14 Chapter Review
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2110
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Medicine
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Jan 9, 2024
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14
Chapter Review
1.
What are the key aspects of health and health care?
Answer
The World Health Organization defines health as a state of complete physical,
mental, and social well-being.
By contrast, illness refers to an interference with good health that is reflected
in differential life expectancy rates, infant mortality rates, and other
indicators of the presence or absence of quantity and quality of life in a
nation.
Health care refers to any activity intended to improve health, while medicine
describes an institutionalized system for scientifically diagnosing, treating,
and preventing illness.
These terms are socially defined and may change over time and between
cultures. In other words,
health and illness are not only biological issues
but also social issues.
Studying health and healthcare issues worldwide
offers insights into illness and how political and economic forces shape
healthcare in nations.
2.
What is social epidemiology, and what key demographic factors are
studied by social epidemiologists?
Answer
Social epidemiology studies the causes and distribution of health, disease,
and impairment throughout a population.
Typically, the target of the investigation is disease agents, the environment,
and the human host (age, sex, race/ethnicity, physical condition, habits and
customs, and lifestyle).
3.
How did the profession of medicine emerge in the United States? What
are the key characteristics of medicine as a profession?
Answer
During the nineteenth century, medical schools were proprietary
institutions, and their officials were often more interested in acquiring
students than in enforcing standards. Gradually, medical schools were
reduced, and licensing laws were established to eliminate unqualified or
irregular practitioners.
Although medicine had been previously viewed more as an art than as a
science, several significant discoveries during the nineteenth century in
areas such as bacteriology and anesthesiology began to give medicine
increasing credibility as a science.
Today, medicine is viewed as a profession because it has the following
characteristics: abstract, specialized knowledge; autonomy that allows them
to rely on their own judgment in most cases; self-regulation based on
licensing, accreditation, and regulatory boards and associations that set and
enforce professional standards; authority and expected compliance with
their directions; and altruism, rather than practicing only for their own self-
interest.
4.
How was US health care paid for in the past, and how has the Affordable
Care Act (Obamacare) changed this?
Answer
Medical care in the United States has been paid fee-for-service for most of
the past hundred years. This approach to paying for medical services is
expensive because few restrictions are placed on the fees that doctors,
hospitals, and other medical providers can charge patients.
Recently, there have been efforts at cost containment, and HMOs and
managed care have produced both positive and negative results in the
contemporary practice of medicine. Health maintenance organizations
(HMOs) provide total care for a set monthly fee with an emphasis on
prevention to avoid costly treatment later.
Managed care is any cost containment system that closely monitors and
controls health care providers’ decisions about medical procedures,
diagnostic tests, and other services that should be provided to patients.
The Affordable Care Act of 2010 includes measures to make insurance
available to millions of previously uninsured or underinsured persons.
However, this act, also referred to as “Obamacare,” includes cost-containment
measures so that health plans will have incentives to compete and keep
premiums low, more control of Medicare payments, and programs that
penalize hospitals when patients are readmitted too frequently, among other
cost-cutting endeavors.
During the Trump administration, efforts have been made to eliminate or
reduce the stipulations of the Affordable Care Act, but in 2020, many aspects
of this law are still in effect.
5.
How do nations such as Canada, Great Britain, and the People’s
Republic of China provide health services for their citizens?
Answer
Other nations have various ways in which they provide health care for their
citizens. Some nations (such as Canada) have a universal health care system
in which all citizens receive medical services paid for by tax revenues.
Other nations (such as Great Britain) have a socialized health care system in
which the government owns the medical care facilities and employs the
physicians.
Today, the People’s Republic of China has a complex mix of market-driven
capitalism, communism, and massive government spending that affects the
delivery of health services in that nation. Like the United States, China has
undertaken a series of reforms to provide greater access and affordability to
health care. These reforms have aimed to provide everyone with universal
health coverage, but this goal has not been reached in many areas, such as
rural villages.
Three basic types of health insurance have existed: rural and urban resident-
based health insurance funded by government subsidies and employee-
based health insurance funded by employer and employee contributions. It
remains to be seen if they will successfully improve that nation's healthcare
quality.
6.
How has advanced medical technology changed the practice of
medicine and the cost of health services? What are holistic medicine
and alternative medicine?
Answer
Sociologists have identified specific social implications of some new medical
technologies:
Advanced technologies create options for people and for society, but these
options alter human relationships. Advanced technologies increase the cost
of medical care. Advanced technologies such as cloning and stem cell
research raise provocative questions about the very nature of life.
Holistic medicine is an approach to health care that focuses on preventing
illness and disease and is aimed at treating the whole person, both body and
mind, rather than just the part or parts in which symptoms occur.
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Alternative medicine refers to healing practices that take a holistic approach
but are either used to complement standard medical practice or are
inconsistent with dominant medical practice. Examples include herbal
therapies, acupuncture, chiropractic medicine, massage, and spiritual
healing.
7.
How do functionalist, conflict, symbolic interactionist, and postmodern
approaches differ in their health and health care analysis?
Answer
According to the functionalist approach, if society is to function as a stable
system, it is important for people to be healthy and to contribute to their
society. Consequently, sickness is viewed as a form of deviant behavior that
society must control.
Conflict theory emphasizes the political, economic, and social forces that
affect health and the health care delivery system. Among these issues are the
ability of all people to obtain health care; how race, class, and gender
inequalities affect health and health care; power relations between doctors
and other health care workers; the dominance of the medical model of health
care; and the role of profit in the health care system.
In studying health, symbolic interactionists focus on the fact that the
meaning social actors give their illness or disease will affect their self-
concept and relationships with others. Symbolic interactionists also examine
medicalization—the process whereby nonmedical problems become defined
and treated as illnesses or disorders.
Postmodern theorists argue that doctors and the medical establishment have
gained control over illness and patients, at least partly because of the
physicians’ clinical gaze, which replaces all other knowledge systems.
8.
What are the key aspects of mental disorders?
Answer
A mental disorder is defined as a condition that makes it difficult or
impossible for a person to cope with everyday life.
By contrast, a mental illness refers to a condition in which a person has a
severe mental disorder requiring extensive treatment with medication,
psychotherapy, and sometimes hospitalization.
9.
What is a disability, and what are some key sociological perspectives on
disability?
Answer
Disability is a physical or health condition that stigmatizes or causes
discrimination.
In viewing disability, sociologists using the functionalist framework often
apply the medical model of disability. According to the medical model, people
with disabilities become chronic patients under the supervision of medical
personnel, subject to a doctor’s orders or a program’s rules and not to their
own judgment.
According to symbolic interactionists, people with a disability experience
role ambiguity because many people equate disability with deviance.
From a conflict perspective, persons with a disability are members of a
subordinate group in conflict with persons in positions of power in the
government, the healthcare industry, and the rehabilitation business, all of
whom are trying to control their destinies.
10.
What is the future of the healthcare system in the United States?
Answer
Many key issues face the U.S. healthcare system now and in the future. Many
of these issues are contingent on the outcome of either the full
implementation of the Affordable Care Act or the replacement of this law
with some other plan or plans for financing and administering health care in
this country.
One key issue is how to deal with continuing crises such as the outbreak of
measles, mumps, and tuberculosis because of the resistance of persons
opposed to vaccinating their children or taking other measures to prevent
the recurrence of these eradicated diseases.
Another key issue is technologies' role and cost for diagnosis and treatment.
A final, but definitely not the only other problem facing US health care is the
extent to which preventive health care is effectively implemented to reduce
high rates of preventable illness with appropriate measures such as diet,
exercise, or not smoking or engaging in other activities that reduce the
quality of health and limit the lifespan of many people.