16 PowerPoint ® Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY Copyright © 2011 Pearson...

16PowerPoint® Lecture Outlines prepared by Dr. Lana Zinger, QCCCUNY

Copyright © 2011 Pearson Education, Inc.

Savvy Health Care Consumerism


Taking Responsibility for Your Health Care

Self-Help or Self-Care• Know your body.• Pay attention to body signals.• Take appropriate action to stop progression of illness or

injury.• Many common forms of self-care, including

• Diagnosing symptoms/conditions that occur frequently but don’t require a physician visit

• Using over-the-counter remedies

• Performing home health tests

• Learning minor first aid



When to Seek Help• Recognize when a condition needs professional help• See a professional for conditions such as serious

accident or injury, adverse drug reactions, unexplained sudden weight loss, and any symptom that is unusual and recurs over time

• Home health tests for many conditions should not be a substitute for professional diagnosis and care



Assessing Health Professionals• Identify what type of help you need and where to find it.• You should feel comfortable with your provider.• Your provider should explain diagnosis and treatment

options thoroughly and involve you in any patient care decisions.

• Be sure to understand coverage options.• Check certifications, affiliations, availability, and

whether provider shows respect and empathy for patient.

• Ask questions.


Choosing Health Products

Prescription Drugs• Prescription drug use has risen by 25 percent over the

past decade.• 45 percent of Americans report taking at least one

prescription drug in the past month, while 18 percent report taking three or more.

• Generic drugs—medications sold under a chemical name rather than a brand name, and contain the same active ingredients as brand-name drugs but are less expensive


Choosing Health Products

Over-the-Counter (OTC) Drugs• Nonprescription substances used in the course of self

diagnosis and self-medication• The FDA has categorized 26 types of OTC preparations• Those most commonly used are analgesics; cold, cough,

allergy, and asthma relievers; stimulants; sleeping aids and relaxants; and dieting aids


Common Over-the-Counter Drugs, Their Uses, and Potential Side Effects

Continued


Common Over-the-Counter Drugs, Their Uses, and Potential Side Effects


The Over-the-Counter Medicine Label


Choices in Medical Care

Conventional Western (allopathic) Medicine

• Primary care practitioners (PCPs)• Osteopaths• Ophthalmologists• Optometrists• Dentists

• Nurses• Nurse practitioners (NPs)• Physician’s assistant

(PAs)


Health Insurance

• Insurance allows the patient to pay into a pool of funds and then the health care provider bills the insurance carrier for all or part of the heath care charges they incur.

• 46 million Americans are uninsured.• 25 million Americans between the ages of 19 and 65 are

estimated to be underinsured.• Many students are uninsured.


Health Insurance

Private Health Insurance• Fee-for-service or indemnity• Deductibles, co-payments, and coinsurance• Preexisting condition clauses• Waiting periods• Lifetime limit


Health Insurance

Managed Care• A network of physicians, hospitals, and other providers

and facilities linked contractually to deliver comprehensive health benefits

• A budget based on an estimate of the annual cost of delivering health care for a given population

• An established set of administrative rules requiring patients to follow the advice of participating providers


Health Insurance

Medicare and Medicaid• Medicare covers 99 percent of adults over 65 years of

age.• Medicaid is a welfare program that includes people with

disabilities and children who do not have health care coverage.

• Diagnosis-related groups (DRGs)


Issues Facing Today’s Health Care System

Cost• The United States spends more than any other nation;

costs are over $2 trillion annually• Individuals with preexisting conditions, and those who

are self-employed often find themselves unable to find or afford health care.

• Health care expenditures are projected to grow by 6.2 percent each year, reaching over $4 trillion annually by 2018—nearly 20 percent of our projected gross domestic product (GDP).



Factors for High Costs• Excess administrative costs• Duplication of services• Aging population• Growing rates of obesity and inactivity• Demand for new diagnostic and treatment technologies• Emphasis on crisis-oriented care• Inappropriate use of services by consumers


Health Care Spending per Person, 2007 (in thousands of U.S. dollars)


Where Do We Spend Our Health Care Dollars?



Access• Access to health care depends on many factors

• Supply of providers and facilities• Proximity to care• Health status• Ability to maneuver in the system• Insurance coverage



Quality and Malpractice• Mechanisms for safety

• Education

• Licensure

• Certification/registration

• Accreditation

• Peer review

• Mistakes do happen, and deaths can occur because of medical errors.

• Outcome measurements access the quality of heath care at the individual level

Do you believe the U.S. health care system is safe?


The Perils of Medical Waste

• Hospitals generate a substantial amount of medical and pharmaceutical waste.

• This can contaminate groundwater and surface water, and pollute oceans

• Pharmaceutical drugs have been detected in drinking water.

• Green ways to manage unused medications• Send your medicine to those in need.• Take your drugs back to the pharmacy.


The Debate Over National Health Insurance

Proponents of Reform:• Health care should be available and affordable for

everyone.• Health care is a right, not a privilege.

Opponents of Reform:• The high cost of changing the system is more than the

United States can afford.• The government should not interfere with market

industry.


The Debate over National Health Insurance

Critical Issues Many Americans feel:

• We are paying for the most expensive system in the world without obtaining full coverage.

• We pay for people who don’t have insurance.• Prevention and early treatment are not emphasized.

The Institute of Medicine, a nonpartisan organization, recommends a single-payer, tax-financed scheme.


The Affordable Care Act of 2010

Health care rationing? Will it cost more? What are some important parts of the reform?

• Parent’s insurance until 26• No discrimination based on pre-existing conditions• Prohibits dropping coverage when people get sick• Covers preventive health services

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