Health Care

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Health Care
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Health Care Introduction

• The Social Problems of Health Care in America
• The rapidly rising costs of health care, the
  aging of the population, and dramatic increases
  in the rates of obesity have brought discussions
  of health care quality and delivery to the
  forefront of American political and social
  discourse.
• This presentation focuses on four health care
  issues facing America at the dawn of the 21st
  century
• Health Care Costs
• Health Care Politics
• Obesity
• Euthanasia

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• Health Care
• Costs
• Politics
• Health Care Reform

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Health Care Costs

• Grace Budrys, Health Care Costs and Cost
  Containment
• Three goals guide the health care delivery system
  in America
• Quality
• Access
• Cost Containment
• You can have any two, but not all three.
• In America, access seems to be third down on the
  list.
• Although the United States spends more as a
  proportion of gross national product on health
  care than any other country, over 45 million
  Americans of ages infant to 65 (17 of persons in
  this age range) do not have health insurance and
  therefore have severely limited access to health
  services. All American citizens have access to
  free health care after age 65 through Medicare.

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Health Care Costs

• Increasing Needs for Affordable Health Care
• Although costs continue to rise and rates of
  uninsured continue to increase, Americans face a
  growing need for affordable, high quality health
  care.
• The age structure of the U.S. population is
  increasing.
• Americans are becoming increasingly obese.
• Real wages for middle-class Americans are
  remaining stable or declining, depending upon the
  industrial sector of their employment.

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Health Care Costs

• Proposed Solutions to Improving Health Care
• Increase the quality of health care.
• This is an expensive proposal because of
• Greater demand for health care (aging
  population).
• Greater demand for exceptional health care.
• Greater regulatory control over health care.
• Increase access to health care (universal health
  care).
• This proposal will be difficult to implement
  because
• The functional needs of society require a
  competitive marketplace.
• Powerful segments of the economy have a vested
  interest in maintaining the status quo.
• Cultural expectations favor self-sufficiency.

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Health Care Costs

• Proposed Solutions to Improving Health Care
• Reduce the costs of health care by
• Reducing services to patients.
• People are demanding more, not fewer services.
• Instituting cuts in the prices we pay for health
  services.
• This option sounds popular to the public, but is
  the least promising approach to cutting costs.
• If profits to pharmaceutical companies were
  reduced by 50 percent, for example, health care
  expenditures would decrease by less than 1
  percent because expenditures for medicines,
  although very high, represent a small percentage
  of total health care costs.
• It would be difficult to lower salaries for
  physicians, nurses, technicians, and other highly
  trained staff.

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Health Care Costs

• Proposed Solutions to Improving Health Care
• Reduce the costs of health care by
• Implementing a single payer system.
• Approximately 25 of health care costs are
  administrative expenses.
• Much of these costs are related to completing
  paperwork needed for health insurance.
• Many different health care plans and insurance
  companies require that clerks at health-care
  providers must be knowledgeable about many
  different rules.
• Because companies often change their plans and
  forms, clerks often make mistakes, which cost
  money to correct.
• The single payer system is proposed as a means of
  reducing administrative costs.

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Health Care Costs

• The Single Payer System
• The Single Payer System (SPS)
• Single set of forms.
• Single set of rules.
• Single reimbursement schedule.
• The federal government would be the single payer
  and everyone would be covered by a single
  health-care plan, with multiple options for
  coverage as are available already with private
  plans.
• Basically, SPS is a government-sponsored health
  care insurance company.
• This system might effectively reduce health-care
  costs, but it raises issues related to ethics,
  economics, and politics.

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Health Care Terminology

• Terminology
• Universal health care The government provides
  health care to everyone.
• Socialized medicine The government controls the
  health care industry.
• The single payer system (SPS) is a form of
  socialized medicine. That is, hospitals and
  clinics, whether private or public, profit or
  not-for-profit, as well as private physicians,
  provide health care. The government is the
  insurance company.
• Because Americans have strong objections to
  socialism, (read Communism), opponents of the
  single payer system call it socialized medicine
  and associate it closely with universal health
  care. Proponents, on the other hand, emphasize
  that the health care is provided by the
  physicians and the insurance is provided by the
  government.

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Health Care Politics

• Health Care Philosophy
• Right to Health Care
• Do people have a fundamental right to health
  care?
• Yes The good society will provide its citizens
  with health care.
• No Universal health care violates individual
  rights because is a non-essential form of wealth
  redistribution (i.e., unnecessary welfare).
• Government Involvement
• Should the government get involved in health
  care?
• Yes Government intervention can improve health
  care.
• No The government is not qualified to provide
  health care.

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Health Care Politics

• Rationale for a Single Payer System
• Those who would otherwise go without care receive
  it.
• People are more likely to seek preventative care,
  which costs less in the long run.
• Death rates are lower in societies with
  socialized medicine.
• Because doctors do not have to worry about
  paperwork, they can concentrate more on treating
  patients.
• Socialized medicine reduces waste in the delivery
  of medical care.

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Health Care Politics

• Critiques of the Single Payer System
• Government-sponsored programs do not encourage
  competition and the development of new
  technologies.
• SPS is a payment system not a health-care
  delivery system.
• SPS is socialized medicine.
• SPS is not universal health care it is a
  government-sponsored administrative system.
• The government, not doctors, would be in the
  business of making health care decisions.
• Business managers already dictate health care
  guidelines for providers as part of private
  health care plans (i.e., Health Maintenance
  Organizations HMOs).
• Insurance companies would be hurt financially.
• Society often sacrifices industries for progress.

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Health Care Health Care Reform

• The debate over health care reform in the United
  States
• whether there is a fundamental right to health
  care,
• who should have access to health care and under
  what circumstances,
• who should be required to contribute toward the
  costs of providing health care in a society,
• whether the government should support health care
  commerce by forcing citizens to buy insurance or
  pay a tax,
• the quality achieved for the sums spent,
• the sustainability of expenditures that have been
  rising faster than the level of general inflation
  and the growth in the economy,
• the role of the federal government in bringing
  about such change,
• concerns over unfunded liabilities.

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Health Care and Education Reconciliation Act of
2010
Summary of the HCER Act CBS News Jill Jackson
and John Nolan Cost 940 billion over 10
years. Deficit Would reduce the deficit by 143
billion over the first ten years. Would reduce
the deficit by 1.2 trillion dollars in the
second ten years. Coverage Would expand
coverage to 32 million Americans who currently
are uninsured.
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Health Care and Education Reconciliation Act of
2010

• Summary of the HCER Act
• CBS News Jill Jackson and John Nolan
• Paying for the Plan
• Medicare Payroll Tax.
• Excise Tax on High End Health Insurance.
• Tanning Tax.
• Changes
• Closes gaps in Medicare.
• Expands Medicaid.
• Insurers cannot deny coverage to children.
• Does not pay for abortions.
• All citizens, except the very poor, must be
  purchase health insurance.

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• Health Care
• Obesity

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Health Care Obesity
Adapted from Wikipedia, The Free
Encyclopedia Obesity A condition in which the
natural energy reserve, stored as fatty tissue,
is increased to a point where it is associated
with certain health conditions or increased
mortality. Obesity typically is measured in
relation to the Body Mass Index (BMI). BMI
kilograms / meters2 The www provides BMI
calculators that accept inches and pounds. See,
for example http//www.consumer.gov/weightloss/bm
i.htm
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Health Care Obesity

• Cultural Significance of Body Weight
• The perceived attractiveness of body weight
  varies across time and societies.
• In some settings, a large, well-fed body has been
  associated with physical attractiveness.
• Size has been associated with health, strength,
  and fertility.
• The culture in modern, western societies favors
  the normal body type (as would be indicated by
  the BMI).
• In fact, in America it is popular to refer to
  normal, as indicated by the BMI, as skinny
  Thus, skinny is good.
• Contemporary culture sometimes associates obesity
  with character traits, some good and some bad
• Lazy, undisciplined, stupid, gluttonous.
• Warm, jolly, easy-going, happy.

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Health Care Obesity
Cultural Significance of Body Weight The
cultural significance of body weight is not a
social problem, unless perceptions lead to
negative health or social outcomes. Thus, what
is thought of as attractive is not a social
problem. If, however, people hurt themselves
physically (e.g., anorexia) to obtain a certain
body image or are discriminated against because
of their body type, then body weight becomes a
social problem. Contemporary social science
research examines how body image, as perceived by
self and others, affects how people treat
themselves and are treated by others. Most
current attention, however, focuses upon the
social causes and consequences of rapid increases
in the rates of obesity.
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Health Care Obesity

• Prevalence
• The United States has the highest rates of
  obesity in the developed world.
• From 1980 to 2006, obesity has doubled in adults
  and overweight prevalence has tripled in children
  and adolescents.
• Approximately 18 of children are overweight.
• Approximately 35 of adults are obese.
• These rapid increases in rates of obesity cannot
  be attributed to biology because biological
  processes (i.e., evolution) do not occur that
  quickly.

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Health Care Obesity
Consequences Cardiovascular diseases Diabetes Dig
estive problems Bone and joint problems Some
types of cancer The U.S. Surgeon General
estimates that, because of rising rates of
obesity, the current generation of Americans will
be the first to have a lower life expectancy than
their parents.
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Health Care Obesity

• Causes
• In its simplest conception, weight gain is the
  intake of more food energy than is expended.
• Additional Factors That Affect Weight Gain
• Genetics
• Chronic illnesses
• Eating disorders
• Certain medications
• Weight cycling
• Stress
• Insufficient sleep
• Smoking cessation
• Race and ethicity
• ISU Tailgating

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Health Care Obesity

• Environmental Factors
• Lack of activity
• Since 1986, physical activity of children has
  declined by 13.
• Increased marketing
• Supersized!
• Fries with that?
• Small 16 oz.
• Changing labor force
• Women in careers rather than at home.
• Children tending for themselves after school.
• Eating out during the day (working) and evening
  (too busy).
• Cheap food.

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Health Care Obesity

• Suggested Policies
• School Environment
• Healthier luncheons
• Fewer pop machines
• More choices
• Marketing
• Recognition of the fast food nation
• Emphasis on Exercise
• Awareness of the problem
• Suggestions for walking, quick exercise routines
• Emphasis on Food Intake
• Diets can be hazardous to your health!
• How to eat right, not how to lose weight.

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Health Care Obesity
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• Health Care
• Euthanasia

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Health Care Euthanasia
Adapted from Wikipedia, The Free
Encyclopedia Euthanasia The practice of
terminating the life of a person, because they
are perceived as living an intolerable life, in a
painless or minimally painful way, either by
lethal injection, drug overdose, or by the
withdrawal of life support. Euthanasia is a
social problem because it challenges the moral
principles that maintain social cohesion and
social solidarity. That is, because it
challenges our sense of ethics and morality, it
threatens to hinder our sense of belonging to one
another or our willingness to work effectively
with one another.
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Health Care Euthanasia

• Physician Assisted Dying
• The process whereby board-approved physicians
  provide a prescription for a terminally-ill
  patient to hasten their death.
• Some physicians will assist the patient in
  administering the medicine.
• Others rely upon the patient or other approved
  caregivers to administer the medicine.
• Government-Sponsored Execution by Lethal
  Injection
• The process whereby board-approved technicians
  provide an injection of lethal medicine to cause
  the death of a felon who has been sentenced to
  death.

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Health Care Euthanasia

• Arguments of Proponents
• Physician Assisted Dying
• Ends the needless suffering of a terminally-ill
  patient.
• Ends the added expense of caring for the patient.
• Living wills can specify end-of-care
  guidelines.
• Ends the stress on family and friends of the
  patient.
• Government-Sponsored Execution by Lethal
  Injection
• Religion-based retribution.
• Closure to a heinous crime.
• Revenge.
• Deterrent to crime.

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Health Care Euthanasia

• Arguments of Opponents
• Physician Assisted Dying
• Morally wrong.
• The patient might make valuable contributions to
  family members, friends, or society in their
  final days.
• The decision is irreversible.
• Government-Sponsored Execution by Lethal
  Injection
• Discrimination, bias, and mistakes made in the
  criminal justice system (ethically wrong).
• Expensive system of appeals and procedures.
• The felon might make valuable contributions to
  family members, friends, or society in the
  remaining life.
• Research shows that the possibility of capital
  punishment is not a detriment to capital crimes.