By: Ronald F. White, Ph.D. Professor of Philosophy College of Mount St. Joseph

1. WHAT IS HEALTH CARE? By: Ronald F. White, Ph.D. Professor of Philosophy College of Mount St. Joseph

2. Introduction • Health Care provision in all societies is comprised of multiple, interacting complex systems: moral, scientific, sociopolitical, and economic.

3. Facts and Values • Descriptive Inquiry (Facts) • Questions of Truth and Falsity • What is a “health care system?” • Prescriptive Inquiry (Values) • Questions of Good and Bad • What is a “good Health Care System?”

4. Structure of Health Care • Moral Structure (Values) • Hippocratic • Judeo-Christian • Western Liberal • Scientific Structure (Knowledge) • Pure Science vs. Applied Science • Biomedical Discovery • Transmission of Biomedical Knowledge • Social and Political Structure (Power) • Human Relationships • Professional organizations, Unions, Corporations, Government • Economic Structure (Money) • Economic Relationships • Buyers and Sellers • professionalism

5. Moral Structure of Health Care • Hippocratic Tradition • Oath • Judeo-Christian • Charity • Western Liberal • Rights-Based • Consequence-Based • Individual • Collective

6. Scientific Structure • From Non-Scientific to Scientific Belief Systems • The Discovery and Dissemination of Scientific Knowledge • Professional Dimension • Credentialism • Specialization • Professional Organizations • Institutional Dimension • Educational Institutions • Colleges and Universities • Public and Private • Research Institutions (laboratories) • Public/Private • Professional Journals • Publishing Companies • Hospitals • Treatment • Research • Teaching • Clinics • Private Offices • Insurance Companies • Technological Dimension • Patents and Licenses • Drugs and Medical Devices

7. Sociopolitical Structureof Health Care • Cultural Factors • Cultural Beliefs • Health and disease • Political Regimes • hierarchy • Information • Dissemination of information • Mass Media • Institutional Factors (Public and Private) • Health Care Research Institutions • Public: Government Laboratories (NIH) • Private: Corporations • Publishing Companies • Medical Journals • Teaching Institutions • Colleges and Universities • Public • Private • Health Care Providing Institutions • Hospitals • Clinics • Doctors offices • Health Care Financing Institutions • Health Insurance • Private • Public

8. Economic Structure of Health Care • Incentives • Why did you expend time, energy, and resources to attend MSJ in pursuit of a career in Health Care? • Why did I agree to teach this course? • Doctors and Patients v. Buyers and Sellers • Market Structure • Information • Competition • Quality • Price • Freedom • Market Values • Don’t Steal • Don’t use Force • Tell the Truth • Keep your Promises

9. Role of Government • Government (Federal, State, Local) • Discovery Function • Should government finance health care research? • NSF • Should government conduct health care research? • NIH • Research Regulatory Function • Should government regulate health care research? • FDA • Provider Function • Should government provide health care? • Medicare • Medicaid • Veteran’s’ • Economic Regulatory Function • Should government mediate between buyers and sellers in the health care industry?

10. Summary • Health Care involves four interacting systemic structures • Moral Structure (right/wrong) • Scientific Structure (truth/falsity) • Sociopolitical Structure (leaders/followers) • Economic Structure (buyers/sellers) • Governments can influence all four dimensions: for better or worse.