US and International Health Care Systems (Sep 1) Week 3 Lecture

Vocabulary practice flashcards reviewing U.S. and international healthcare system structures, historical regulations, funding models, and comparative outcomes.

Health

A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, as defined by the World Health Organization (WHO).

Determinants of Health

The five core factors influencing health outcomes: Genetic Inheritance, Physical Environment, Social Environment, Health Behavior, and Health Care.

Health Care System Goal

To achieve the 'Best Health' for its consumers through the coordinated actions of people, facilities, research, and financing mechanisms.

Oak Tree vs. Banyan Tree Analogy

A comparison of structural design in healthcare systems: most countries operate a unified structure (Oak Tree), whereas the United States operates a complex, decentralized structure (Banyan Tree).

Primary Care

The level of healthcare delivery centered on the practice of basic general medicine.

Secondary Care

Healthcare services involving surgical procedures and diagnostic treatments provided by specialists.

Tertiary Care

Highly specialized diagnostic, therapeutic, and rehabilitative healthcare services.

Pure Food and Drug Act (1906)

Initial U.S. legislation focused on food and drug safety, addressing misbranding and requiring accurate labeling without assessing drug efficacy.

Food, Drug, and Cosmetic Act (1938)

Federal law that established the modern FDA and required premarket evidence of safety, though it did not create a distinction between prescription and non-prescription drugs.

Durham-Humphrey Amendment (1951)

An amendment to the FDC Act of 1938 that established the legal category of 'legend' (prescription) drugs, prohibiting dispensing without a prescription.

Kefauver-Harris Drug Efficacy Amendment (1962)

Legislation requiring proof of both efficacy and safety for drug approval, disclosure of accurate advertising details, reporting of adverse events to the FDA, and informed consent for human clinical trials.

Flexner Report (1910)

A 1910 investigation exposing major deficiencies in medical education, prompting reform that placed medical training within universities under AMA accreditation and triggered the 'Golden Age' of medicine.

Charters Report (1927)

A 1927 study titled 'Basic Materials for a Pharmaceutical Curriculum' that formally defined pharmacy as a profession and led to the establishment of the 4-year Bachelor of Science degree in 1928.

Hospital Survey & Construction Act (Hill-Burton, 1946)

A 1946 federal act passed during the Era of Expansion to fund the construction and modernization of public and non-profit hospitals.

Health Maintenance Organization (HMO) Act (1973)

Legislation passed during the Cost Containment Era to foster the growth of managed care and cost-effective healthcare delivery systems.

Medicare Diagnosis-Related Groups (DRGs)

A prospective payment system introduced in 1983 to control escalating healthcare expenditures by standardizing Medicare hospital reimbursements.

Police Power

The constitutional authority granted to state and local governments to enact and enforce regulations that protect public health, safety, and general welfare.

Private Funding (Health Care)

Healthcare financing structures involving direct out-of-pocket payments by individuals or premium payments made by employers and employees to private health plans.

Public Funding (Health Care)

Healthcare financing structures where public plan options are funded by taxpayers and administered to reimburse healthcare providers.

Beveridge Model

Also known as the Socialized Medicine Model; a system where healthcare is financed and provided entirely by the government through tax revenue, treating healthcare as a public service (e.g., Great Britain, Cuba).

Bismarck Model

Also known as the All Payer or Social Insurance Model; a system using non-profit private insurance plans ('sickness funds') financed through employer and employee payroll deductions with strict government rate controls (e.g., Germany, Japan).

National Health Insurance Model

Also known as the Single Payer Model; a system where the government runs a central insurance program funded by citizens, paying private-sector healthcare providers (e.g., Canada, South Korea).

Out-of-Pocket Model

Also known as the Pay-to-Play or Market-driven Model; a system common in developing regions where individuals pay directly for care out-of-pocket without public or private insurance.

United States Patchwork Model

A healthcare framework combining multiple funding models for different demographics: Medicare (National Health Insurance), VHA (Beveridge), working citizens (Bismarck), and uninsured populations (Out-of-Pocket).

US Healthcare Spending (% of GDP)

The tracking of national spending on health from 1980 to 2019, showing the U.S. reaching $16.8\%$ of GDP in 2019, substantially higher than all other high-income nations.

Comparative Health Care System Performance Scores

An international performance analysis comparing 11 high-income healthcare systems, positioning Norway, the Netherlands, and Australia as top performers, while ranking the United States lowest overall.

Health Care System Performance Rankings Table

A breakdown of rankings across key healthcare metrics including Access to Care, Care Process, Administrative Efficiency, Equity, and Health Care Outcomes across 11 developed countries.

Institute of Medicine (IOM) 21st-Century Aims

Six core quality domains for healthcare systems established in the 2001 report 'Crossing the Quality Chasm': Safe, Effective, Patient-Centered, Timely, Efficient, and Equitable.

Eras of 20th Century Health Care

The three historical periods of U.S. healthcare development: Era of Expansion (1940s–1960s), Era of Cost Containment (1970s–1980s), and Era of Assessment & Accountability (1990s–Present).