tertiary care due to limited resources