Introduction

This course is designed for health science participants—medical, nursing, nurse practitioner, physician assistant, pharmacy, social work, public health, and others—who will benefit from comprehending the complex environment in which they will work. It is a guide that helps delegates to comprehend the health care system so that they can better work in the system and change what needs to be changed.
This course is the most trusted and comprehensive guide to healthcare, as it provides everything students and professionals need to build a solid foundation on the field’s most critical issues.

Objectives

On completion of this course you should be able to:

– Gain a wide knowledge of structure, organization, and financing of the health care system.
– Discuss the key principles, descriptions, and concrete examples included to make important issues interesting and understandable.
– Illustrate difficult concepts and demonstrate how they could be applied to real-world situations.
– Answer a comprehensive list of review questions reinforce what you have learned
– Discuss Short descriptions of patients, physicians, and other caregivers interacting with the health care system are based on past experiences.
– Comprehend how the healthcare system works and how you can succeed in it.
– Develop a clearer, more systematic way of thinking about health care in the United Kingdom, its problems, and the alternatives for managing and solving these problems.

Course Outline

Day 1

Introduction: The paradox of excess and deprivation
– Excess and deprivation.
– The public’s view of the health care system.
– Understanding the crisis.

Paying for Health Care
– Modes of paying for health care.
– The burden of financing health care.
– Conclusion.

Day 2

Access to Health Care
– Financial barriers to health care.
– Nonfinancial barriers to healthcare.
– The relation between health care and health status.
– Conclusion.

Reimbursing Health Care Providers
– Units of payment.
– Methods of physician payment.
– Methods of hospital payment.
– Conclusion.

How Health Care is Organized: “Primary, Secondary, and Tertiary Care”
– Models of organizing care.
– Forces driving the organization of health care in the United Kingdom.
– Conclusion.

Day 3

How Health Care is Organized: “Health Delivery Systems”
– The traditional structure of medical care.
– The seeds of new medical care structures.
– First-generation health maintenance organizations and vertical integration: The Kaiser-Permanente Medical Care program.
– Second-Generation Health Maintenance Organizations and “Virtual Integration”: Network Model HMOs, Independent Practice Associations, and Integrated Medical Groups.
– Comparing Vertically and Virtually Integrated Models.
– Accountable Care Organizations.
– From Medical Homes to Medical Neighbourhoods.

The Health Care Workforce and the Education of Health Professionals
– Physicians.
– Physician Assistants.
– Registered Nurses.
– Nurse Practitioners.
– Pharmacists.
– Social Workers.
– Supply, Demand, and Need.
– Women in the Health.
– Underrepresented Minorities in the Health Professions.

Painful versus Painless Cost Control
– Health Care Costs and Health Outcomes.
– Cost Control Strategies.
Mechanisms for Controlling Costs
– Financing Controls.
– Reimbursement Controls.
Quality of Health Care
– The Components of High-Quality Care.
– Proposals for Improving Quality.
– Where Does Malpractice Reform Fit in?
What Is Prevention?
– The First Epidemiologic Revolution.
– The Second Epidemiologic Revolution.
– Individual or Population?
– Models of Prevention.
– Does Prevention Reduce Medical Care Costs?

Day 4

Long-Term Care
– Who Pays for Long-Term Care?
– Who Provides Long-Term Care?
– Improving Long-Term Care.
Medical Ethics and Rationing of Health Care
– Four Principles of Medical Ethics.
– Ethical Dilemmas, Old and New.
– What Is Rationing?
– Commodity Scarcity: The Case of Organ Transplants.
– Fiscal Scarcity and Resource Allocation.
– The Relationship of Rationing to Cost Control.
– Rationing by Medical Effectiveness.
– A Basic Level of Guaranteed Medical Benefits.
– The Ethics of Health Care Financing.
– Who Allocates Health Care Resources?
Health Care in Four Nations
– Germany.
– Canada.
– The United Kingdom.
– Japan.

Day 5

Health Care Reform and National Health Insurance
– Government-Financed National Health Insurance.
– The Employer-Mandate Model of National Health Insurance.
– The Individual-Mandate Model of National Health Insurance.
– The Pluralistic Reform Model: The Patient Protection and Affordable Care Act of 2010.
– Secondary Features of National Health Insurance Plans.

Which Financing Model for National Health Insurance Plan Is Best?
– Conflict and Change in America’s Health Care System.
– The Four Major Actors.
– The Years 1945 to 1970: The Provider–Insurer Pact.
– The 1970s: Tensions Develop.
– The 1980s: The Revolt of the Purchasers.
– The 1990s: The Breakup of the Provider–Insurer Pact.
– The New Millennium: Provider Power Re-Emerges.
– The Challenge.