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introduction to health systems > Module 5 lecture part 5 > Flashcards

Module 5 lecture part 5 Flashcards

1
Q

What can threaten the health of society at large?

A

Relying on rationing based on ability to pay and the lack of central planning

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2
Q

How has technology influenced the medical system?

A

Influencing medical education
Making it possible to deliver medical services in settings other than hospitals
Promoting corporatization of medicine

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3
Q

What are the four main eras of HC evolution in the US?

A

Pre-industrial, or consumer sovereignty
Post-industrial, or professional dominance
Corporatization or corporate dominance
HC reform, or gov’t dominance

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4
Q

Characteristics of the pre-Industrial Era: 1700s to 1800s

A

Medical practice in disarray
Primitive medical procedures
Missing institutional core
Unstable demand
Substandard medical education

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5
Q

Why was medical practice in disarray in the 1700s to 1800s?

A

It was a trade, not a profession

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6
Q

Give examples of primitive medical procedures in the 1700s to 1800s

A

Bleeding
Emetics
Purgatives

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7
Q

Describe the institutions of the 1700s and 1800s

A

Almshouses and pesthouses
Dispensaries
Mental asylums

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8
Q

What was the result of unstable demand in the 1700s and 1800s?

A

Self-reliance

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9
Q

Describe medical education in the 1700s and 1800s

A

Apprenticeship
College-based education lacked scientific training

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10
Q

Describe the characteristics of the post-industrial era: late 1800s-mid 1900s

A

Professional sovereignty of American physicians
Specialization in medicine
Development of PH
Birth of workers’ comp
Rise of private health insurance
Failure of national HC initiatives
Creation of Medicare and Medicaid
Development of managed care

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11
Q

What were the reasons medicine became a profession of power and authority?

A

Urbanization
Science and tech
Institutionalization
Pt dependency
Autonomy and organization
Licensing
Educational reform

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12
Q

Describe characteristics of specialization in medicine

A

It’s a hallmark in American medicine
58:42 specialist to generalist ratio
Also specialized fields in allied health professions

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13
Q

What is a consequence of preoccupation with specialization?

A

Lack of a rational coordination of medical care

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14
Q

Describe the gatekeeping model of HMOs

A

Has been occurring since early 1900s
Initial contact with GP required for a referral to a specialist

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15
Q

What were three forces behind the health insurance movement in the early 1900s?

A

Technology: advanced txs became available, but they were expensive
Social: desirability of HC
Economic: unpredictability of medical needs and costs of tx

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16
Q

What occurred for health insurance in 1911?

A

Blanket insurance policies for large industrial pops (life, sickness, accidents, nursing care)

17
Q

What occurred for health insurance in 1916-1918?

A

State employer mandates failed

18
Q

What occurred for health insurance in 1929?

A

Modern health insurance Baylor Plan
-Established for public school teachers
-At Baylor University hospital in TX
-A prepaid plan
-The model for Blue Cross

19
Q

What occurred for health insurance in 1933?

A

Blue Cross plan for hospital charges in MN

20
Q

What occurred for health insurance in 1939?

A

Blue Shield plan for physician services in CA

21
Q

What occurred for health insurance in 1974?

A

Combined hospital and physician coverage
-Blue Cross and Blue Shield of greater NY
-Similar plans in other states followed
-The success of BCBS prompted commercial insurance companies

22
Q

What were the 3 main developments that pushed insurance to become employer-based?

A

Wage freezes during WWII
1948 Supreme Court decision
1954 tax ruling

23
Q

What occurred during the wage freezes during WWII in terms of health insurance?

A

Employers were offering health insurance in lieu of wage increases

24
Q

What was the 1948 Supreme Court decision relating to health insurance?

A

Legitimized health insurance as a negotiable item in union-management bargaining

25
Q

What was the 1954 tax ruling in relation to health insurance?

A

Employer contributions for health insurance became exempt from taxable income for employees

introduction to health systems (66 decks)

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