Medical Sociology Ch16 – Flashcards
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Which countries have a socialized form of healthcare?
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Canada, Great Britain, and Sweeden
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Which countries have decentralized national health programs
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Japan, Germany, Mexico
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Which countries have former socialist systems
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Russia and China
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What are the same problems faced by health care delivery systems worldwide?
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rising costs, aging populations, and requirement to meet the nation's health needs
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What country established the first national health insurance system?
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Germany
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What is the difference in social values of Americans and Europeans?
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Americans stress individualism, Europeans view government in more paternalistic fashion
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What country spends more on health care than any other in the world?
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United States
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What are the two most common measures of a country's level of health?
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Infant mortality and life expectancy
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Which country spends the least on health care?
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Mexico
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What countries had lowest infant mortality rates?
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Japan and Singapore
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What countries had highest life expectancies?
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Switzerland and Japan
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What is socialized medicine?
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a system of health care delivery in which health is provided in the form of a state-supported consumer service. Healthcare is purchased by government, so it is available at little or no cost to consumer in a capitalist economy.
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What type of health care delivery does Canada have?
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socialized medicine
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Who is responsible for providing health care in Canada?
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each province or territory
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What pays for health care in Canada?
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taxes and premiums (public money) collected by federal and territorial governments
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What is the major problem facing Canada with respect to health care delivery?
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rising costs
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What is happening to the power of Canadian and American physicians?
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it is in decline
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How are doctors in Canada paid?
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in "patient fees", where government determines how much they can charge
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What is the big difference between Canadian hospitals and American hospitals?
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In Canada, hospitals cannot make more money by providing more services. Canadian government gives fixed amount of money to each hospital
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What is the largest drawback of the canadian healthcare system?
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long waits for some medical procedures
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What type of health care does Great Britain have?
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National health insurance system
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what country has the largest publicly funded health service in the world?
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Great Britain
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Who is responsible for providing health care in Great Britain?
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government, first national now local health districts and hospitals
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Which country had the first health care system in any Western society to offer free medical care to the entire population?
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Great Britain
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In what country was the Labor Party?
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Great Britain
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What did the Labor Party want
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to ensure that everyone would receive medical treatment free of charge
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How are physicians in Great Britain paid?
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annual capitation fee for each patient on their patient list, as part of an agreement with NHS
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Are physicians in Great Britain allowed to treat private patients?
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Yes, a limited number of them
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With whom do conflicts and problems about health care delivery in Britain usually arise?
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between health care providers and government
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What is the central problem faced by the NHS in Great Britain?
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lack of financial resources
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What type of health care and economy does Sweeden have?
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Socialized system of health care in capitalist economy
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In what country are taxes highest in the world?
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Sweden
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How does Sweden pay for national health care?
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taxation, county councils pay for most of it
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What country has the lowest proportion of poor people in Europe?
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Sweeden
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How are physicians in Sweden paid?
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based on number of hours worked rather than number of patients treated. Physicians must work fixed number of hours per week
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What is a major characteristic of the NHS in Sweden?
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General hospitals are owned by county and municipal governments
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What recent changes has Sweden made to health care systems?
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resources rationed, payment to hospitals based on number of patients treated, competition between hospitals allowed. Purchaser-provider model within government-run healthcare system
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How do decentralized national health programs differ from socialized medicine?
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government control and management of health care is more indirect
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What is the primary role of government in decentralized national health programs?
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to regulate the system, not operate it.
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What must japanese do during their annual physical according to national law?
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have their waistlines measured. People exceeding government limits are given guidance for dieting and time periods for weight loss. Companies and local governments that don't meet weight loss goals are fined.
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How are doctors in Japan paid?
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1/3 in private practice on fee-for-service basis, the rest are full-time salaried employees of the hospital. Government sets fees and all doctors are paid the same amount for the same procedure according to a uniform fee schedule
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Who uses more prescription drugs than anywhere else?
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the Japanese
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How do japanese doctors receive supplementary income?
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from the drugs that they provide
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who is responsible for the healthcare of people in Japan?
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companies must take care of their own employees
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What are problems with japanese healthcare systems?
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hospitals are old, lack space, overcrowded
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why are there long waits at japanese clinics?
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they don't use the appointment system - it is first come first served
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why are relationships between doctors and patients more impersonal in Japan than the US?
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based on trust and traditional japanese value of deference to authority, patient doesn't ask questions
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What is true about the proportion of people living to old age in Japane
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it is increasing faster than anywhere else in the world
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what type of healthcare system does Germany have?
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national public health insurance plan
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How are physicians in Germany paid?
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medical certificate presented to physician, physician submits certificate to association of registered doctors, payment made by doctors' association according to fee schedule
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what is the primary role of government in health care in Germany?
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administration, NOT financing
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What is unusual about the changes seen in German population demographics?
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Germany has the lowest birthrate in Europe, and its population is shrinking (death rate is higher than birth rate)
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what type of healthcare system does mexico have?
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decentralized national health care system
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What is the IMSS social solidarity program
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health services are provided free of charge to low-income workers and their families in return for about 10 days of work in public projects
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why does mexico not really have a national health care system in reality even though they have one in theory
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because not everyone has access to it
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how much of the population in Mexico has health insurance?
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about 50%
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How does the health problem in Mexico City differ from other parts of Mexico?
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surplus of doctors in Mexico city, shortages elsewhere
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what is a major problem with health care in mexico?
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it is oriented towards curative rather than preventative medicine. also various health insurance plans differ in level of benefits provided, lacks coordination
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What seems to be Mexico's highest priority at this point?
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healthcare for the urban poor
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what is the socialist model of health care?
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central government ownership of all facilities, employment of workers, and free universal care paid out of the national budget
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where does socialist health care persist?
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cuba and north korea
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What new health plan did Russia put in place after the collapse of the old soviet union?
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health insurance consisting of compulsory and voluntary plans
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In Russia, what is mandatory and what can people choose?
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health insurance is mandatory, but individuals or employers have a choice of insurance companies
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What was one of the most important changes in Russia's health care?
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shift funding from federal to local level
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Before the collapse of communism, what was the goal of healthcare in Russia?
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to establish a classless society
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who is responsible for healthcare in Russia?
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the state
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what is unusual about the doctor demographic in Russia?
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lots of women were sent to medical schools where they were given cram courses because of the shortage of manpower from industrial and military demands
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what are the major problems with health care in Russia
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low financing of health care services and declining life expectancy
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what caused life expectancy in russia to go up and then back down?
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the anti-alcohol campaign being put in place and then repealed
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what is unusual about the gender gap in life expectancy in Russia?
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it is the largest in the world
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what demographic is the principle victim of rise in premature deaths in russia
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male, working class, middle age
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what type of political and economic structure does China have?
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socialist politically, but market-driven economy
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how is the chinese health care system financed
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fees paid by patients, employers, and health insurance companies
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what did communist government do for healthcare in china?
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improved it through the "patriotic health movement" and revival of traditional chinese medicine
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china is the only country that does what?
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treats traditional and scientific medicine equally
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where did the barefoot doctors movement happen
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china
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what set back china's attempts at improving its healthcare system?
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the cultural revolution
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why was the cultural revolution bad for healthcare?
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no research or training of doctors for 4 years
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what were barefoot doctors?
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paramedical personnel were trained in rudimentary medicine and sent to rural areas to provide basic medical treatment
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what happened to barefoot doctors when china transitioned from communal agricultural system to household-centered approach?
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they left health care or went into private practice
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who is responsible for health care in China?
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provincial and county governments
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what is the modern health care model in china?
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fee- for-service model (end to universal free health care)
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what is unusual about socioeconomic disparities in health in China?
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the well-educated and higher-income chinese tend to have the worst health
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what is the largest source of income for chinese government?
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tax revenues from tobacco sales
