Block 1 Flashcards
Enable all citizens to obtain needed health care sevices
Access
Services must be cost effective
Cost
Services must meet established standards
Quality
3 things considered to be acceptable healthcare
Access, Cost, Quality
- Cultural beliefs and Values
- Social Changes
- Technological Advances
- Economic Constraints
- Political Opportunism
5 factors that influenced our health care system
What are the 3 eras of US healthcare
- pre-industrial era
- post-industrial era
- corporate era
Care was provided by minimally educated physicians and some nurses
inexpensive: payment in cash or trade
Pre-industrial era
Development and growth of medical profession, nursing profession
Increased education
Urbanization led to concentration in cities and towns
Development and growth of hospitals
Post-industrial era
Post industrial era gave rise to what?
private health insurance
Explain employer based private health insurance
employers offered health insurance as a benefit instead of raising wages
What are the 4 main features of the corporate era?
- corporatization
- growth of non-physician workforce
- information revolution
- globalization
medical care is dominated by large corporation
corporatization
Many educated health professionals
growth of non-physician workforce
massive amounts of knowledge and information at everyone’s finger tips
information revolution
cross- border exchange of goods and services
globalizations
when was the Affordable Care Act passed
2010
Why do people have health insurance
run a risk of an accident or developing a disease to limit the high out of pocket cost
If a person applies for insurance they are automatically accepted
Guaranteed issue
as an employer you must supply insurance
employer mandate
Government says you must be covered by insurance (like school)
government mandate
an individual applies for an insurance and the insurance company looks at the risk factors and depending on those risk factors will change them more or less
underwriting
Underwriting is based on what?
judgement based on risk
Explain Risk pool: adverse/favorable selection
Insurance companies have a certain number of people apply to purchase a insurance and the people that make up the risk pool can either be good or bad for the insurance company
Explain the 4 make up of risk pools
- large pool: more healthy than sick=healthy large pool
- Small pool: more healthy than sick= healthy small pool
- Large pool: more sick than healthy= Large sick pool
- Small pool: more sick than healthy=small sick pool
