Medicine Merit Badge Class 4

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Medicine Merit BadgeClass 4

• By Pedro Gelabert

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Overview

• Class 1
• History of Medicine
• Key Figures
• Hippocratic Oath
• Class 2
• Health Care Provider-Patient Relationship
• Health Care Professions
• Medical Education and Specialties
• Class 3
• The Practice of Medicine
• Class 4
• Influencing Medical Practice
• Medicine - Here and Abroad

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Influencing Medical Practice

• Role of Religion
• Patient or doctor religious belief dictates
  boundaries on social issues, such as, cloning,
  stem cell research, assisted suicide, withholding
  of medical care, abortion, prayer and meditation
  vs. anti-depressants
• Role of Federal Government
• Executive Branch
• proposes health-care programs, example Medicare
  and Medicaid
• sets/restricts research, example embryonic stem
  cell research
• Legislative Branch
• control allocation of funds, set fees for
  Medicare and Medicaid
• Judicial Branch
• makes decision on social issues like abortion,
  right to refuse medical treatment, right to die,
  etc.

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Influencing Medical Practice

• Role of State Government
• Practice Acts - Determines parameters for
  practice of health-care within its borders
• Minimum requirements for education and training
• Certifies qualified individuals
• Investigates complaints
• Provides health care for poor, manages Medicaid
• Role of Insurance Companies
• Cost of health care spread over a large group of
  people - healthy subsidize the cost of healthcare
  for sick
• Negotiates fixed fees for all treatments and
  procedures
• Set best practices for treatment
• Role of Professional Societies
• Present views of member, lobby congress,
  education, sharing information

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Medicine in the US and abroad

• Factors influencing health-care delivery
• Resources developed vs developing countries
• Specialization primary care vs specialists
• Values
• Life sustaining care
• Essential care
• Elective care example cosmetic surgery
• Expectations

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Medicine in the US

• Capitalist with some socialism
• Capitalism
• Good doctors get paid more, bad doctors paid less
• Can you afford it? Postpone care until absolutely
  necessary which leads to more expensive
  treatments
• Socialism
• Medicaid available to families with income very
  close to poverty level (0-30 more than poverty
  level)
• Little incentive in several areas of preventive
  care
• Exercise, quit smoking, nutrition and diets, etc.
• Total cost unpredictable
• Depends on health care provided and free market
  values

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Medicine in Sweden

• Why Sweden?
• Similar quality of life education, housing,
  transportation, available goods and services
• Nationalized
• Everybody entitled to healthcare, same standard
  level of care
• Paid through high taxes and small copayments
• Rich can go to private practitioners or another
  country
• Management spread out (regional or city
  government)
• Physicians receive a salary
• Total costs are predictable
• Greater emphasis on preventive care
• System is rigid and bureaucratic (lots of
  paperwork)
• New technologies and procedures take longer to be
  introduced due to impact on overall costs

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Medicine in Canada

• Why Canada?
• Similar quality of life education, housing,
  transportation, available goods and services
• US neighbor
• Nationalized
• Government directed program with some private
  healthcare
• Healthcare personnel employed by state government
  and salaried
• Program paid by taxes
• System is rigid and bureaucratic (lots of
  paperwork)
• New technologies and procedures take longer to be
  introduced due to impact on overall costs

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Medicine in China

• Why China?
• Developing nation, mostly rural, large
  population, most of the population at poverty
  level
• Government controlled
• Medical services vary greatly
• Village doctor with 3-6 month training
• Township health centers
• Large county hospitals similar to US
• Cost paid by government with recently patients
  paying for some of the cost

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Medicine in Mexico

• Why Mexico?
• Developing nation, large cities and rural areas,
  most of the population at poverty level
• Private and Nationalized
• Less money available than Canada thus, more
  limited services
• Lower expectations by the Mexican people
• Less specialists, more primary care physicians

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Comparisons

• US has the most sophisticated medical and
  surgical technology
• US infant mortality higher than several other
  developed nations, like Sweden. Some areas has
  the same infant mortality as China
• US has higher violent deaths (guns, knifes)
• US has higher lifestyle issues
• Obesity, smoking, heart disease, diabetes
• US has rising healthcare costs
• US has 45M uninsured (US population 290M)