The 11th Jabra Jabra TEXT lecture

🏥 Flashcards: The U.S. Healthcare System 💙

💔 Flashcard 1: What does “fragmented” mean in U.S. healthcare?

🧩 It means our system is split into many parts!
There are hospitals, doctors, and other providers — but they don’t always work smoothly together.
➡ Everyone’s doing their own thing! 😅

🏥 Flashcards: The U.S. Healthcare System 💙

🏨 Flashcard 2: Types of Hospitals

🏦 For-Profit: Goal = Make money 💰 (about 24–25% of hospitals)
❤ Non-Profit: Goal = Serve the community 🫶
⛪ Religiously Affiliated: Run by faith-based groups 🙏

🏥 Flashcards: The U.S. Healthcare System 💙

🧠 Flashcard 3: Other Kinds of Hospitals

🏫 Academic medical centers (AMCs) = teaching hospitals 👨‍🏫
🏥 Community hospitals = local care 💁
🩹 Safety net providers = care for vulnerable populations ❤‍🩹
🧪 Ambulatory centers, radiology, labs, behavioral health = specialized care 🧬

🏥 Flashcards: The U.S. Healthcare System 💙

👩‍⚕ Flashcard 4: Physicians

🩺 Primary care doctors = your main “go-to” docs 👨‍⚕
🧑‍⚕ Specialists = experts (heart, brain, etc.) 💡
👔 Some doctors work for hospitals, others work for themselves 🏢 vs 🏠

🏥 Flashcards: The U.S. Healthcare System 💙

🤕 Flashcard 5: The Primary Care Problem

😓 There’s a shortage of primary care doctors!
Even in Massachusetts (where it’s “better”), access is still tricky.
Result? Longer waits ⏳ and less access for patients.

🏥 Flashcards: The U.S. Healthcare System 💙

💸 Flashcard 6: HMO vs PPO

🏥 HMO (Health Maintenance Org):
✅ Lower cost 💵
🚫 Less flexibility (must see doctors on the list) 📋

💳 PPO (Preferred Provider Org):
💰 Higher cost
✨ More freedom — can see any doctor, but might pay more 🩺

🏥 Flashcards: The U.S. Healthcare System 💙

🧾 Flashcard 7: Hospitals Over Time

📆 In 1890 — few hospitals 🏚
Now — hospitals are standard and regulated across the U.S. 🌎
Most are non-profit, based in charity law ❤

🏥 Flashcards: The U.S. Healthcare System 💙

🙋 Flashcard 8: Hospital Patients

🏥 Some hospitals (like Boston Medical Center) treat vulnerable patients 💔
💵 Others (like Mass General) have wealthier patients & more profits 💰

🏙 Urban hospitals – more stable
🌾 Rural hospitals – many have closed (150+ in 15 years!) 😞

🏥 Flashcards: The U.S. Healthcare System 💙

💰 Flashcard 9: Key Terms – Charge, Price, Cost

💵 Charge = What hospital “wishes” to get (example: $40,000 knee replacement 🦵)
💲 Price = What insurance actually pays 🧾
💸 Cost = What hospital spends to do the procedure 🏥

🏥 Flashcards: The U.S. Healthcare System 💙🧑‍💼 Flashcard 10: Who Buys Insurance?

👩‍💼 Employers — choose plans for workers 👷
🧍‍♂ Patients — may pick private or public insurance

📋 Common plans:

• HMO 🧩 (cheap, limited)

• PPO 🔄 (flexible, pricey)

• Tiered or high cost-sharing = 🪙 pay more for more choices

🏥 Flashcards: The U.S. Healthcare System 💙

💳 Flashcard 11: Public vs Private Insurance

🩹 Public plans: Medicare, Medicaid, SCHIP 💖
🏢 Private plans: bought from employers or marketplaces 💼

😟 Eligibility can change — some people lose coverage and become uninsured 🚫

🏥 Flashcards: The U.S. Healthcare System 💙

🚑 Flashcard 12: Hospitals – How They Work

🏥 Licensed by states 🪪
🫶 Mostly non-profit (charity-based)
👨‍👩‍👧‍👦 Governed by local community boards
💼 Boards = responsible for quality care & loyalty
📈 Many hospitals are joining into big corporate units
🏆 Accredited by groups like JCAHO = quality check mark ✅

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕

💵 Flashcard 1: What is a Charge?

💰 Charge = the “wishful thinking” 💭 amount the hospital puts on paper!
🧾 Example: A knee replacement might be listed as $40,000 😱
👉 But hospitals rarely get this full amount.
🎯 It’s like the sticker price on a car that no one actually pays!

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕

💳 Flashcard 2: What is a Price?

💵 Price = the negotiated amount actually paid by insurance.
🏦 Example: Insurance company says, “Nah, we’ll pay $22,000 instead of $40,000.”
💸 That $22,000 = the price!

📊 Patients might also have a small out-of-pocket payment 🚶‍♀💵

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕

🧾 Flashcard 3: What is a Cost?

💉 Cost = what it really costs the hospital to perform the procedure.
👩‍⚕ Includes:

• Doctor & nurse pay 💼

• Operating room use 🏥

• Anesthesia & equipment 💊

📉 Example: The knee surgery might cost $14,000.
🏦 So: Hospital Charge 💰 $40K | Price 💳 $22K | Cost 💉 $14K

💡 Profit = Price – Cost = $8K

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕

🌫 Flashcard 4: Why is Cost So Tricky?

🤔 Costs aren’t the same everywhere!
🏥 Each hospital has:

• Different doctors 👨‍⚕

• Different equipment ⚙

• Different patient needs 🧓 vs 🧑

💬 So, a surgery might cost $14K at one hospital, and $20K at another.
🔍 Even hospitals themselves often don’t know exactly what the cost is! 😅

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕
🛡 Flashcard 5: What is Decision-Making in Healthcare About?

🩺 It’s all about keeping patients safe and making smart choices 🏥
Includes:
1⃣ Patient Safety 😷
2⃣ Negligence 🚫 (When a provider makes a careless mistake)
3⃣ Informed Consent ✍ (When doctors don’t explain risks)
4⃣ Competence 🧠 (Can the patient make their own decisions?)
5⃣ Research vs. Treatment 🔬 (Different rules apply!)

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕

⚖ Flashcard 6: What is Professional Negligence?

💥 When a doctor or provider fails to do something that a reasonable provider should have done.
🩺 Example: A doctor forgets to warn about a known risk 💬 — that can be negligence!

💡 Case Example: Cobbs (about informed consent)

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕

✍ Flashcard 7: What is Informed Consent?

🧾 It means the doctor must:

• Explain the procedure 🏥

• Talk about the risks 💀

• Offer alternatives ⚖

🚨 If a doctor skips that talk, and something goes wrong — ❌ that’s a problem!
🧠 Case Example: Cobbs, Cruzan

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕

🧠 Flashcard 8: What is Competence to Make Medical Decisions?

👩‍⚕ A person is competent if they can understand:

• What the decision is about 🧩

• What could happen next 🔮

🚫 Legally incompetent patients can’t make medical decisions — others (family or guardians) help them 💌

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕

🔬 Flashcard 9: What’s the Difference Between Research and Medical Care?

🧪 Research: Tries to find new knowledge 🧠
🏥 Medical Care: Focuses on helping the current patient ❤
⚖ The ethics and rules for research subjects are stricter — because they volunteer and face risks 💡

💸 Flashcards: Hospital Payments, Decision Making, and Patients vs Consumers 💰👩‍⚕

🧍‍♀ Flashcard 10: Who Are Patients? ❤

👩‍⚕ Patients are people who receive care — no matter how much money they have 💵 or don’t have 🚫
✅ Care is based on need, not payment.
👩‍⚕ They rely on doctors & nurses.
⚖ Unequal knowledge — doctors know more than patients!