MGT 3301 EXAM 1 - Chapter 1, 2 & 3. Top Questions with accurate answers, graded A+

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MGT 3301 EXAM 1 - Chapter 1, 2 & 3. Top Questions with accurate answers, graded A+ Why did the professionalization of medicine start later in the U.S. than in some Western European nations? - �... ��✔-American medicine lagged behind the advances in medical science, experimental research and medical education and maintained a domestic character because... (i) Americans had a tendency to neglect research in basic sciences and placed more emphasis on applied sciences (ii) American attitudes about medical treatment placed emphasis on natural history and conservative common sense. Why did medicine have a domestic, rather than professional, character in the preindustrial era? How did urbanization change that? - ✔✔-1) Medical Practice was in disarray- Anyone could practice without restriction or training 2) Medical procedures were primitive- no technical expertise 3) Missing institutional core- no widespread development of hospitals 4) Demand was unstable- low demand due to self-reliance (family folk-remedies), economic conditions (opportunity cost of transportation), and purchase costs (fee for service) 5) Medical education was substandard-apprenticeship, unrestricted entry, and deficient in science based training Urbanization increased reliance on specialized skills of paid professionals because.. a. Distanced people from families and neighborhoods- no more family-based remedies b. Women began working outside the home- no longer caring for the sick c. Physicians became less expensive and more accessible- telephones, cars, roadsreduced opp. cost of time and travel- more affordable d. Better geographic proximity of patients and physicians Which factors explain why the demand for the services of a professional physician was inadequate in the preindustrial era? How did scientific medicine and technology change that? - ✔✔- Demand was low because: - Small rural communities were self-reliant: family care, home folk remedies. Most "physicians" had no expertise to offer - Not affordable - Indirect cost of transportation and opportunity cost of travel (time lost) - Costs doubled- 2 ppl (physician and emissary) had to make trip back and forth - Private funds, no insurance- personally pay for fee-for- service Science and technology led to.. - Increased demand for advanced services - specialized training became necessary and medicine practice became more professional- no longer provided by families - Legitimacy and complexity- effectiveness of scientific medicine became widely recognized - Cultural Authority- general acceptance of and reliance on the judgement of members of a profession because of superior knowledge and expertise - People's lives became increasingly governed by medical decisions made by physiciansadmission to hospital, necessary treatment, prescriptions, granting medical leave, worker's compensation cases, pre-employment physicals, etc. How did the emergence of general hospitals strengthen the professional sovereignty of physicians? - ✔✔-a. Hospitals were dependent on physicians to keep the beds filled- empowered physicians and enhanced their dominance because hospitals had to keep them satisfied even though they were not employed by the hospitals. They had enormous influence over hospital policy. Discuss the relationship of dependency within the context of the medical profession's cultural and legitimized authority. what role did medical education reform play in galvanizing professional authority? - ✔✔-Dependency emerged because... a. Society expects a sick person to seek medical help and try to get well b. Cultural authority- medical judgements... i. Legitimize sickness ii. Exempt the individual from social role obligations i.e. school/work iii. Provide competent medical care so the person can get well and resume social role obligations c. Need for hospital services for critical illness and surgery d. Referral role, prescriptions Educational reform further legitimized the profession's authority and galvanized its sovereignty - upgrade of med-school standards, physicians clear monopoly on the practice of medicine How did the organized medical profession manage to remain free of control by business firms, insurance companies, and hospitals until the latter part of the 20 th century? - ✔✔-Individual physicians who took up practice in corporate setting were castigated by the - medical profession and pressured to abandon such practices Legal doctrine in some states- "Corporate practice doctrine"- corporations could not employ licensed physicians w/o engaging in unlicensed practice of medicine AMA ("organized medicine")created in 1847-principal goal: advance professionalization, prestige, and financial well-being of memberso Strongly resisted national healthcare initiative- lobbying In general, discuss how technological, social, and economic factors created the need for health insurance. - ✔✔-Scientific and tech. advances made health care more desirable, but less affordable Because of its well established healing values- medical care is individually and socially desirable growing demand for medical services Economic- ppl couldn't predict future needs for medical care or the costs o Great Depression- 1929- ppl needed protection from economic conseq. of sickness and hospitals needed protection from economic instability Which conditions during the WWII period lent support to employer-based health insurance in the US? - ✔✔-1) To control high inflation in the economy during WWII, congress imposed wage freezes Employers started offering health insurance in the place of wage increases - National healthcare=communism (More of a Cold-war influence) Other reasons (not really WWII related): 2) 1948- supreme court ruled employee benefits (including health insurance) as legitimate part of union management negotiations-- -- health insurance=employee benefits in postwar era 3) 1954-Congress made employer paid health coverage non-taxable Discuss why reform efforts to bring in national health insurance have historically failed in U.S. - ✔✔-a. Organized Medicine i. AMA and AHA strongly opposed plans for national health care- felt that their sovereignty was threatened ii. AMA launched massive campaigns against it- hired public relations firm of Whitaker and Baxter to launch very expensive lobbying effort-- -- campaign directly linked national health insurance with communism b. The Middle Class i. Beliefs and values (summarized below) represented sentiments of American Middle class- support was necessary for any broad-based health care reform c. American Beliefs and values i. Market justice ii. Individualism and self-determination iii. Distrust of government iv. Reliance on private sector v. Anti-German and anti-communism feelings: national health insurance= "socialized medicine" Which particular factors that earlier may have been somewhat weak in bringing about national health insurance later led to passage of Medicare and Medicaid? - ✔✔-Government intervention was not desired when it came to health care for most Americans Mecidare and Medicaid met less opposition because reform was proposed for the underprivileged and vulnerable classes - Poor and elderly: special class(not for the stongly opposed working-middle class with private health insurance) It became clear that market alone could not ensure access for vulnerable population groups Growing elderly middle class was becoming politically active force On what basis were the elderly and the poor regarded as vulnerable groups for whom the special government-sponsored programs needed to be created? - ✔✔-On their own, most elderly and poor could not afford increasing health care costs Health status of these groups was significantly worse than that of general populationrequired higher level of health care services Less than half of the elderly population were covered by private insurance-- - had to rely on own resources, public programs, charity Discuss the governments role in the delivery and financing of health care, with specific reference to the dichotomy between public health and private medicine. - ✔✔-Government provides financing for Medicare and Medicaid, but services are delivered by private sector. -Publicly Financed, Privately delivered Expansion of Medicare and Medicaid gov's regulatory powers increasingly encroached upon private sector Government's Regulatory powers/ authority were give to state public health agencies which monitor compliance of private health care delivery institutions. Explain how contract practice and prepaid group practice were the prototypes of todays managed care plans. - ✔✔-Contract Practice o inducements- guaranteed salary for physicians or contract with independent physicians and hospitals at flat rate fee per worker per month- capitation o Utilization was managed by requiring second opinions for major surgery and by reviewing length of hospital stays Prepaid Group Plan: enrolled population received comprehensive services for a capitated fee- Kaiser Discuss the main ways in which current delivery of health care has become corporatized. - ✔✔- Corporatization: Growth and consolidation of large business corporations/organizations Managed care has emerged as dominant force and primary vehicle for insuring and delivering health care (demand side empowerment) Larger, integrated health care organizations (supply side empowerment) o expansion of alternative settings (outpatient surgery, home health care, longterm care, specialized rehabilitation) to make up for losses in acute inpatient sector o Physicians becoming employees of large clinics, hospitals, and other medical corporations In the context of globalization in health services, what main economic activities are discussed in this chapter? - ✔✔-1) Advanced telecommunication in telemedicine cross border transfer of info 2) Medical tourism- travel abroad to receive elective, nonemergency medical care 3) Foreign direct investment in health services enterprises- providing medical equipment, supplies and services in another country 4) Immigration of health professionals- to countries with higher demands for their services and better economic conditions 5) US Corporations expanding operations overseas- health plans for expatriates 6) Medical care delivery by US providers is in demand overseas What were the two main aspects of the Supreme court's ruling in lawsuits filed against the ACA? - ✔✔- 1) majority of ACA provisions- including the individual mandate- are constitutional under Congress's power to ta [Show More]

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