Week 4 Health Care Around the Globe PDF

Week 4 health care around the glob hospital bill for skin-to-skin contact “As a mother myself, this seems nuts. As an obstetrician, I guess I can kind of rationalize it. Hospitals have encouraged immediate skin-to-skin after vaginal deliveries longer than they have offered it after C-sec...

Week 4 health care around the glob hospital bill for skin-to-skin contact “As a mother myself, this seems nuts. As an obstetrician, I guess I can kind of rationalize it. Hospitals have encouraged immediate skin-to-skin after vaginal deliveries longer than they have offered it after C-sections. Doing it while the mother lies cut open on the operating table requires an extra labor and delivery nurse on hand to ensure the immobilized and often drugged-up patient doesn’t accidentally drop the baby onto the floor or smother him or her among the surgical drapes. It sounds silly, perhaps, but it’s a valid precaution.” https://slate.com/human-interest/2016/10/hospitals-char ge-new-parents-for-skin-to-skin-contact.html  measures for evaluating health care systems universal coverage portability geographic accessibility comprehensive benefits affordability financial efficiency consumer choice The book chapter outlines health care systems provided in six countries: – Germany – Canada – Great Britain – China – Mexico – the Democratic Republic of Congo (DRC – (+ USA)  universal coverage e.g. All legal residents of Great Britain & Canada – regardless of income, place of residence, employment status, age, or any other demographic characteristic can obtain state-supported health care – although they are guaranteed neither immediate service nor every service they want.  portability whether you can keep your healthcare coverage when your personal circumstances change e.g. when – you lose your job – your marital status changes – you move to a different city  geographic accessibility “Both rural areas and poor inner-city neighborhoods in the United States typically have relatively few health care providers per capita. Meanwhile, other areas have an excess of doctors—a situation that can pressure doctors to increase their prices or perform perhaps unnecessary procedures to maintain their incomes despite competition for patients (Aizenman, 2010; Bodenheimer, 2005c).” (Weitz 2020: 199)  compulsory service in Turkey “To address shortages in less developed areas, the strategy of compulsory service for physicians has been used occasionally since the 1920s but more intensively since 2005. […] This strategy has been successful in part, but it has not been able to completely overcome the problem. Furthermore, as Türkay et al. (1996) discussed, this practice has also brought about some problems concerning the quality of health services and the job satisfaction of workers.” (Yıldırım et al 2020 213-214)  comprehensive benefits the scope of healthcare services provided What’s considered essential? Where do you draw the line between essential and luxury? – Primary care: day-to-day healthcare provided by hospitals & community health centres by doctors nurses – Secondary care: healthcare provided by specialists (usually requires referral) – Mental health? Prescription drugs? Plastic surgery?  affordabilit y Access ≠ affordability Financially regressive systems: e.g. USA – Everyone pays the same premium irrespective of income Financially progressive systems: e.g. UK, Turkey (social security) – Low-income employees pay less premium  consumer choice As to services and providers e.g. In “Mexico, China, and the DRC, some citizens have far greater choices in health care than do others, whereas in Germany, Great Britain, and Canada, all citizens have similar levels of health care choice” (Weitz 2020: 201)  the case in Turkey as well, for those who can afford  (some terms in the chart) Capitation: a fixed amount of money per patient per unit of time paid in advance to the physician for the delivery of health care services. – “[In the UK] General practitioners are paid by capitation, a system in which doctors are paid a set fee per year for each patient in their practice regardless of how many times they see their patients or what services the doctors provide. In such a system, doctors lose income when they provide more services (Weitz 2020: 208). Lump sum: a single payment of money, as opposed to a series of payments made over time  Healthcare convergence: practices becoming similar – Globalization – Financial constraints: Over time, countries that are primarily capitalist have restricted market forces in health care; countries that How many times on average do citizens see a doctor in a year? US: 4 Germany: 10 Canada: 8 Britain: 5 Mexico: 3 (data from 2018)  four principles adopted by the Communist gov’t in China (1950) 1. the primary goal of the health care system would be to improve the health of the masses rather than of the elite. 2. the health care system would emphasize prevention rather than cure. 3. the health care system would integrate Western medicine with traditional Chinese medicine. 4. to attain health for all in a country with few doctors and widespread poverty, China decided to rely heavily on “physician extenders” (e.g. nurses) (ibid: 210)  China “Increasing women’s education was especially important. Once women’s educational levels increased, their power in the family increased, giving them greater control over family planning. Women’s lives thus were less often cut short by childbirth, and their babies were born healthier. In addition, as women’s status rose, they and the children who depended on them more often received a fair share of the family’s food, thus reducing malnutrition and increasing life expectancies.” (ibid: 213)  epidemiological transition China: “chronic and degenerative diseases increasingly outpacing infectious diseases as the leading causes of death.” (213) Mexico: “cancer and heart disease now kill more Mexicans than do infectious diseases.” (216)  DRC “Because of both cultural traditions and a lack of access to Western medicine, many Congolese rely on homemade herbal remedies or seek care from traditional midwives or traditional healers called ngangas (Inungu, 2010). Ngangas are believed able to determine whether an illness was caused by natural or supernatural forces and to prescribe appropriate treatments such as wearing a talisman to ward off evil or drinking an herbal potion. Some of the treatments used by traditional practitioners undoubtedly help (if only through a placebo effect), but others undoubtedly cause harm.” (ibid: 217)  discussion Do health care workers have a duty to provide care to everyone under all circumstances? – If yes, which services? – How about patients who make poor lifestyle choices? Do other members of the society have a duty to pay the costs of state-funded health services?