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28 Cards in this Set
- Front
- Back
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Perspectives on sociology of health - central point
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Functionalism: Health care system plays a role in success of larger society
Conflict theory: Health care reflects the inequalities in society Symbolic interaction: Illness in (partly) socially constructed |
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Perspectives on sociology of health - policy implications
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Functionalism: Examine and improve how health care is serving larger society
Conflict theory: Improve access to health care, reduce cost Symbolic interaction: Re-examine how we define illness/healthcare, role of patient, role of doctor, etc |
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WHO US ranking, life expectancy
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37th, 70
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Problem #1 in US healthcare system - DISTRIBUTION
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Unequal distribution of health care by race (ethnicity, social class, gender - more available to white/middle class)
By region (live too far away from doc/hosp/ER) Inadequate health education of inner-city/rural parents |
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Problem with specialization in medicine..
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Lack of primary care physicians
With end of WW2, growth of medical establishment, increased specialization Today, specialists = 80%, general practitioners = 20% |
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Social class
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Lower social status = less access to adequate health care
41million/17% American have no health insurance |
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Least likely to have health insurance
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Hispanic/below poverty/southerners/18-24 years old
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Problem #2 : COST
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US = most %GNP exp on health
Greatest contributers: Soaring costs of hospital care Rise in fees for services of physicians |
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Medical malpractice
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High malpractice insurance premiums (150K)
Cost passed along to patients |
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Role of HMOs
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Private clinical care orgs that provide medical services in exchange for a set membership fee
AMA has argued HMOs pay too much attention on cost containment and not patient welfare |
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Problem #3 (special issues): Race
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RACE:
Being in racial/ethnic minority influences physical/mental health (discrepancy btw white and black life expectancy) |
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Problem #3 (special issues): Gender
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Older women more likely to suffer stress, overweight, hypertension, chronic illness than older men
Tendency for male-dominated profession to regard problems of women as non-mainstream, special |
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Potential solutions from experts
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1)Emphasize primary care
2) Stick to what works (standard of care) 3)Emphasize prevention 4) IM efficiencies through IT 5) manage chronic disease 6) Import/negotiate cheaper drugs 7) Pay providers less 8) Consumer-directed health care |
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Role of US gvt in healthcare
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Sought to have some form of guaranteed health service, at least to certain groups: veterans, poor, elderly
Medicare program (1965 under Lyndon B Johnson) provides medical insurance covering hospital costs for those of 65 Provides health insurance for poor, welfare, disabled |
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Why not nationalized health care
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Bureaucracy, slow, lack of individual choice
BUT Canada has it and has 70% approval rating, every citizen covered, longer life expectancy, cheaper, etc |
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Massachusettes Plan (Romneycare)
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2006
1)Individual Coverage mandate for all state residents 2)Fair share assessment for employers 3) Commonwealth connector 4) Sliding scale subsidies 5) Medicaid expansion for children |
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What are the issues addressed by Mass. Plan?
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1) Unequal dis by race - ethnicity, social class, gender, region
2) the 17% that has no health insurance 3) 20% GPs, 80% specialists 4) Inedequate health edu for inner city/rural parents 5) High cost of health care |
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Affordable Health Care for America - ObamaCare: Making coverage affordable
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Tax credits:
Sliding scare tax credits help cover premium insurance Premiums/co-pays for essential benefits are deductible if they exceed a certain % of income Out of pocket spending capped: Insurance must pay after certain pt Low income families eligible for medicaid |
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ObamaCare: How it pays for new coverage
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Half from redcing waste/fraud in medicare/medicaid
Other half from: taxes on rich, health care industry, high cost plans Closing tax loopholes |
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Obamacare: health care insurance exchanges
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State run + federal run insurance brokerages for individuals and small business
Info provided in understandable, easy-to-compare form |
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Obamacare: Strengthening healthcare workforce
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1) Incentives to increase number of primary care doctors/dentists
2) Programs/money to support those pursuing nursing 3)Strengthen support for those involved in community, preventative, geriatric health care and education 4)Proactive measures to adjust to future needs for healthcare professionals |
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Obamacare: Strengthening medicare
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1)Reduce/eliminate drug donut hole
2)Make preventive services free 3)Private insurance companies system must use 85% for care, not admin 4) Bring private medicare insurance company fees into line with regular medicare; reward their saving money 5) Hold nursing homes more accountable 6)Create center for medicare/medicaid innovation |
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Obamacare: Shared responsibility
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1) All must have health insurance, except in hardship cases
2) Penality equal to policy cost for those who don't comply 3)Employers w/ 50+ employees must help pay for coverage or face penalties 4) Employers with 200+ must offer coverage/face penalties 5) Tax credits for small employers who elect to offer coverage |
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Obamacare: Prevent waste fraud and abuse
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1)New compliance programs
2) Better monitoring 3) New penalties |
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Obamacare: Disparities
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Put 11 billion into primary care community heath centers
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Obamacre: Reward quality, not quantity of care
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1)Bundle payments
2) Incent reductions in unneccary readmission 3) Incent high quality of care |
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Obamacare: Cost containment
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1)Prevention
2)Competition 3) Value-based, not volume-based 4) Reduce waste/fraud/abuse 5) Study way to contain costs further |
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Issues the US plan addresses
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Unequal dist by race
17% w/o healthcare 20%GPS, 80% specialists Inadequate health edu of inner city/rural parents High cost of health care |
