US Health Care

US Health Care

1. Health Care in the United States

   • US Health Care - Over View
     • Government Healthcare agencies - primarily responsible for research and policies
       • Federal
         • Examples: DHHS - Department of Health and Human Services,
           • CDC - Center for Disease Control and Prevention
             • Health, Safety and Security Issues
           • FDA - Food and Drug Assosiation
             • standards for food and drugs
           • NIH - National Institutes of Health
             • Research in Health Areas
       • State
       • Local
     • Voluntary and Not for Profit (Profit back in org. and obtain grants and funs)
       • American Heart
       • the red cross
       • Visiting nurse Association
       • Professional health organizations
         • American Nurses Association
         • American Medical Association
         • American Public Health Association
     • For Profit and Private
       • Private Nursing homes
       • commercial health insurances
       • acute care hospitals
       • Managed Care Organization - MCO
       • EHSs - Employee HEalth Services
   • Health Care Facilities
     • Goverment
     • State run health care
     • Voluntary Organizations
     • private
     • not for profit
     • Long term facilities
       • Nursing
       • Geriatric Care
       • skilled care
       • independent and assisted living
     • Home Health Care
     • Emergency Medical Services (EMS)
       • Ambulances
       • Rescue squads
     • Mental Health Care Facilities - counselling and treatment for physical and chemical abuse, treatment for depression, psychosis etc.
     • Rehabilitation Centers
     • Hospice center - promote death with dignity for terminally ill patients by giving palliative or supportive care and counselling
     • Industrial Health Care
       • Industrial healthcare centers offer diagnostic facilities and treatment for occupation-related diseases and substance abuse, and provide travel medicine to address the health problems of employees traveling overseas. 
       • Federal Law and OSHA
   • Access to Health Care: Insurance pays for health
     • Problems: Limited Coverage Restriction to network lack of diagnostic facilities and physicians
     • Language barriers, lack of proper transportation facilities, and ignorance about good health practices are other factors that affect immigrants’ health.
     • Employer,
     • Private
       • HMO - Health Maintenence Organization
         •  provides members with access to a network of doctors and hospitals. Individuals can choose to join HMOs, and employers can provide group HMO plans to their employees
       • Employer sponsored
         • Employer pays for employee Employers provide this type of insurance to employees as part of their benefits packages.
       • PPO
       • Individual Health Insurance Market
         • Individual Health Insurance Market These people pay the premiums for coverage themselves. Benefits vary as per the plan chosen.
     • Goverment
       • Medicare
         • +65 age group does not consider income or medical history Medicare benefit payments cover physicians’ bills, skilled nursing facilities, hospital inpatient and outpatient services, home health care, prescription drugs, etc. It does not cover long-term care and dental services, however. The government finances Medicare through general government revenues, payroll tax contributions, beneficiary premiums, and state payments. 
       • MEdicaid
         • citizens under the age of 65 who belong to low-income groups - Taxes are the main source of finance for Medicaid - 
       • CHIP
         • Children's Health Insurance Program (CHIP), which covers the children of families that earn more than the Medicaid eligibility standard (but not enough to afford private insurance), 
       • TRICARE
         • TRICARE, a Department of Defense (DoD) health program for military personnel and their families.
   • Health Care LAWs
     • Emergency Treatment and Active Labor Act (EMTALA) regulate the operations of healthcare institutions. The act ensures that hospitals receive funds from governmnet insurance
     • ERISA = Employee Retirement Income Security Act (ERISA) that ensures employees receive insurance coverage post-retirement
     • Consolidated Omnibus Budget Reconciliation Act (COBRA) provides workers and families the option to continue with group insurance plans for a limited time under circumstances such as job loss, during the transition period between jobs, etc.
     • The Health Insurance Portability and Accountability Act (HIPAA) establishes the rights of group insurance plan participants and beneficiaries.
     • Patient Protection and Affordable health care - ObamaCare -
       • mandatory for all to have health insurance makes sure all insurance companies provide insurance to those with present illness as well. 
     • Health care and educational reconcilation

2. Health Care and Technology

   • Technology and Diagnostics
     • Electrocardiograph
       • Electric Activity of Heart Ultra High Frequency Sound waves
       • Electrocardiogram: is the recording produced through cardiograph
         • stress test or to find cardiovascular problems
     • CT : computerized tomography; The CT scan directs a narrow beam of radiation at a body part and displays a cross-sectional view of its internal structure on a computer screen.
       •  imaging procedure for viewing the structure of body parts and detecting disorders such as tumors and inflammations, or internal bleeding or faults in the tissues, organs, or bones
     • MRI : viewing the internal body structure in closer detail than that shown by a CT scan
       • An MRI is useful for detecting diseases or disorders throughout the body, such as tumors in the lung, swelling in the brain, and inflammation in the spine. It is also useful in evaluating the effect of treatments such as chemotherapy on cancerous tumors.
     • PET Scan : diagnostic method where a person receives an injection of a slightly radioactive molecule that helps to create a three-dimensional (3D) image of the interior of an organ or a bone.
       • , and it helps to detect internal disorders or irregularities.
     • Ultrasonography: Ultrasonography is a scanning method where a machine obtains a picture of the interior of a body part using high frequency sound waves directed at the body part
     • Digital Radiography
       • They place an electronic sensor in the mouth of the patient, and the images generated by it display on a computer screen. Dentists can use digital radiography to detect any decay or disorders in the oral cavity
     • computer-aided detection (CADe) and computer-aided diagnosis (CADx)
   • Technology and Theraputics
     • Laser Eye Surgery
     • Radiation Therapy
       • A machine directs a beam of ionizing radiation at a tumor in the body to destroy cancerous cells by damaging their DNA. Computers allow healthcare professionals to set a precise area for radiation exposure.
     • Bracytherapy
       • Healthcare professionals also use brachytherapy to treat cancer patients. In this treatment, medical professionals insert radioisotopes sealed in capsules into a patient’s body, in an area close to the tumor, using needles or catheters. Radiation from the capsules targets and destroys the cancerous cells.
     • Ultrasound or high frequency sound waves
     • Hearing aids that amplify sound waves are available for individuals with hearing difficulties
     • Computer-aided design (CAD) uses three-dimensional imaging to design prosthetics for amputees, Dentists make use of CAD to design crowns, dental implants, and bridges.
     • Robotic Surgery
       • A surgeon can program the robot using a computer, and then oversee the procedure or use a telemanipulator to guide the robot’s movements. Surgeons can also perform robotic surgery using a voice-controlled robot.
     • Image Guided Surgery
     • automated drug dispensing systems (ADDS) and automated dispensing cabinets (ADC).
     • Computerized drug prescriptions
     • Computer Technology to monitor patients example: oximeter is a device that measures oxygen levels in the blood through a sensor placed on the finger.

3. Cultural Diversity in Health Care

   • cultural diversity
     • jewish
       • diet bless their chicken
     • amish
     • irish
       • they have homemade remedies
     • north americans
     • aisian
       • herbal remedies acupuncture acupressure ayurveda
     • germans
       • put pepper and salt , put around the neck, and sleep to cure sore throat
     • italian
       • chicken soup
     • middle eastern
       • meditation charms and amulets
     • south american
       • like to use tea and herbs  azabache - to ward off the evil eye
   • barriers
   • sensitivity