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Sociology of Health and Illness > Terminology > Flashcards

Terminology Flashcards

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1
Q

Moral Hazard

A

lack of incentive to guard against risk were one is protected from its consequences

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2
Q

Canadian Health Act

A

Through this Act, the federal government ensures that the provinces and territories meet certain requirements, such as free and universal access to publicly insured health care.

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3
Q

Five principles of the Canadian Health Act

A

UPPAC: Universality, portability, public administration, accessibility, comprehensiveness

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4
Q

When was the Canadian Health Act passed?

A

1984

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5
Q

Free Market

A

Free markets are characterized by a spontaneous and decentralized order of arrangements through which individuals make economic decisions/an economy with unobstructed competition and only private transactions between buyers and sellers.

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6
Q

What are the three aspects of HC systems

A

Financing, Delivery and Allocation

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7
Q

Financing Aspect Questions

A

Who pays for health care services? How is it routed?

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8
Q

What are the 2 types of Financing

A

Private Sources, Public Sources

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9
Q

Private Sources

A

1) Individual Out of Pocket

2) Insurance: individual and employment based

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10
Q

2 types of delivery

A

1) Private Organizations and Providers

2) Government Organizations and Providers

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11
Q

3 options for allocation

A

1) On basis of market competition
2) on basis of central plan
3) on basis of quality

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12
Q

Allocation: Market competition

A

multiple auto-buyers and competitors for business. Physician income based on number of patients

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13
Q

Allocation: Central Plan

A

negotiated plan: agreement with how much they will be paid, negotiation between government and physicians

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14
Q

Allocation: quality

A

problematic because what counts as quality

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15
Q

Conditions of a pure competitive market (free market)

A

1.Freedom to enter and leave the market, 2.adequate info on price and quality, 3.many buyers and sellers,4. freedom for prices to go up and down

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16
Q

Limitations to freedom to enter and leave the market

A

Licensing laws = sellers (physicians) prevent entry, buyers (patients) do not know when they will “enter” the market, cannot choose to not purchase health care

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17
Q

Limitations to information on price and quality

A

Quality is asymmetric and imperfect

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18
Q

2 Limitations to number of sellers and buyers in free market

A

not enough sellers = monopolies, not enough buyers = organized larger third party (monopsonies)

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19
Q

limitations to price range in free market

A

prices are not free to go up and down because of imbalance between buyers and sellers

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20
Q

monopsony

A

market situation where there is only one buyer

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21
Q

where do pure markets exist?

A

no where

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22
Q

4 types of health models

A

Mutual Aid Model, State Model, Professional Model, Corporatist Model

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23
Q

Mutual Aid Model

A

” to support fellow members and their families when ill”

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24
Q

Who is responisble in Mutual Aid Model

A

Individual.

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25
Power in Mutual Aid Model
local
26
Financing of Mutual Aid Model
Voluntary, organized insurance for health care. there is a collective sense that you're not going to do something that will increase your risk
27
advantages of Mutual Aid Model
more emphasis on public health, needs are determined by community
28
disadvantages of Mutual Aid Model
voluntary
29
State Model
to strengthen via a healthy vigorous populations
30
individual in State Model
conceived as a responsibility of the state
31
power in State Model
of the state, not authoritarian
32
financing in State Model
mandatory, taxes
33
Professional model idea
to give access to people who can pay, less emphasis on universal
34
Professional model allows
inequality
35
Professional model: individual
choice to participate in the health care systems
36
advantages of Professional model
great innovation
37
corporatist model
refers to different interest groups, corporations in terms of groups of people
38
basis of corporatist model
negotiation on how the health care system will look and operate
39
example of corporatist model
contemporary germany
40
what kind of model is canada
state bilateral monopoly
41
what does light say about different health care systems
we should think about the fact that there are different values behind these health care systems. technical comparisons are important but the value that allows the tech is too.
42
Argument of Hacker
concerned that government spending is starting to cut in to important systems like education but politicians don't want to increase taxes in case they get voted out
43
Competition under Light:
comparative sociocultural point of view, “competition” is a dominant myth or ideology in modern society that is used to explain and justify how economic activity is organized
44
compelling promise of competition is that
maximize individual gain will increase the wealth and power of the society as a whole
45
Light: beneficial competition only occurs if
a number of conditions or restrictions are in place.
46
4 Key factors in the evolution of health care systems
political system, strength go the working class, strength of medical profession, history
47
key moments in the historical evolution of health care systems
great depression, world war 2, rise of neoliberalism
48
1945 Tommy Douglas Saskatchewan (4)
Free care for pensioners and poor people, swift current insurance plan, 1947 hospital insurance plan, 1961 provincial medicare program
49
CHA discourages
private financing of "medically necessary" services
50
how many provinces prohibit third party insurance for services covered by provincial plans
six
51
in alberta, a physician may "opt out" of a public plan and charge what they wish but...
private insurance for publicly insured services is prohibited, and public sector coverage denied for patients revoking insured services from opted out physicians
52
3 key features of Healthcare System
Financing: predominantly publicly financed "singer payer Delivery: predominately privately delivered Allocation: mix of market and planning: physicians paid on a fee-for-service basis
53
4 advantages of single payer
less paperwork and fewer administrate costs, prevents risk rating, may prevent neglect of public system, choice in providers
54
a sociological perspective on health care policy points out that
policy decisions about financing, delivery and allocation are social decisions and that the shape of a health care system reflect underlying values and social structures
55
a sociology perspective examines
the socially-informed assumptions underneath policy requirements, the local consequences of policy decisions
56
what are the 3 period of health care since ww2
1945-65: era of professional dominance 1966-65: era of federal involvement 1983-present: era of managerial control and market mechanisms
57
3 characteristics of The Era of Professional Dominance
most americans gained insurance through employment, struggle over whether to implement a national health insurance plan, provider-driven system
58
2 characteristics of era of fed involvement in usa
passage of medicare and medicaid in 1965, beginning of "buyers backlash" in 1970s
59
era of managerial control (now)
govt share continues to grow and implements payment caps for hospitals, most covered through employment based insurance
60
Regressive or Progressive? Individuals out of pocket
regressive
61
insurance: Regressive or Progressive?
regressive
62
government taxation (general) Regressive or Progressive? ?
progressive
63
sales and social security taxes: Regressive or Progressive? ?
regressive
64
Hacker argues that health care policies have been dominated by growth of
health care costs
65
neoliberal ideology
suggests that governments have exceeded what they should participate in the market
66
Marg Thatcher idea
governments should be smaller and let the market handle services
67
Fraser Institute advocates
greater role of market mechanisms. claims canadians are worse off
68
Hacker writes that thatcher and fraser institute discourse were
rhetoric in dismantling role of government in health care
69
governments that adhere to neoloberalist did not...
produce much changes to health care systems
70
Health care systems change on grounds that
never intended through politics.
71
the British National Health Service (NHS) is what kind of model
state model
72
NHS financing
primarily public, through taxation (progressive)
73
NHS is more generous while
paying less
74
NHS delivery
consultants are salaried public employees
75
Allocation NHS
General Practitioners are paid through a combination of capitation and fee for service: idea of trying to reduce cost per patient. healthier patients = cheaper
76
What was the 4 ways of restructuring the NHS
Purcher-Provider Split, New Managerialism, Empowering the Consumer, Welfare Pluralism
77
Purcher-Provider Split
given a budget to buy services that their patients need
78
Purcher-Provider Split gets rid of
the asymmetry problem
79
Purcher-Provider Split attemps to create
situation with more competition, hooping to increase quality and reduce costs
80
New managerialism
bring business quality to health care system
81
Welfare Pluralism
increase private services and financing
82
oldest national health system
german
83
Germany is what kind of model
coporatist: state is the umpire. Major interest groups are self governing
84
in germany, cost control became dominant concern in what time period
1990s
85
what percent of germans are covered by mandatory, employment based sickness fund
90%
86
in germany, almost all services are
covered
87
is there gatekeeping in german HC
no
88
what is gate keeping
a hc prof usually a primary care physician who is the patients first contact with the health care system
89
two findings of Roos et al
1) the utilization of health care services is related to health status 2) even though the system is free in canada, Manitobans of lower income do not overuse services
90
Roos et al found that those of lower SES tend to
be of poorer health, therefore hospital costs are higher for them
91
Roos et al found that physician costs are
not higher for those of lower SES
92
implications of Roos et Al
linking payments to utilization will only discourage the poor form getting care they likely need

Sociology of Health and Illness (2 decks)

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