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34 Cards in this Set
- Front
- Back
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What does Allocation of Healthcare resources refer to?
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What do do when patients interests conflict with each other
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What is Allocation?
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The decisions that set levels of funding for programs rather than determine care for individual patients
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What does Allocation NOT refer to?
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Decisions that determine care for individual patients.
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What is Macroallocation?
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Policy-level choices that determine fund distribution for Medicaid and such
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What is Rationing?
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Decisions at the bedside or in the office to limit care for individual patients due to limited resources.
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What is rationing because care is too expensive called?
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Microallocation
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What type of allocation policies are used in the United States?
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A patchwork system that is not coherent.
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Because of the absence of fair social agreement on allocation in the US, what do physicians have to decide?
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Whether they can ethically carry out rationing at the bedside.
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What 2 ethical principles does Bedside rationing of resources go against?
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-Fiduciary principle
-Patient advocacy |
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What is a major argument FOR bedside rationing?
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It is not the physician's absolute duty to act in the patient's best interest ALWAYS
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What is an example?
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HAving to breach confidentiality for infectious disease, risk of third party, driving inability.
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What are 2 additional arguments in favor of bedside rationing?
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-Leaving doctors OUT Of macroallocation decisions will harm patients
-Other patients may be seriously harmed if resources arent rationed |
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Does the US constitution have anything to say about whether people have a RIGHT to healthcare?
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no
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What are 3 types of patients that have a right to healthcare according to case law?
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-Prisoners
-Involuntarily committed patients -Fiduciary duty |
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What are 3 types of patients that have a right to healthcare according to statutory law?
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-Veterans/federal employees
-People >65 (medicare/caid) -Emergency treatment |
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What is the law that wa passed in 1986 so that everyone has access to emergency medical treatment?
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EMTALA
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What does ethics think about people having the right to medical care?
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They have a right to a decent minimum
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What is the ethical disconnect here?
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People think we should have a right to medical care, but no one wants to pay for it.
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Who are the 3 major entities that pay for medical care? What % is each?
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-Private insurers - 40%
-Government - 40% Self pay |
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What is the current and projected US cost of healthcare?
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Current: 14% of the US gross domestic product
Projected: 30% of the US gdp |
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What has the government decided to pay for so that we won't ration and prevent patients from getting it?
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End stage renal disease dialysis
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What has happened to the government coverage of ESRD?
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We've prolonged the lives of those people; so now we pay for even more dialysis.
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Why are costs increasing in healthcare?
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1. Technology advancements
2. Aging population 3. Increased prevalence of chronic disease |
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How does cost shifting increase healthcare costs?
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The insured have to pay for uninsured - increases our costs
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What do public health issues have to do with increasing healthcare costs?
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-We educate and help people stop smoking; but then they live longer and get sick anyway
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What costs are increasing even more than hospital costs?
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Pharmaceuticals
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What are 2 less obvious contributors to increasing cost in healthcare?
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-Malpractice and defense costs
-Administrative costs |
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What % of americans are uninsured? In what population is uninsurance higher?
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16%
-Higher in young/unmarried -African americans -Hispanics |
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What trend are we seeing in uninsured patients?
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They are increasing
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What is the Oregon basic health services act?
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An act that improved healthcare access by expanding Medicaid coverage
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What is the basis of the Oregon basic health services act?
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Instead of just paying for medical services, they are RANKED so that high priority services are paid for in preference of low priority.
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Why are healthplans currently increasing copays?
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So that there is a disincentive for people to just go to the doctor or hospital at the drop of a hat
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What are employers currently tending to do with insurance?
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Discontinuing it and not offering it or hiring more part time employees
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What is the Physician's obligation in terms of healthcare allocation?
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To use resources WISELY but NOT ration at the bedside
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