Week 1 Post

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CHAPTER 1

History and
Overview of
the U.S.
Healthcare
System

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Learning Objectives

Describe the five milestones sections of the
history of the U.S. healthcare system.

Discuss the differences among primary,
secondary, tertiary, and quaternary prevention.

Analyze the concept of the Iron Triangle.
Discuss the importance of health literacy and
social justice to health consumers

Identify pieces of social legislation and their
importance

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Five Milestones

These are medicine and medical education,
nursing education, the hospital and healthcare
system, public health, and health insurance.

Let’s review each table and discuss the
important events of each system component.

In class discussion: Which sections and
events stand out for you and why?

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Basic Concepts of Health (1 of 3)

Three main concepts of how health care is
provided to consumers.

Primary prevention avoids the development
of a disease. Examples include:
Smoking cessation programs
Immunization programs
Educational programs for pregnancy and
employee safety

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Basic Concepts of Health (2 of 3)

Secondary prevention is focused on early
disease detection, which prevents progression
of the disease. Examples include:
Screening programs, such as high blood
pressure testing

Colonoscopies
Mammograms

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Basic Concepts of Health (3 of 3)

Tertiary prevention reduces the impact of an
already established disease by minimizing
disease-related complications.
Focuses on rehabilitation and monitoring of
diseased individuals

Quaternary prevention is an extension of
tertiary prevention. It is state-of-the-art
medical care with the mindset of mitigating
unnecessary efforts on care that may not be
working.

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Iron Triangle

The iron triangle is a balancing act of access,
cost containment, and quality.

The quality of the service, the cost of the service,
and the accessibility of the service must be in
balance in order to provide good health care.

Activity: Give an example of how an imbalance
could occur.

If the three points of the triangle are not
balanced, problems may arise:
If an increase in cost is emphasized, a
decrease in access to affordable health care
may occur.

If a decrease in cost is emphasized, quality
may suffer.

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Examples of Social Legislation

Social regulations: Rules and regulations that
protect consumers
Sherman Antitrust Act
Newborns’ and Mothers’ Health Protection Act
Women’s Health and Cancer Rights Act
Mental Health Parity Act
Genetic Information Nondiscrimination Act
Lilly Ledbetter Fair Pay Act
Affordable Care Act

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Social Legislation

Select two of the acts and let’s discuss their
importance to health care.

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Health Literacy

In class discussion: What is health literacy,
in your opinion?

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Different Definitions

Title V of the ACA defines health literacy as
the degree to which an individual has the
ability to obtain and absorb basic health
information to make the best health decision
for themselves.

Individual health literacy is impacted by
culture, the complexity of the health system,
the ability of the health consumer to navigate
these systems, and communication by the
healthcare providers.

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Different Definitions of Health
Literacy

DHHS indicates that health literacy is based
on the principles that (1) everyone has the
right to health information that helps them
make informed decisions and (2) health
services should be delivered in ways that are
understandable and beneficial to health,
longevity, and quality of life.

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Social Justice

Social justice in health care focuses on the
right of all individuals to have access to
resources, including health care, which means
health equity for all cultural groups.

Studies have shown that clinicians tend to
have more negative attitudes toward people of
color, and unconscious racial bias among
clinicians has been shown to lead to poorer
communication and lower quality of care,
which is unacceptable.

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Conclusion

The United States does not have universal
healthcare coverage. It is the most expensive
in the world.

The U.S. healthcare system has many sectors
which must communicate with each other to
provide quality heatlh care.

Health disparities exist across the nation as a
result of social injustice.

Social justice needs to occur to eliminate
health disparities, which results in health
equity.