Chapter 13 REVIEW QUESTIONS AND NOTES (HEALTHCARE SYSTEM)

Hales, D. (2004). Chapter 13: Consumerism, Complementary and Alternative Medicine, and the Health-Care System In An Invitation to Health (3 ed.) (pp. 339 - 355). Belmont, CA: Wadsworth.

[Last update: 5/3/04]

REVIEW QUESTIONS

1. M/C: Approximately what percentage of the U.S. Gross National Product is spent on health care? (a) 1% (b) 5% (c) 15% (d) 25% {Correct answer is c -- the text says expenditures will reach 2.2 trillion in 2008, or 16.2% of GDP}
2. T/F: Self-care requires you to educate yourself about health, disease, and health care systems.
3. Matching.
   Terms: Acupuncture; Message therapy; Ayuveda; Chiropractic; Integrative medicine; Allopathic medicine.
   Definitions:
   1. Treatment based on the theory that human diseases are caused by misalignment of bones.
   2. Ancient Chinese form of medicine based on the philosophy that energy circulates through the body to control health.
   3. The type of medicine practiced by MDs which based on correction of pathophysiologic, anatomical, and mental dysfunction.
   4. Brings together allopathic medicine and Complementary/Alternative Medicine.
   5. Uses hands to rub, stroke and knead the body to affect health in a positive way.
   6. A traditional type of medicine used in India that premises illnesses on incorrect mental attitudes, diet, and posture.
4. T/F: Herbal remedies undergo rigorous testing and standardization.
5. Name the two main federal healthcare coverage (insurance) programs in the U.S. and describe who they serve.
6. M/C: Who pays the majority of healthcare costs in the private sector? (a) individuals (b) employers (c) the government (d) hospitals
7. Match the type of managed health care coverage plan with its description. Types of managed care: Group-HMO; IPA-HMO; PPO; capitation plan
• third parties (e.g., unions, insurance companies) contract with physicians and hospital for treatment of members.
• offices and clinics are run by the Health Maintenance Organization
• individual physicians provides services in their own offices.
• any plan in which a fixed amount is paid per patient regardless of the type and number of services actually provided.
8. T/F: Although some patients are annoyed by the service they receive from HMOs, the outcomes of treatments provided by HMO are generally as good as for patients who receive fee-for-service health care.
9. T/F: Patients in a managed care group must follow certain procedures in advance of seeking care and must abide by a limit of reimbursement for certain services.
10. M/C: All of the following are vital signs EXCEPT: (a) blood pressure (b) cholesterol level (c) pulse (d) body temperature
11. M/C: All of the following are normal body temperatures EXCEPT: (a) 98.9 (b) 99 (c) 99.9 (d) 102
12. M/C: Which of the following is a normal adult blood pressure? (a) 90/50 (b) 100/55 (c) 110/60 (d) 120/70A normal pulse rate for an adult is: (a) 40 beats per minute (b) 72 beats per minute (c) 140 beats per minute (d) 200 beats per minute
13. M/C: The term that describes your rate of breathing is: (a) respiration rate (b) oxygen use (c) maximal oxygen uptake (d) respiratory reserve
14. M/C: All of the following are screening tests which can be taken at home EXCEPT: (a) pregnancy (b) colon cancer (c) HIV (d) osteoporosis
15. M/C: This hormone is detected by home test kits for pregnancy: (a) human growth hormone (b) luteinizing hormone (c) human chorionic gonadotropin (d) follicle stimulating hormone
16. M/C: A colon cancer screening works by identifying: (a) blood from a finger stick (b) blood in the urine (c) hormones in the saliva (d) blood in the stool
17. M/C: A home test for urinary tract infection measures this in the urine? (a) protein (b) white blood cells (c) HIM (d) red blood cells
18. M/C: All of the following are guidelines for evaluating online health sites EXCEPT: (a) look for sites written by those also selling products (b) check the date the page was created to find the most recent research (c) check the references (d) consider the author
19. M/C: All of the following are ways to determine if a news report about a medical advance is valid EXCEPT: (a) the scientists should be legitimate health professionals (b) the findings should be found in peer-reviewed journals (c) the report should include testimonials from cured patients (d) researchers should not try to sell you something
20. M/C: A patient must give consent for hospitalization, surgery and other major treatments. This is known as: (a) informed consent (b) living will (c) malpractice (d) guardian ad lidum
21. M/C: Methods of treatment that focus on the whole person are: (a) quackery (b) holistic (c) alternative (d) complimentary
22. M/C: The practice that combines conventional and alternative medicine is: (a) exclusive medicine (b) experimental treatment (c) holistic therapies (d) integrative medicine
23. M/C: An ancient Chinese form of medicine based on cycles of energy circulating through the body and which uses needles to redirect this energy is known as: (a) acupuncture (b) reflexology (c) acupressure (d) chiropractic
24. M/C: Managed-care health plans that emphasize routine care and prevention by providing complete medical services in exchange for a predetermined monthly payment is: (a) fee-for-service (b) capitation plan (c) point-of-service plan (d) none of the above.
25. M/C: What is the difference between Health Maintenance Organizations and Preferred Provider Organizations?
26. When people treat their own health problems this is known as __________ __________.
27. Temperature, blood pressure, pulse rate and respiration rate are known as __________ __________.
28. Compare HMOs to PPOs. (HMOs are managed care plans that emphasize routine care and prevention by providing complete medical services in exchange for a predetermined monthly payment. PPOs are a third party contracts with a group of physicians and hospitals to treat members at a discount. Both are capitation plans.

• Nature is the best healer. (Many illnesses resolve spontaneously.) A good strategy for 90%+ of health problems is do no harm.
• About 15% of GDP goes into health care and health care research. (It's a large part of the economy, and I see nothing wrong with that.)
• People today are doing better (in terms of objective health outcomes) but feeling worse. This may have more to do with expectations, emotions, psychology, etc., than with physical health.
• Allopathic medicine = the type of medicine MDs practice, based on 
  • physiology (body function) and anatomy (body structure)
  • environmental (including social) and genetic cause
• MDs are (in general) the most reliable source of health information (although there are certainly some dumb MDs out there)
• CAM = Complementary and Alternative Medicine = everything other than allopathic medicine. Has gotten a "free-ride." Despite what the book says, very few herbal remedies have proved to be effective. Several have proved risky (e.g., ephedra).
• Integrative medicine = brings together allopathic medicine and CAM.
• types of health care systems:
  • Government funded: e.g., Medicare (for the elderly) and Medicaid (for the poor and unemployed)
  • Privately funded: e.g., employer funded insurance, self-insured, and private payment
• Uninsured people receive health care through public hospitals (esp. emergency rooms). 
• Managed care = a network of approved providers with "capitation" payment  (preset fee per person) 
  • Group HMOs - HMO owns clinics and employs staff
  • IPA-HMO - individual practice associations
  • PPOs  - contracted for by a third party (union, insurance company, business)
• We are relying more and more on self-care and self-education. Chap 13 includes information on how to evaluate online health information. Let's take this opportunity to review article from earlier (Harris, 1997) on this topic. You must use judgment (including common sense and experience), to address
  • Credibility
  • Accuracy
  • Reasonableness
  • Support