1.4 Our Healthcare System Health 1 & 2: Life Management Skills/Personal Health MAST at Homestead 2017-2018

Discussion Preview Healthcare Services Health Insurance Healthcare Costs Regular Checkups/Screenings

Healthcare in the United States Focus shift: from treatment to prevention Healthcare field employs more people than any other business field in the US Industry Services Diagnosis: identification of a disease, disorder, disability Treatment: use of medicine, surgery, counseling or other therapy to try and correct a condition Rehabilitation: recovery of function following surgery, disease or injury Prevention: reducing potential causes of diseases, disorders, injuries Education: teaching of self-care, health promotion, first aid and disease prevention Research: scientific study of causes, treatments and prevention of diseases and disorders

Primary Healthcare Primary Care Physician: a person’s regular doctor Provides checkups, screenings, treatments and prescriptions Practices the full scope of medicine: diagnosis, prescription, medical treatment Doctor of Medicine (MD) or Osteopathic Doctor (DO) Physician Assistants: work under the supervision of physicians Nurse Practitioners: provides many of the same services as a doctor

Medical Specialists Specialists: possess extensive training and experience in a focused area of health/medicine Need a referral from your primary care physician Common Specializations Cardiologist Gastroenterologist Neurologist Oncologist Orthopedist Pediatrician Psychiatrist Surgeon

Healthcare Settings Inpatient Facilities: patients reside/stay overnight during diagnosis, treatment, surgery, therapy/rehabilitation Outpatient Facilities: patients receive diagnosis and treatment services but do not stay overnight Doctor’s offices Healthcare clinics Private Walk-in/urgent care High schools/colleges County/public Emergency rooms Counseling centers

Government Role U.S. Department of Health & Human Services: Public Health Service Provides leadership, funding and oversight of the healthcare system Does not provide healthcare services Special Exceptions Veterans Administration (VA): healthcare for military veterans Military Health System: healthcare for active military personnel & families Indian Health Service: healthcare for Native American Indians

Health Insurance Healthcare services = EXPENSIVE 3-day hospital stay = $30,000 (average) Broken leg = $7,500 Medicines = $100/month Counseling = $100+/hour Health Insurance: an agreement by which a person pays a company and the company promises to pay money if the person becomes injured or sick Employers offer insurance as a benefit by splitting the cost of the insurance plan with their employees

Health Insurance Plan Basics Premium: a regular fee paid in exchange for insurance services Usually paid monthly The insurance company pools premiums from all customers to cover healthcare costs Deductible: amount the customer is required to pay before the insurance company begins to cover the remaining cost Co-Payment: The portion of the bill you are responsible for each time you receive a service

Deductible vs. Co-Pay If you have a $500 deductible per year, and each doctor's visit costs you $100, your insurance may not kick in until you've been to the doctor five times. When you go to the doctor after you've reached your deductible, you may no longer have to pay the full $100; instead you may pay a $25 co-pay, while your insurance picks up the other $75.

Types of Health Insurance Source: Kidshealth.org Health Maintenance Organization (HMO): consumer chooses a primary care doctor in the company’s network doctor coordinates all medical care: annual physicals to hospitalizations. co-pay for these services is fairly low Consumer can't see any kind of specialist without a written referral Preferred Provider Organization (PPO): consumer chooses any doctor More flexibility/options More expensive

Health Insurance Assistance Medicaid: health insurance available to those disabled, unable to work and/or impoverished Funded by US government and individual states Medicare: health insurance available to people 65 years and older Funded by paycheck taxes

Health Insurance Legislation Patient Protection and Affordable Care Act (2010) AKA Affordable Care Act or Obamacare 4 key elements Expanded Access to Insurance No denial based on pre-existing conditions Parents can cover young adult children up to 26 YO Businesses required to provide a health insurance option No sudden drops Cost Reduction & Affordability Increased premiums must be publicly explained “Open Marketplace”: publishes costs from all insurance companies Improved Health Care Preventive healthcare is covered Emergency healthcare available anywhere Patient Bill of Rights: fair treatment and appropriate information

Patient Bill of Rights On your handouts, read each protection and highlight key terms: Words/short phrases that convey the most meaning about the topic

Controlling Healthcare Costs PREVENTION!! Generic Drugs vs. Brand Name Explore health insurance options Health savings account

Regular Checkups & Screenings Annual physical exams can identify health issues and prevent them from worsening Discuss family medical history Make the most of your doctor visit: List questions you have Ask about options Write down important information Compliance