LECTURE IV

Question 1

this concept requires reasonably good health and that all people value health

Answer 1

the Good life

Question 2

what is the main cause for the health care crisis?

Answer 2

cost

Question 3

what is maldistribution of access?

Answer 3

poor can’t afford healthcare and rural areas do not have access to healthcare, with also the rise in the number of specialist and lack of GPs complicates access even for those in urban areas with money

Question 4

what are the two types of distributive justice?

Answer 4

formal justice and material justice

Question 5

what is this type of justice?

equals must be treated equally and unequals must be treated unequally

any criteria could be used: age, sex, marital status, land ownership

Answer 5

formal justice

Question 6

what type of justice is this?

principles that specify relevant characteristics or determine morally relevant criteria with regard to treatment

nonmedical example: any exception to a rule on the basis of a morally or practically relevant circumstance

medical example: determining who qualifies for a transplant based on viability, prognosis, lifestyle

Answer 6

material justice

Question 7

this rule is the one in which no persons should be granted social benefits on the basis of underserved advantage and no persons should be denied social benefits on the basis of underserved disadvantages

under this rule, no one should be denied on the basis of sex, race, IQ, national origin, sexual preference, or social status

Answer 7

Fair Opportunity Rule

Question 8

healthiest state in the US?

Answer 8

Utah

Question 9

unhealthiest state in the US?

Answer 9

Nevada

Question 10

what are the three theories of justice?

Answer 10

egalitarian theory
utilitarian theory
libertarian theory

Question 11

what is this theory of justice?

emphasis on equal access to goods and services

Answer 11

egalitarian theory

Question 12

what is this theory of justice?

emphasis on “the greatest good for the greatest number”

Answer 12

utilitarian theory

Question 13

what is this theory of justice?

emphasis is on personal rights to social and economic liberty

the free market approach is largely what we currently have, hinging on ability to pay

idea is to have the gov’t out of the way and let the market work

Answer 13

libertarian theory

Question 14

this is the idea that you wouldn’t expend so many dollars at the end of someone’s life and would anticipate death somewhere between 78 and 82 years of age

note: 30% of medicare dollars are spent in the last year of someone’s life

Answer 14

Natural life span argument

Question 15

what are Callahans Principles for Practice of NLS approach?

Answer 15

after a person has lived out a normal life span, medical care should no longer be oriented to resisting death

medical care following NLS would be limited to relief of suffering

the existence of technologies capable of extending life beyond a NLS creates no technological imperative for its use

Question 16

the for plans that coordinate care through a primary physician?

Answer 16

managed care

Question 17

what managed care plan is this?

patients must stay within the network to get reduced rates; less coverage of out of network services

doctors agree to a discounted fee in return for being listed in the PPOs provider network?

Answer 17

preferred provider organization (PPO)

Question 18

what managed care plan is this?

similar to PPO, but with more restrictions for out of network services (no coverage)

Answer 18

exclusive provider organizations (EPO)

Question 19

what managed care plan is this?

set monthly premium for every patent enrolled
care is coordinated through primary physician
small fee for office visit

Answer 19

health maintenance organization (HMO)

Question 20

what managed care plan is this?

HMO contracts with network of doctors to provide service at a discount

incentives such as bonuses or penalties for cost control goals met or not met

Answer 20

individual physician association (IPA)

Question 21

what managed care plan is this?

hospital or clinic based HMOs, doctors are salaried and work only with HMO enrollees (Kaiser Permanente hospitals are like this)

Answer 21

staff model HMO

Question 22

AMA concerns about managed care prompted these guidelines?

Answer 22

duty of patient advocacy
when care plans restrict treatment options, alternatives are possible
physicians should not enter into plans that offer financial incentives to limit care
physicians should encourage both that patients be aware of the benefits and limitations of their healthcare coverage and exercise autonomy