Bioethics - Chapter 11 Flashcards

Main reason for lack of healthcare coverage

cost

What demographic did the affordable care act primarily benefit prior to 2014?

People over 65; 44 million under 65 uninsured

What changed about the ACA in 2014?

Expanded government health insurance (Medicaid), many people could buy insurance with tax credits

What did coverage look like in 2016?

26.7 million people under 65 with no coverage

How does risk of death change for insured vs. uninsured people?

Risk of death is 25% higher for the uninsured

Lack of health insurance is a _________ as well as a health risk

financial burden

Over 75% of the uninsured are

members of families with full-time workers

What does Medicare do?

Covers 65+ and some <65 with permanent disabilities. Collects payroll taxes during employment and provides coverage after 65

What does Medicaid do?

Publicly supported program that covers under-65 low-income people

US per-capita spending on health care

>$10,000

Is the US's per capita spending on healthcare higher or lower compared to other countries?

Higher

US life expectancy

~81 yrs

Is the US life expectancy higher or lower than that of other economically advanced countries?

Lower

What are some strengths of the US health system?

Development and use of medical technologies, some important measures of health care quality (ex. 30-day heart attack mortality, obstetric trauma, cancer mortality)

What are some weaknesses of the US health care system?

High rate of death, high rate of disability, frequent cases of preventable disease, high medical error rate, etc.

Managed Care

system for providing care to a particular group of patients using regulatory restraints to control costs and increase efficiency

Most US healthcare is allocated through

managed care

Managed care plan examples

health maintenance organization (HMO), preferred provider organization (PPO)

Managed care plans try to

control costs by influencing the kind and amount of care providers offer and by restricting the choices that members have

The concern with managed care is that

providers cut corners for the sake of economical medicine

In 2010, _________ signed the ____________________

Obama, Patient Protection and Affordable Care Act

ACA major provisions

most individuals required to have health insurance by 2014, individuals without access to affordable employer coverage can purchase it through a health insurance exchange, employers required to pay penalties for employees who receive tax credits for health insurance through the exchange, new regulations imposed on all health plans that prevent insurers from denying coverage to people, medicaid expanded

2012 National Federation of Independent Business v. Sebelius decision

ACA constitutional, but states could opt out of law requirement to expand Medicaid

Distributive Justice

justice regarding the fair distribution of society's advantages and disadvantages, or benefits and burdens

Libertarian theories of justice

benefits and burdens of society should be distributed through the fair workings of a free market and exercise of liberty rights of noninterference

Under the libertarian view, who has a right to healthcare

No one, and universal healthcare is unjust

Utilitarian theories of justice

a just distribution of benefits and burdens is one that maximizes net good (utility) for society

Utilitarian view on allocation of healthcare

depends on society's resources and needs and likely effects of allocation policies and programs

Egalitarian theories of justice

affirm that important benefits and burdens of society should be distributed equally

Egalitarian view on healthcare

system that gives people equal access to healthcare

human rights approach to healthcare

just distribution of health and healthcare can come from ensuring human rights are respected

negative rights

rights entailing duties not to interfere with someone obtaining something

positive rights

rights entailing duties to help the person in their efforts to get something

derivative right

a rule justified by the assessments of utility

principle of justice articulated by Jon Rawls

"fair equality of opportunity"; everyone is entitled to an equal chance

Decent minimum of healthcare

argument for a right to a minimal, basic array of healthcare resources

Rationing

the choices that must be made in allocation of healthcare when a system exists with limited resources

QALY

quality life-adjusted year

QALY is associated with __________ and describes __________

utilitarianism; a calculation used to determine a treatment's impact

social value

valuation of a person's life according to their contribution to society