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Ch 32 Consumer Choices and Public Health

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1 Ch 32 Consumer Choices and Public Health
Lesson 1 Selecting Health Care and Services

2 The Health Care System The health care system includes all the ways you receive and pay for medical care. Many people and organizations work together to promote individual and public health. Have any of you been personally involved with any parts of this system in the past year? You have if you went to the dentist, had a sports physical, saw the school nurse, went to an emergency room or clinic, worked at or visited a nursing home or assisted living, picked up a prescription from a pharmacy, received reimbursement for a health service from an insurance company, donated blood, read an article about a food borne illness in which the Food Safety and Inspection Service became involved. There are many job opportunities available within these areas.

3 Lesson 1 Objectives: Identify health care providers and examine careers in the field. Explain the significance of health insurance and the impact of rising costs. Describe the four parts of the health care system Take a few minutes for students to team up with a partner to brainstorm as many health care professionals as they can. See which group comes up with the longest list. With a partner, brainstorm as many health care professionals as you can.

4 Health Care Providers Physicians
Primary care physician – provides the first line of health care, s/he often provides check ups and general care, s/he may provide a referral to a specialist Specialist – a physician who has received additional training in a particular area of medicine You often need a primary care physicians referral to see a specialist. Does anyone know how many years of schooling is needed to become a physician or specialist? We’ll look at a MN Careers book later for some answers about this and other things such as job outlooks and salary. Anyone interested in these careers? Anyone have friends or family in these careers? Ask students to think about if they were moving off to college and then became sick and needed to see a doctor. How would they find one living in a new city and what 5 characteristics would they want in that doctor and why? Are the doctor’s soft skills or hard skills more important to them?

5 Who does what? Match the specialist to the area of expertise.
1. Allergist 2. Gynecologist 3. Neurologist 4. Urologist 5. Ophthalmologist 6. Dermatologist 7. Internist 8. Oncologist 9. Orthopedist 10. Rheumatologist A. Pain in joints or muscles B. Cancer C. Skin diseases D. Urinary tract problems E. Female reproductive concerns F. Skeletal injuries or concerns G. Internal diseases H. Eye diseases I. Nervous system problems J. Allergies

6 Who does what? How did you do? Check your answers.
1. Allergist 2. Gynecologist 3. Neurologist 4. Urologist 5. Ophthalmologist 6. Dermatologist 7. Internist 8. Oncologist 9. Orthopedist 10. Rheumatologist J. Allergies E. Female reproductive concerns I. Nervous system problems D. Urinary tract problems H. Eye diseases C. Skin diseases G. Internal diseases B. Cancer F. Skeletal injuries or concerns A. Pain in joints or muscles

7 Health Care Providers Nurses
LPNs (licensed practical nurses) – assist physicians and provide direct care such as bathing or changing bandages RNs (registered nurses) – have more responsibilities and may supervise RNs Nurse practitioners – advance training allows them to work independently of physicians, can assume primary care roles Anyone interested in pursuing a career in this field? Anyone know if the demand for nurses is high or low? How about the pay? What would be the benefits and challenges of a career as a nurse? Check out the MN Careers book in a little bit.

8 Health Care Providers Allied Health Care Professionals
Other auxiliary professionals Examples include: dentists, physical therapists, clinical psychologists, and others Can you think of any others? Others might include dieticians, occupational therapists

9 Who does what? Match the allied health care professional to area of expertise.
1. Dietitian 2. Physical Therapist 3. Optometrist 4. Pharmacist 5. Dental hygienist 6. Nurse’s aide 7. Social worker 8. Lab technician 9. Radiology tech 10. EMT A. Cleaning and polishing teeth B. Feeding & bathing patients C. Counseling people D. Nutritional counseling E. Testing urine and blood F. Physical rehab after injury G. Taking x-rays H. Dispensing medicines I. Emergency treatment J. Testing vision for eye glasses

10 Who does what? How did you do? Check your answers.
1. Dietitian 2. Physical Therapist 3. Optometrist 4. Pharmacist 5. Dental hygienist 6. Nurse’s aide 7. Social worker 8. Lab technician 9. Radiology tech 10. EMT D. Nutritional counseling F. Physical rehab after injury J. Testing vision for eye glasses H. Dispensing medicines A. Cleaning and polishing teeth B. Feeding and bathing patients C. Counseling people E. Testing urine and blood G. Taking x-rays I. Emergency treatment

11 Ch 32 Lesson 1 Assignment Exploring a Career in Health Care
There are many careers available within the health care field. Using the MN Careers books provided by the teacher, choose one that you might possibly be interested in as a future career. Complete the worksheet and hand it in by the due date given by the teacher. Note that in order to earn full points for the project, you will have to utilize another resource.

12 Health Care Facilities (any place staffed by health care professionals and equipped for the delivery of health services) Short-Term Hospitals Inpatient care Outpatient care Clinics Other types Birthing centers Drug treatment centers Long-Term Nursing homes Rehabilitation centers Assisted-living facilities Who knows what Hospice Care is? People come into a home to provide care for a terminally ill person and his or her family? What people skills would it take to do this type of a job? Could anyone in class imagine doing this? What challenges face adult children when they are faced with the decision of convincing their elderly parents to move into an assisted living or nursing home? How does the care between these two institutions differ? (A possible progression for a person who should not be at home alone as they age might be to move from home to a senior apartment where they could receive occasional home health care services (bathing, shopping help, med set up), to an assisted living apartment where there is more regular help with tasks but still a sense of independence, to a nursing home which has the highest level of care for people who need a lot of assistance with daily activities). Birthing centers are set up to be a more homelike atmosphere rather than an operating room atmosphere.

13 Health Insurance Definition – a plan to cover part or most costs of expenses and care associated with medical treatment Premiums – fees that are paid to maintain coverage (people with a higher risk of developing a health problem may pay more) Deductible – the amount you must pay towards a claim before your insurance starts to pay Could be purchased from a group through employers or on your own privately Share some average costs of procedures such as Tommy John surgery and rehab $20,000. As a minor or full-time college student, you can remain on your parents insurance to the age of 25. Explain how private insurance was purchased for about $47 per month after my graduating from college. If I had something happen, I would have to pay the first $1000 worth of expenses during a year (called a deductible), insurance would pay 80% of eligible expenses after the deductible was met (physician services, prescription drugs and medical supplies, inpatient and outpatient hospital care, emergency room care, x-rays and labs, medical supplies hospital room, occupation or physical therapy, nursing care or home health care). Preexisting conditions would not be covered. Do you think all procedures are covered? No (plastic surgery, hearing aids for elderly There is a relationship between premiums and deductibles. Can anyone guess what it is? Premiums are lower if the deductible is higher and vice versa. Some costs might be covered 100% with no deductible (expense out of your pocket) like an immunization while other costs like emergency room care or med supplies might be 80% covered after the yearly deductible has been met from out of your pocket.

14 Health Insurance Reasons health care costs have soared in recent years: Wealthier countries can afford to spend more on health care technologies The US population is getting older and disease prevalence has changed Insurance coverage has increased Americans pay a lower share of health expenses than they used to Providing care to a person who is hooked up to millions of dollars worth of technological equipment would obviously cost more than care in a country where the technology was not available. The elderly population tends to be heavy users of medical care and the proportion of elderly people is and will continue to increase. They also tend to be a vocal group when it comes to political voting. More obesity relates to more diabetes and other conditions which can be costly to manage. Do you think the US should continue to push for research for new technologies to help cure cancer, diabetes or AIDs research? Would you feel differently if you or a loved one were affected? Should extraordinary means be used to keep an elderly person alive? Can you see yourself signing a living will that outlines what means you would want to be used to keep you alive if you were old or severely injured (CPR to start your heart if it stopped, keeping you on a respirator if your brain showed no activity). Would you feel differently if if was your wife or child and you had to make the decision for them? Other countries might make prescription drugs available faster than the US. We like to thoroughly test products before we make them available to the consumer. What are the advantages and disadvantages of this theory? Safer and more accuracy about long term affects but expensive and not available to someone who has no other options available in the form of a cure. Would you want to take a “not thoroughly tested treatment or drug if you were terminally ill? Should the following people be provided insurance coverage for the following conditions? Breast implants, breast reconstruction after breast surgery, a person who wants Tommy John surgery so he can throw harder, a person who wants to wear contacts, marriage counseling, artificial insemination, dentures, smoking cessation programs, hospice care, nutrition supplements, autopsies, or sex change operation costs. Advances in medical technologies can make for some complicated ethical decisions. What do you think about the following situation? When is dead? Is it when a person is not breathing or brain dead? Should a person like Kevorkian be able to assist a person in killing him or herself? Is euthanasia right or wrong? If an organ became available, who should have first dibs on it? An insured person or uninsured person? A younger person or an older person? A famous wealthy person or a humble blue collar worker. Would it be okay for a death row person to be spared his or her life if s/he donated one of his kidneys? Is s/he likely to have a healthy kidney based on past history of health habits (smoking, illegal drug use)? Should doctors be helping couples who can’t get pregnant by inseminating women with multiple fertilized eggs that lead to very expensive premature multiple births?

15 Health Insurance 2 alternative programs are provided by the government: Medicare – health insurance program available to people age 65 and over and to people who receive Social Security disability benefits Medicaid – assistance program of medical aid for people of all ages who are unable to afford medical care

16 Can You Meet the Objectives of Ch 32 Lesson 1?
Identify health care providers and examine careers in the field. Explain the significance of health insurance and the impact of rising costs. Describe the four parts of the health care system. Take a few minutes for students to team up with a partner to brainstorm as many health care professionals as they can. See which group comes up with the longest list.

17 Ch 32 Consumer Choices and Public Health
Lesson 2 Being an Alert Consumer

18 Lesson 2 Objectives: Identify factors to consider when selecting a health care plan. Discuss guidelines for choosing a health provider. Describe the responsibilities that a good patient assumes, including the purchase and use of medicines.

19 Choosing a Health Plan Factors to consider: Cost Special Needs
HMOs may have lower premiums but choice of doctors is limited to those physicians affiliated with the plan PPO’s are a type of health insurance in which medical providers agree to charge less to members of the plan Special Needs Certain conditions or treatments may not be covered or they may have ceilings (limits) Eligibility May be limited by affiliation (ex - professional org or who your employer is associated with) Insurance available through group plans (through your work) usually cost less than individual policies. Individual policies are more likely to require a physical before they let you join the group but some group plans are even doing this.

20 2 Main Forms of Health Insurance
Fee-for-service Patient pays for all medical expenses up to a certain minimum amount (deductible) When deductible is met, the insurance company covers a percentage of the patient’s cost (often 80%) The portion the patient must still pay is called co-insurance Patient often pays fees up front and sends in forms for reimbursement Patients can usually go to doctor of choice Managed care Plans hold down costs by limiting patient’s choices and encouraging preventative care HMOs require patients to choose doctors from a limited pool May not cover certain types of care (ex. Mental health) Patient pays small fixed fee (co-payment) for each visit with less paperwork Out of pocket expenses tend to be lower than fee-for-service types

21 Could you afford to pay the typical costs for common medical services without insurance? Let’s play the “Price is Right.” Guess the following prices…

22 How much does each cost? Routine physical in doctor’s office (visit, common tests, and immunizations Female exam Care for injury in emergency room Average MRI Normal delivery of baby C-Section delivery of baby without complications

23 How close was your guess?
Adult routine physical in doctor’s office (visit, common tests, and immunizations…$ Female exam……………………….$ Care for injury in emergency room...$ Average MRI……………………..$500-1,300 Normal delivery of baby…………$ C-Section delivery of baby without complications……………………$

24 Choosing a Health Care Provider
Brainstorm how you would find a new doctor if you had moved to a new city after high school Ask people you know for referrals. Ask other health professionals for referrals. Call your local medical society – they will provide three names chosen in rotation from a roster. Use an American Medical Directory from a library.

25 Patient Skills Know your medical history (information about immunizations, allergies, previous health problems, family history, etc.) Ask questions about medical procedures and treatments Follow up on visits as needed Follow instructions, read labels and comparison shop for OTC (over the counter) and prescription drugs How many of you could tell a doctor of your known allergies? Would you know if the answer if your doctor asked if you have a family history of cancer, diabetes, or high blood pressure? What kind of questions would you ask about a treatment or procedure? Cost, side affects, how long laid up, pain, success rate, long term affects, etc. You go to the doctor and s/he gives you a prescription for some concern you have. When you get home you realize that the name of the prescription on the bottle is different than what the doctor says he gave you. What did you just get? A generic product. Remind students that it is important to recognize the responsibilities that they will face as adult health care consumers. The decisions they make could greatly affect their health maintenance and finances. (Remember the budget that was completed at the beginning of the trimester.)

26 Can You Meet the Objectives of Ch 32 Lesson 2?
Identify factors to consider when selecting a health care plan. Discuss guidelines for choosing health care providers. Discuss responsibilities that a good patient assumes, including the purchase and use of prescriptions.

27 Ch 32 Consumer Choices and Public Health
Lesson 3 Strategies for Dealing with Consumer Problems

28 Lesson 3 Objectives: Identify popular types of product and treatment fraud. Identify agencies and organizations that exist to help health consumers with fraud.

29 Medical Fraud It is illegal to make false claims, promising a medicine or medical treatment can do something that it cannot do. Quackery is a type of medical fraud that plays on human emotion, weakness, and fear. Quacks are people who try to make money off of other people’s misfortune. What groups of people do you think are most susceptible to quackery? Vulnerable ones who don’t know better, ones that want a quick fix (athletes and weight gain or dieters), lonely ones who enjoy the telephone conversation (elderly living alone), someone with a terminal disease hoping for any help s/he can find. How can falling for quackery hurt the person? It could be useless, expensive, harmful, or cause the person not to seek the real medical attention that is needed, it could interfere with other treatments.

30 Watch out for claims like this:
“Secret formula or cure” “Miracle cure” “Overnight results” “All natural “Hurry, this offer expires soon” A famous person swears by it (testimonial) Who do you think would be most susceptible to fraud? Base your answer on age groups. Middle aged adults trying to hang onto their youth, elderly who are lonely and receive phone solicitations, young people looking for a beauty treatment, athletes trying to find the easy way to “get buff”, a terminally ill patient who has run out of choices and is desperate, someone trying to lose weight quick and easily, etc. Are any students willing to share a worthless product they once purchased that did not do the trick? If you were Tommy Lasorda and someone offered to pay you $100,000 to say that “Slim fast works for you”, would you take the money? Even if you knew you were eating better and exercising more and those factors might be the contributing factors? I am not saying SlimFast does this, I am just saying what would you say in the situation. Point in mind – should we believe testimonials? Have you ever seen the before and after dieting pictures or body sculpting pictures? Posture is poor on the before pictures. Could different bodies be imposed on the other face????

31 Protect yourself from health fraud by:
Checking out the product or service’s claims with a doctor or other health professional Talking to others for their opinions Checking with the Better Business Bureau about complaints Checking with a professional health organization about the claim

32 True or False? Because of government regulations, all advertising must be accurate. False Many products praise an item by using inflated opinions and exaggerations called puffery. Puffery isn’t illegal because the words can’t be proven false (or true) by the Federal Trade Commission. “…3 out of 4 doctors recommend…” – How many were surveyed? “----- gives fast relief.” - How fast?

33 Help for Consumer Problems
Licensing Boards AMA (American Medical Association) peer reviews physicians Consumer Affairs Bureaus BBB (Better Business Bureau) – nonprofit organization provides information on products and services, reliability reports, and background information on businesses and organizations Media Action Programs Newspapers, radio, and TV offer action groups or phone-in services Private Consumer Groups Advocates speak out for others Government Services Consumer Product Safety Commission – can ban and recall products Consumer Information Center – distributes consumer information Food and Drug Administration – ensures that medicines are safe, effective and labeled correctly, determines if a med should be OTC or prescription Federal Trade Commission – prevents unfair, false, or deceptive advertising

34 Lesson 3 Activity The teacher will provide you with 3 activity options. Choose one option and be prepared to report your findings to the class on the assigned date. You will be asked to hand in a hard copy of your findings as well.

35 Lesson 3 Activity Options
1. Go online to find an example of health or medical fraud being reported by an organization, newspaper, or other source. Share the news with the class. 2. Read any one of the numerous articles found at quackwatch.com and summarize what you found with the class. 3. Go to one of these government sites and investigate a health related topic they have addressed that is of interest to you. It does not have to be fraud related but it should be a consumer health issue. Share your findings with the class: Consumer Product Safety Commission Consumer Information Center Food and Drug Administration Federal Trade Commission

36 Lesson 3 Activity Rubric
5 points for the article Relates to a health related issue Relates to one of the three activity options Article was handed in on time with a name on it 5 points for student sharing article in class Accurate verbal summary of article provided Shared personal insights about topic with class

37 Can You Meet the Objectives of Ch 32 Lesson 3?
Identify popular types of product and treatment fraud. Identify agencies and organizations that exist to help health consumers with fraud.

38 Ch 32 Consumer Choices and Public Health
Lesson 4 Community Health

39 Lesson 4 Objectives: Identify public health agencies and their functions Practice accessing agencies in order to find pertinent information Ask students to name a public health agency of which they are aware and what service it provides.

40 Public Health Agencies
Public Health at the Local Level March of Dimes or American Lung Assoc (examples) Usually run by local volunteers and funded through donations Common goals – educating public, raising funds for research or treatment County and state health departments – may pass regulations to set standards for sanitation in restaurants, compile health statistics, and control environmental pollution

41 Public Health Agencies
Public Health at the National Level National Institutes of Health (NIH) The Centers for Disease Control and Prevention (CDC) The Agency for Health Care Policy and Research The Health Resources and Services Administration The Agency for Toxic Substances and Disease Registry

42 Ch 32 Lesson 4 Activity Learning to Find and Use Reliable Sources of Health Information
Use the handout provided by the teacher to visit 2 websites, “The National Institutes of Health” and “The Centers for Disease Control and Prevention”. Learn what valuable information they make available to health consumers. Written results will be handed in for 20 points and volunteers will be asked to share their findings. Due date _______________

43 Chapter Evaluation Students will take a 20 point exam on the information covered in Chapter 32. There will be 10 points in matching questions and 10 true and false questions. The teacher will let you know what day the test will be given.

44 Can You Meet the Objectives of Ch 32 Lesson 4?
Identify public health agencies and their functions. Practice accessing agencies in order to find pertinent information.


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