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Consumer Health

Responsible Consumerism: Choices and Challenges. Attracting Consumers' DollarsTactics usedSome are subtleMany choices availableImportant to choose carefully. Responsible Consumerism: Choices and Challenges. Putting Cure into Better PerspectiveSpontaneous remissionPlacebo effectTaking responsi

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Consumer Health

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    1. Consumer Health UNIT 9

    2. Responsible Consumerism: Choices and Challenges Attracting Consumers’ Dollars Tactics used Some are subtle Many choices available Important to choose carefully

    3. Responsible Consumerism: Choices and Challenges Putting Cure into Better Perspective Spontaneous remission Placebo effect Taking responsibility for your health care Self-help or self-care When to seek help Assessing health professionals

    4. Choices in Medical Care Traditional Western (Allopathic Medicine) Primary Care practitioners Physician assistants Osteopaths Ophthalmologists Optometrists Do you always consider the person’s qualifications? Why or why not?

    5. Choices in Medical Care Traditional Western (Allopathic Medicine) (continued) Dentists Orthodontists Oral surgeons Nurses

    6. Health Care Organizations, Programs, and Facilities Critical Decisions Choosing an insurance carrier or type of plan Choosing from among the health care providers Types of Medical Practices Group practice Solo practitioners

    7. Health Care Organizations, Programs, and Facilities Integrated Health Care Organizations Loosely joined to tightly run operations Hospital classifications Patient Dumping Outpatient (ambulatory care) Surgicenters Satellite clinics Be aware of JCAHO Be aware of your consumer rights

    8. Issues Facing Today’s Health Care System Costs U.S. spends the most on health care 1998 nearly $1.1 trillion on health care 15% of GDP Why does the U.S. spend so much on health care?

    9. Issues Facing Today’s Health Care System Access Supply Proximity to care Health status Insurance coverage

    10. Issues Facing Today’s Health Care System Quality and Malpractice Estimates of 1 in 6 patients suffer injuries due to malpractice Deaths can occur because of mistakes Mechanisms for safety Do you believe the U.S. health care system is safe?

    11. Third-Party Payers Insurance People pay into a pool of money Draw from this money when ill 40 million Americans are uninsured 75% are working or dependents of workers Many students are uninsured

    12. Third-Party Payers Early Private Health Insurance 1940’s nonprofit insurance Major medical Fee-for-service or indemnity Deductibles, co-pays, coinsurance Preexisting conditions Waiting periods Lifetime limit

    13. Third-Party Payers Medicare and Medicaid 1965 Medicare Medicaid DRGs

    14. Third-Party Payers Managed Care Capitation Elements 1) A budget on an estimate of the annual cost 2) A network of physicians, hospitals, and others 3) An established set of administrative rules

    15. Third-Party Payers Health Maintenance Organizations (HMOs) The staff model Group network model The independent model What are some of the downsides to HMOs?

    16. Third-Party Payers Point of Service (POS) Fastest growing managed care Can go outside of HMO Pay extra Preferred Provider Organization (PPO) Networks of independent doctors Contract to provide discounts Have choice of provider Pay more

    17. Article Review

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