Group Assignment (due by 1700 October 4)

Instructions:

We would like for the following exercises to be completed on an individual basis, but you may discuss and generate ideas within your group. Your group may want to work on one exercise at a time, so that the entire unit does not feel so burdensome. This is a lengthy exercise.  Remember you have 3 weeks to complete the assignment; but, just don't wait until the last minute. Your group discussion should be conducted in your group's section on the discussion board. 

Individual portion: If you are not a facilitator for this assignment, you will complete the exercise individually before sharing it with your group. After you have completed your individual assignment, share it by posting it in the group discussion area designated for your group on the discussion board. All individual portions of the assignment must be posted by three days prior to the due date for the group assignment . Your unit 3 group summary assignment is due by 1700 on 10/04/06. This means your individual responses must be posted on the discussion board before 1200 on 10/01/06.

IMPORTANT: Individual work posted after the individual response time will not be incorporated into the group assignment summary, therefore, the individual student will receive a zero for that group assignment.  At the discretion of the faculty, individual work posted after the individual response due date but before the group summary assignment due date may be considered for partial credit not to exceed half of the assignment points.

Facilitator portion: Your group facilitator for this assignment will be responsible for summarizing your groups' individual contributions and posting a summary on the discussion board in the area designated for your group. The facilitator is not required to post an individual response, although it is encouraged in order to assure thoughtful and participatory interaction with the group. The facilitator may pose questions for clarification to individual members, so it is very important that all group members remain active participants in your group's sections on the discussion board until the group summary is completed and posted. The group summary is what will be graded.  Please indicate group contributors and non-contributors on your submitted group summary work.

The Unit 3 Group Assignment is broken into three parts: Economics, Health Care Issues, and Culture and Environment.

ECONOMICS

Case Study: Choose one of the following cases and respond to the questions asked.

Case # 1

Joe works for a small company and does not receive health benefits. Joe is married and has two children, ages 3 and 5. His annual income is $25,000.

1. Calculate approximately how much Joe will take home after taxes each month. From the estimated monthly living expenses, how much money will Joe and his family have left over after paying for these expenses?  What additional incidental expenses might the family incur?

2. Can the family afford for Joe's wife to work outside the home?

3. When will Joe and his family access our health care system?

4. How will Joe's children receive preventive health services?

5. Describe what obstacles Joe's family will encounter in our health care system.

6. Describe the health and financial burdens this family will experience if  Joe's wife develops cancer.

Case # 2

Mrs. Smith, a 75 year old widow has suffered a severe stroke. She is bed-bound and will require a 24 hour caregiver. Her annual income is $25,000 from a retirement fund and investments. She has the following expenses:

1. What are her yearly expenses?

2. Can she afford a paid caregiver? What options does she have in our health care system?

3. What services can she access?

4. What services will she be denied?

5. What is she likely to do without?

6. Is Mrs. Smith a likely candidate for a nursing home? Who will pay for that?

7. If Mrs. Smith's income changed to $5000/year, how would your answers to the above questions change?

HEALTH CARE ISSUES

Our health care system has been characterized as a "paradox of excess and deprivation."  In general, our health care system has been criticized:

• for using excessive health care services without evidence of what constitutes effective treatment outcomes; 
• for providing care to those who can pay; 
• for being one of the best health care systems in the world for about 10% of our nation's population; 
• for being "mediocre" for 80% of our population; 
• for being one of the worst systems in the world for about 10% of our population;
• for making some providers wealthy and some consumers impoverished.

Managed care companies are criticized for putting cost before the individual patient's needs. Physicians criticize managed care organizations for dictating what they can provide for individual patients. Managed care companies are accused of enrolling only healthy individuals in their programs. Consumers say they are locked out of seeing specialists when they desire.  Yet, managed care companies have increased the likelihood of individuals and groups receiving preventive services, have increased the use of disease management protocols, and have advanced the practice of outcomes based medicine. The two vignettes put personal faces to the problems of our health care system. Read these vignettes before completing the following exercise:

In your group summary offer suggestions about ways that our health care system could be changed to:

• Provide basic health care for all citizens.
• Reduce escalating, runaway costs.

In this new system that you are discussing:

• How would you define basic health care?
• Would we be able to offer expensive treatments (transplants, separating conjoined twins) to all citizens?  If not, how would we decide who qualifies?
• If we continue with an expensive system whereby options like transplants are offered, what are you willing to give up, for example - less public education, less take home pay due to higher taxes etc.?
• How will you pay for this system that you are suggesting?

CULTURE and ENVIRONMENT

After completing your readings on Culture, Economics, and Environment identify one minority ethnic/cultural group when answering the questions below.

Members of ethnic/cultural groups have been shown to have poorer health care outcomes than others in the U.S. population. In part, this is due to lack of access to care due to financial constraints. Even when members of these groups have health insurance; however, their health outcomes tend to be less favorable than among Caucasian members of the population with similar forms of health care coverage.

Reflecting on one minority ethnic/cultural group that is different from your own, answer the following questions. Give examples from the identified ethnic/cultural group to support your discussion.

1. What  factors other than those listed above might be contributing to these differential outcomes?

2. Which of these factors arise out of ethnic cultures and which arise out of the dominant culture or the culture of the health care system?

3. What environmental hazards might affect your identified ethnic/ cultural group?  What health effects, if any, could these hazards cause?

Questions from Clark: Chapter 5: The Economic Context, p. 95 & Clark: Chapter 7: The Environmental Context.