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Community and mental health exam 3 study guide
- Course
- Community & Mental Health
- Institution
- Rockhurst University
Lecture notes of 28 pages for the course Community & Mental Health at Rockhurst University (Study guide)
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Community and Mental Health Exam 3Overview of Health Policy
Public Health Policies (local, federal, and state)
- Decisions made at all levels of government (local, state, or federal)
- Influence health care through monitoring, production, provision, and financing of health care services
- Everyone is affected, from providers to consumers
- Influence all health care organizations
- Authority for protection of the public’s health largely vested with states
- Most state constitutions delineate their responsibility
- Each state establishes policies or standards for goods or services that affect the health of its citizens
- If the federal government or the local government imposes a higher standard than the state requires, the lower
standard is negated by the higher standard
- Compliance with federal program standards is voluntary but impacted by revenue
Private Health Sector (insurance companies)
- Includes employers, professional organizations, nonprofit health care organizations, and for-profit
corporations that deliver, insure, or fund health care services outside of government control
- Policies evolve differently influenced by economics and business management, as compared with the social
and political theories that predominate in the public sector
- Economics is central factor in decision making, whereas in the public sector economics is but one of many
factors
- Decisions are swift and proactive, whereas in the public sector, decisions are slow, deliberate, and more
reactive
- Needs determined by consumerism, market trends, and economics; public-sector needs are determined by
voting shifts, electoral realignment, and term limits
Private Health Care Subsystem
Focus on the individual
Nonprofit and for-profit agencies
Models of services
- Solo practice
- Single specialty group practice
- Multispecialty group practice
- Integrated health maintenance model
- Community health center
Voluntary or nonofficial agencies
Public Health Care System
Mandated by the U.S. Constitution (overall)
Required by law to address the health of populations by “promoting the general welfare of its citizens”
Federal policies and practices influence local and state governments
,Coordination of services under Department of Health and Human Services (HHS), second largest department of the
federal government
Concerned with the health of the population and a healthy environment
Federal-Level Subsystem
Most health-related activities are implemented and administered by the US Department of Health and Human
services (HHS)
Many federal agencies perform activities related to health:
- US Centers for Disease Control and Prevention (CDC)
- US Public Health Service (USPHS)
- Health Resources and Services Administration (HRSA)
- National Institutes of Health (NIH)
- Centers for Medicare and Medicaid Services (CMS)
- Food and Drug Administration (FDA)
- Environmental Protection Agency (EPA)
- US Department of Agriculture (USDA)
Targets general population, special populations, and international health
State-Level Subsystem
States are responsible for the health of their citizens
Organizations and activities vary widely among the states
Health commissioner or secretary of health appointed by the governor
- Health officer is usually a physician with a degree and experience in public health
- In some states, the health officer directs the state health department
Highly dependent on the federal level for resources and guidance
- Example: Medicaid (jointly funded by the federal government and states)
Responsible for its own public health laws
Local Health Department Subsystems
Responsible for the direct delivery of public health services and protection of the health of citizens
Local health departments
- Not in every community
Organization varies widely depending on community size, economics, partnerships with the private health care
system, health care facilities business support, health care needs, transportation, and the number of citizens requiring
public health care
Health officer or administrator appointed by local government
- Half of the states require that the health officer have a medical degree
Professional staff members: public health nurses, health inspectors, dentists, social workers, epidemiologists,
nutritionists, health educators
Services fall into the following four major categories:
- Community health services
o Control of communicable disease such as surveillance and immunizations, maternal-child health
programs, nutrition services, education, preventative screening
- Environmental health services
o Food hygiene; protection from hazardous substances; control of waste, air, noise, and water
, pollution; occupational health
- Personal health services
o Provide care to individuals and families
- Mental health services
Factors Influencing Health Care Costs
Historical perspective – costs have risen exponentially since the mid-1960’s
Use of health care – demand for the product increases when the need expands and funding is available
Lack of preventative care – curative measures have traditionally been the focus
Lifestyle and health behaviors – the leading causes of death and illness can be positively affected by changes in
lifestyle
Societal beliefs – belief in cure rather than prevention, society passive participant
Technological advances – numerous and expensive
Aging of society – expenditures rise with age, dramatically so at older ages
Pharmaceuticals – utilization of drugs, increased costs
Shift to for-profit health care – from nonprofit
Health care fraud and abuse – costs the US tens of billions of dollars annually
**Over our lifetimes, our health care costs increase with age**
**Decreasing fraud and abuse would have the most impact of decreasing healthcare costs in US**
Medicare – Part A (Hospital Insurance)
Eligible at age 65 - no monthly premium if you or your spouse paid Medicare taxes for a certain amount of time
while working (premium-free Part A)
Eligible if under 65, if the following apply:
- People who are disabled OR
- Have End-Stage Renal Disease (ESRD) OR
- Have amyotrophic lateral sclerosis (ALS)
Covers:
- Inpatient hospital care, skilled nursing facility care, hospice care, home health care
Deductibles and co-insurance applies
Medicare – Part B (Medical Insurance) – Outside the Hospital
Monthly premium (may be higher depending on income)
Covers:
- Preventative and screening services
- Physician services
- Outpatient services
- Ambulance services
- Durable medical equipment (DME)
- Mental health (inpatient, outpatient, and partial hospitalization)
Deductible and co-insurance applies
Medicare – Part C (Advantage Plans)
Replaces Medicare A and B
Provided by private insurance companies approved by, and under contract with Medicare
Costs vary by plan
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