Medical Law and Ethics Chapter 13

Stakeholders

those who have:
*a vested interest in the health care industry in the United States
and
*any efforts to reform the industry

Cost

the amount individuals, employers, state and federal governments, HMOs, and insurers spend on health care in the United States

Access

the availability of health care and the means to purchase health care services

Quality

the degree of excellence of health care services offered

Gross-Domestic Product (GDP)

the total value of all goods produced and services provided in America during one year

Agency for Healthcare Research and Quality (AHRQ)

the lead federal agency responsible for tracking and improving the:
*quality
*safety
*efficiency
*effectiveness
of health care for Americans

Life span

the number of years an individual actually lives

Pharmacogenomics

the science that defines how individuals are genetically programmed to respond to drugs

Genometrics

the science of determining how genes cause the expression of certain traits in individuals

Life expectancy

the statistical probable number of years an individual can expect to live, calculated from his or her birth

Epigenetics

the study of changes in gene activity that do not involve alterations to the genetic code, but are still passed down to at least one successive generation

Proteomics

the study of the proteins that genes create or "express

Personalized medicine

the products and services that leverage the science of genomics and proteomics and capitalize on the trends toward wellness and consumerism to enable tailored approaches to prevention and care

What are the key issues of concern to health care industry stakeholders?

*Cost
*GDP
*Access
*Quality

What rises yearly?

health care costs as a percentage of gross national product (GDP)

Factors adding to health care costs annually include:

*Medical technology
*Administrative costs
*Widespread adoption of health information technology (HIT)
*Wasteful spending and fraud
*Unhealthy lifestyles
*Aging population

Three steps for attaining access:

*Gain entry into the health care system
*Find a health care provider who meets the needs of each patient and with whom patients can develop a relationship based on mutual communication and trust
*access health care service sites offering ongoing care

What does the latest Agency for Healthcare Research and Quality (AHRQ) report show?

*health care quality and access are often suboptimal, especially for minority and low-income groups
*Overall quality is improving, access is getting worse, and disparities are not changing
Urgent attention is warranted to ensure continued improvements in:

What health care advances have been forecast for the near future?

*Rational drug design-use of computers to create drugs designed to attack specific diseased cells or to otherwise pinpoint delivery and enhance efficiency
*Continuing advancement in imaging equipment and techniques
*Genetic mapping and testing
*Gene thera

What are three additional areas where we should see improvement/advancement in the near future?

*Use of stem cells
*Tissue engineering
*Health information technologies (HITs)

What are broader movements that forecast the future of health care?

*Common interests
*Markets
*Policy
*Science and Technology

Areas for change in the future

*Data and connectivity
*Prevention and population health
*Personalization and participation

Who are the major stakeholders in the American health care system?

*The public
*Employers
*Healthcare facilities and practitioners
*Federal, state and local governments
*Managed care organizations
*Private insurers
*Voluntary facilities and agencies that provide healthcare or influence
*healthcare practitioner training i

What three issues are of primary concern to stakeholders within the American health care system?

*Cost
*Access
*Quality

Identify six factors that have added to health care costs.

*Medical technology
*Administrative costs
*Widespread adoption of health information technology
*wasteful spending and fraud
*Unhealthy lifestyles
*An aging population.

Of what significance is the percentage of the gross domestic product represented by health care spending?

As the percentage of GDP spent on healthcare grows, that means less money is spent on other things like roads, schools, research, environment
and social programs.

How do waste and fraud add to health care costs?

Insurance companies, as well as the federal and State insurance programs pay out large sums of money in fraudulent claims. Recovering the money is difficult, and simply adds to the cost of health care.

Is health care listed as a right for all Americans in the 10 amendments to the U.S Constitution called the Bill of Rights?

No

What are two areas of continuing concern revealed in the most current National Healthcare Quality Report (NHQR)?

Health care quality and access are often below what is desired, especially for minority and low-income groups, and especially in the South.
Over-all, improvements are urgently needed in quality of diabetes care, maternal and child health care, and adverse

Why is the United States 26th on a list of life expectancies in various countries?

Health care cost, access, and quality are major issues that affect life expectancy and life span in all countries.

How many people may develop diabetes in the next 40 years?

1 in 3

What is the number one cause of adult blindness, kidney failure and limb amputation?

Diabetes

What is seventh on the list of diseases that cause death in the Unites States?

Diabetes

About how many adults 20-years and over are obese (at least 20% over their ideal body weight?

approximately 35.7 %

In 2013, how many children and adolescents were overweight or obese?

almost 1/3rd

When was the human genome project started?

1990

When did the human genome project end?

mid-2000

Rational Drug Design

the use of increasingly powerful computers to develop new drugs by looking at the molecular structure and chemical composition of target cells and creating substances that will bind to certain molecules, affecting their function inside the body

Stem cells pros

Scientist have been able to grow:
*functioning bladders
*urethras
*heart tissue
*lung tissue
from a person's own cells

Stem cells cons

Tissue-engineered hearts and lungs are still in the experimental stage

Those who have a vested interest in the American Health care industry are called:

Stakeholders

According to a survey done by IMS Institute for HC Informatics in 2014, what percentage of Americans said they % use the internet as their #1 source for information about health care?

70-75%

What is the term for the total value of all goods produced and services provided in America for one year?

Gross domestic product

Three key issues of concern to everyone within the American health care industry are:

*Cost
*Access
*Quality

What is the main force expanding the federal budget?

Health care costs

List three steps vital to attaining access to health care.

*Gain entry into the health care system.
*Find a health care provider who meets the needs of each patient and with whom patients can develop a relationship based in mutual communication and trust.
*Access healthcare service sites offering ongoing care.

What is most often cited as the reason for being uninsured or underinsured?

Costs

The largest purchasers of health care for most working adults are:

*Government
*Employers

What are reasons for the relatively high rate of infant mortality in the United States?

Fewer births than other nations

What is the name of the lead federal agency responsible for tracking and improving the quality, safety, efficiency, and effectiveness of health care for Americans?

AHRQ

High-quality health care in the US is:

*Possible
*Expensive
*Practical

What is the term for the statistically probable number of years a newborn out to live, based on environment, heredity, lifestyle and health practices, risk factors, and so on?

Life expectancy

What is the number of years an individual actually lives called?

Life span

The science that defines how individuals are genetically programmed to respond to drugs is:

Pharmacogenomics

The science of determining how genes cause the expression of certain traits in individuals is called:

Genometrics

What is the process called that involves correcting defective genes responsible for disease?

Gene therapy

What is recommended as a future focus for health care?

*Policy
*Common interests
*Markets

Areas within health care likely to change in the future include:

*Data
*Connectivity

What is likely for the future of health care?

A focus on health of the entire population

An article by Robert J. Samuelson in the December 10, 2007, issue of Newsweek stated, "The politics of health care rests on a mass illusion: Most Americans think that someone else pays for their care."
Who pays for the health care of the uninsured?

The government (taxpayer)

An article by Robert J. Samuelson in the December 10, 2007, issue of Newsweek stated, "The politics of health care rests on a mass illusion: Most Americans think that someone else pays for their care."
As the number of people age 65 and older increases, w

*The government (taxpayers)
*Cost of Medicare premiums will rise.

An article by Robert J. Samuelson in the December 10, 2007, issue of Newsweek stated, "The politics of health care rests on a mass illusion: Most Americans think that someone else pays for their care."
How do increasing numbers of uninsured Americans add

Care for the uninsured will have to continue.
This increases:
*government health care spending
*the cost of insurance to those with coverage.