Foundations of Health Care Systems Exam #1

Health Care Delivery

The structured system of providing health services, akin to the organized social scene of the Upper East Side.

Patients

The individuals receiving care, comparable to the Upper East Siders at the center of social interactions.

Providers

The entities delivering care and controlling access, similar to social gatekeepers in a community.

Payers

Sources of funding for healthcare, represented by private insurance, employers, and government programs.

Vendors

Entities that supply goods for healthcare, like pharmaceutical and medical device companies.

Health Care Spending

The annual expenditure on healthcare in the U.S., likened to the extravagant tuition of Upper East Side schools.

Care Continuum

5 different types of care that patients may receive throughout their health journey, including preventive, primary, secondary, tertiary, and end-of-life care.

Disease Prevention & Health Promotion

Activities aimed at keeping individuals healthy before illness occurs.

Primary Care

The first point of contact for patients in the healthcare system.

Acute Care

Emergency and immediate hospital care for sudden illnesses.

Rehabilitative Care

Just like a character's journey back to their former state, this care focuses on recovery.

Palliative Care

Care aimed at managing symptoms of serious illnesses to improve quality of life.

Health Care Financing

The various methods of funding healthcare systems, analogous to managing wealth among elites.

Insurance

A system of risk pooling that covers healthcare costs for individuals.

HMO

Health Maintenance Organization, requiring referrals for specialists and offering a limited network.

PPO

Preferred Provider Organization, providing more freedom but at a higher cost.

High Deductible Plans

Insurance plans with low premiums but high out-of-pocket costs for individuals.

Comparative Health Systems

Analyzing different healthcare models used globally, comparing them to the U.S. system.

Beveridge Model

Funded by taxes, public hospitals, everyone covered—like Blair’s mom ensuring her entire team gets benefits.

Bismarck Model

Funded by employer & employee contributions, private providers but universal coverage—similar to how Bart ensured his employees were covered.

National Health Insurance

Government-run insurance but private providers (like how Gossip Girl influences everything but doesn’t directly run the UES).

Out-of-Pocket Model

Pay directly for care; if you don’t have money, no treatment—like Rufus struggling to pay for things without Lily’s help.

U.S. System Performance

An evaluation of the effectiveness and challenges of healthcare access and quality in the U.S.

Administrative Efficiency

The effectiveness of healthcare organization in managing resources and paperwork.

Inequity in Healthcare

Disparities in care access and quality based on income levels.

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Key Takeaways

The system is complex, expensive