US Healthcare System - History, Hospitals, and Health Insurance (Lecture Notes)

A set of practice flashcards covering key concepts from the lecture notes on the history of the U.S. healthcare system, hospitals, insurance evolution, public health, and pandemics.

What were the major public health challenges in the 18th–19th century United States, as discussed in the lecture?

Epidemics caused by environmental factors such as cholera from bad water and yellow fever from mosquitoes; health problems were public-health/environmental issues rather than medical care issues.

What does ambulatory health care mean in the 1850–1900 period?

Care outside of hospitalization; doctors visiting patients at home or patients going to doctors; little emphasis on contemporary Western medicine at that time.

Which insurer is noted as the first to resemble today’s health insurance plans, and what is its symbol?

Travelers Insurance; the symbol is the red umbrella.

What is the 'plateau effect' in health insurance branding as described in the notes?

The first entrant (Travelers) builds strong name recognition, so later entrants must climb a steep hill of marketing to achieve comparable visibility.

How are the US health care system and Europe different in terms of organizational structure (silos vs integration)?

The US tends to have siloed systems where hospitals, insurers, and physicians operate separately; Europe tends to have more integrated, government-involved systems.

What are 'voluntary hospitals' and give examples of names reflecting their religious origins?

Hospitals started by religious groups; examples include Mount Sinai, Saint Jude, Mercy Hospital, Holy Cross, Sinai Hospital.

What is the difference between for-profit and nonprofit hospitals?

For-profit hospitals maximize profits for owners; nonprofit hospitals have no owners and reinvest earnings into the organization to fulfill their mission.

What does the motto 'no margin, no mission' mean for nonprofit hospitals?

Nonprofits must generate margins (revenues) to fund their mission; without margins, they cannot sustain care and services.

What is Jackson Memorial Hospital and how is it funded?

A public (government) hospital in Miami-Dade County funded by taxes and public dollars.

How do nonprofit and for-profit hospitals differ in terms of taxes and ownership?

Nonprofit hospitals have no owners and typically do not pay taxes; for-profit hospitals have owners/investors and distribute profits to them.

What is the historical origin of community hospitals and what role did European physicians play?

Community hospitals emerged as physicians from Europe introduced Western medicine, often funded by donations and local efforts, evolving into independent or system-affiliated hospitals.

What are the main hospital classifications and how do they differ (public, private nonprofit, private for-profit)?

Public (government-funded), private nonprofit (charitable, reinvests earnings), private for-profit (owned by stockholders, profits distributed).

What is the role of chaplaincy in hospitals?

Chaplains provide ecumenical spiritual support to patients, families, and staff across different faiths.

What is the impact of environmental design on healing in hospitals?

Green spaces and access to natural light are associated with faster healing and shorter hospital stays.

How were contagious diseases historically managed at seaports, and how did this relate to COVID-19 practices?

Seaport quarantine facilities managed contagious diseases; during COVID-19, airport and port quarantines were similarly used to manage importation and spread.

What are antigenic drift and antigenic shift, and how do they relate to epidemics and pandemics?

Antigenic drift: small mutations causing annual epidemics; antigenic shift: major changes causing pandemics.

What two steps are required for a disease to become a pandemic?

Animal-to-human transmission followed by human-to-human transmission.

How did the Spanish Flu (1918–1919) compare to COVID-19 in terms of mortality and affected groups?

Spanish Flu caused tens of millions of deaths globally (roughly 20–40 million); it affected children more and had different age/race patterns than COVID-19, which disproportionately affected older and some minority groups.

What are Mayo Clinic and Cleveland Clinic examples of, in the context of the lecture?

Early group practices; Mayo Clinic is highlighted for its name-recognition plateau, with Cleveland Clinic as another highly recognized example.

What role did yellow journalism and muckrakers play in public health reform?

They highlighted poor living and working conditions, spurring reforms that improved public health and environmental conditions.