Social Problems, 13eD. Stanley EitzenMaxine Baca ZinnKelly Eitzen Smith

Chapter 17The Healthcare System

The Healthcare System

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Learning Objectives

17.1 Understand the extent of the healthcare crisis in the United States.

17.2 Explain how the healthcare system has shifted from physician-centered care to managed care, and the consequences of this shift.

17.3 Explain how access to healthcare varies by social class, race, and gender.

17.4 Compare and contrast the Bismarck, the Beveridge, and the National Health Insurance models of healthcare.

17.5 Discuss some alternatives to improve the healthcare delivery system in the United States.

17.1 - Crises in Healthcare: Cost, Coverage, and Consequences

• Rising Healthcare Costs

• Does the High Cost of Healthcare Translate into Good Health Consequences?

LO 17.1 - Rising Healthcare Costs

• In 2010, Americans spent $2.6 trillion on healthcare

• Why is American healthcare so expensive?– Profit driven– Inefficiency– Defensive medicine– Malpractice lawsuits– Development of new technology

LO 17.1 - Does the High Cost Mean Good Health Consequences?

• The U.S. spends 50 percent more per capita on healthcare than any other country

• The U.S. ranks 47th in average life expectancy

• The U.S. ranks last among 23 wealthy countries in its infant mortality rate

• The U.S. ranks 54th out of 191 countries in terms of the fairness of its healthcare system.

LO 17.1

Doctors practice __________ medicine; ;they order unnecessary tests to avoid lawsuits.

A. malpractice

B. defensive

C. efficient

D. technological

LO 17.1

Doctors practice __________ medicine; ;they order unnecessary tests to avoid lawsuits.

A. malpractice

B. defensive

C. efficient

D. technological

LO 17.1

The high cost of the U.S. healthcare system translates into better health outcomes than those of other wealthy nations.

A. True

B. False

LO 17.1

The high cost of the U.S. healthcare system translates into better health outcomes than those of other wealthy nations.

A. True

B. False

17.2 - The Healthcare System in the United States Prior to 2010 Reform

• Different Plans for Different Categories

• Private Insurance

• For-Profit Hospitals

• Managed Care Networks

LO 17.2 - Different Plans for Different Categories

• Workers

• Native Americans, Military Personnel, and Veterans

• Those 65 and Over

• The Uninsured

LO 17.2 - Private Insurance

• Health insurance firms are for-profit – Try to enhance profits through

• Raising rates

• Hiring adjusters

• Rescissioning• Not covering preexisting conditions

• Health insurance is crucial – Many Americans have inadequate coverage

LO 17.2

LO 17.2 - For-Profit Hospitals

• Traditionally, hospitals were run by churches, universities, and municipalities

• Since the 1960s, for-profit hospitals and chains have emerged

LO 17.2 - Managed Care Networks

• Doctors used to practice alone– Today, 93 percent of medical school

graduates will work in a hospital system, clinic, or other large setting

• Implications for doctor-patient relationship– medlining

LO 17.2

In order to increase profits, for-profit hospitals may eliminate __________ departments.

A. maternity

B. intensive care

C. cardiac

D. emergency

LO 17.2

In order to increase profits, for-profit hospitals may eliminate __________ departments.

A. maternity

B. intensive care

C. cardiac

D. emergency

LO 17.2

Insurance companies are designed to help the sick, not the well.

A. True

B. False

LO 17.2

Insurance companies are designed to help the sick, not the well.

A. True

B. False

17.3 - Unequal Access to Healthcare

• Social Class

• Race/Ethnicity

• Gender

• HIV/AIDS: The Intersection of Class, Race, and Gender

LO 17.3 - Explorer Activity: Health and Healthcare: Social Context and Healthcare

http://www.socialexplorer.com/pearson/plink.aspx?dest=http%3a%2f%2fwww.socialexplorer.com%2fSpiceMap%2f%3fv%3dbfe57c16290f4616

Please log into MySocLab with your username and password before accessing this link.

LO 17.3 - Social Class

• Wealth = Health– Disease– Diet/nutrition– Shelter– Sanitation – Economic stress– Access to medicine– Insurance (Medicaid)

LO 17.3

The infant mortality rate in the United States is more than twice as high as the rate in the countries with the lowest rate.

LO 17.3

LO 17.3 - Race

• Life expectancy

• Infant mortality

• Maternal mortality

• Prenatal care

• Low birth weight

• Cancer and other diseases

LO 17.3 - Gender

• Women:– Health advantages over men

• biological and social

– less likely to have health insurance than men– left out of medical research– Doctor-patient interaction is different

LO 17.3 - HIV/AIDS: Class, Race and Gender

• Blacks account for about one-half of all the people in the U.S. who live with HIV

• The number of HIV cases per 100,000 population was – 15.3 for Whites, – 44.7 for Latinos– 116.0 for African Americans

• Two-thirds of new infections among women occur in Black women

LO 17.3

LO 17.3

According to the textbook, one of the best predictors of health status is __________.

A. gender

B. race

C. social class

D. religion

LO 17.3

According to the textbook, one of the best predictors of health status is __________.

A. gender

B. race

C. social class

D. religion

LO 17.3

Women have health advantages over men, but women are also more likely to face discrimination in the healthcare system.

A. True

B. False

LO 17.3

Women have health advantages over men, but women are also more likely to face discrimination in the healthcare system.

A. True

B. False

17.4 - Models for National Healthcare: Lessons From Other Societies

• The Bismarck Model

• The Beveridge Model

• The National Health Insurance Model

LO 17.4 - The Bismarck Model

• Germany, Japan, France, Belgium, and Switzerland– Private insurance with no profit – Covers everyone– Government regulation of fees

LO 17.4 - The Beveridge Model

• Great Britain, Italy, Spain, Cuba, Scandinavia– Medical treatment is a public service– No bills– Government-owned hospitals– Doctors are government employees

LO 17.4 - The National Health Insurance Model

• Canada, Taiwan, South Korea– Single-payer plan– Doctors/hospitals are private– Government run insurance

LO 17.4

LO 17.4

Examining alternative plans for healthcare, we learn that __________.

A. socialized medicine is a burden

B. there are many cost-effective alternatives

C. changing plans would be detrimental to our health status

D. private insurance plans are the best

LO 17.4

Examining alternative plans for healthcare, we learn that __________.

A. socialized medicine is a burden

B. there are many cost-effective alternatives

C. changing plans would be detrimental to our health status

D. private insurance plans are the best

LO 17.4

Countries utilizing single-payer healthcare plans spend more of their GDP on healthcare.

A. True

B. False

LO 17.4

Countries utilizing single-payer healthcare plans spend more of their GDP on healthcare.

A. True

B. False

17.5 - Reforming the Healthcare System of the United States

• The Politics of Health Reform

• The Obama Plan

• The Supreme Court and the Affordable Healthcare Act

• The Future of the Affordable Healthcare Act

LO 17.5 - The Politics of Health Reform

• Efforts to oppose reform include:– Influencing the Public– Influencing Congress– Legislative Blockage by the Minority

LO 17.5

LO 17.5 - The Obama Plan

• Changes to the status quo:– Everyone must have insurance.– Government will subsidize those with low

income.– Individuals may keep their current plan.– Private plans will compete for business.– Individuals cannot be denied for a preexisting

medical condition.– 31 million uninsured will become insured.

LO 17.5

LO 17.5 - Video: Obama Healthcare Plan

http://abavtooldev.pearsoncmg.com/sbx_videoplayer_v2/simpleviewer.php?projectID=APcontent&clipID=obama_healthcare.flv&ui=2

LO 17.5 - The Supreme Court and the Affordable Health Care Act

• Challenged as unconstitutional– Supreme Court upheld the act

• The Big Picture

• The Ingredients of the Affordable Health Care Act

In 2012 the Supreme Court ruled by a 5–4 vote to uphold the constitutionality of the individual mandate and most of the provisions of the Affordable Health Care Act.

LO 17.5

LO 17.5 - The Future of the Affordable Health Care Act

• The plan is not perfect– Both sides see problems– Costs need to be contained

• But it is a start

LO 17.5

Conservatives oppose the Affordable Health Care Act because __________.

A. the system remains private

B. the government has too much control

C. private insurers will turn a larger profit

D. the underinsured will still suffer

LO 17.5

Conservatives oppose the Affordable Health Care Act because __________.

A. the system remains private

B. the government has too much control

C. private insurers will turn a larger profit

D. the underinsured will still suffer

LO 17.5

The Affordable Health Care Act is basically a socialist healthcare plan.

A. True

B. False

LO 17.5

The Affordable Health Care Act is basically a socialist healthcare plan.

A. True

B. False

LO 17.5Question for Discussion

Compare and contrast the conservative and progressive views on healthcare reform.