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1. General Introduction about Health care in the United States


Title: 1. Health care in the United States Author: jia-haimei Last modified by: jia-haimei Created Date: 9/3/2009 2:43:11 AM Document presentation format – PowerPoint PPT presentation

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Title: 1. General Introduction about Health care in the United States

1. General Introduction about Health care in the
United States
  • Health care in the United States is provided by
    many separate legal entities. More is spent on
    health care in the United States on a per capita
    basis than in any other nation in the world. A
    study of international health care spending
    levels published in the health policy journal
    Health Affairs in the year 2000 found that the
    U.S. spends more on health care than other
    countries in the Organization for Economic
    Co-operation and Development (OECD), and that the
    use of health care services in

  • the U.S. is below the OECD median by most
    measures. The authors of the study conclude that
    the prices paid for health care services are much
    higher in the U.S. Medical debt is the principal
    cause of personal bankruptcy in the United
    States, weakening the whole economy.
  • According to data compiled and published by the
    international pharmaceutical industry , the US is
    the world leader in biomedical research and
    development as well as the introduction of new
    biomedical products pharmaceutical industry
    trade organizations also maintain that the high
    cost of health care in the U.S.

  • has encouraged substantial reinvestment in such
    research and development. Despite that, the US
    pays twice as much yet lags other wealthy nations
    in such measures as infant mortality and life
    expectancy, which are among the most widely
    collected, hence useful, international
    comparative statistics. For 2006-2010, the USA's
    life expectancy will lag 38th in the world, after
    most rich nations, lagging last of the G5 (Japan,
    France, Germany, UK, USA) and just after Chile
    (35th) and Cuba (37th).

  • Active debate over health care reform in the
    United States concerns questions of a right to
    health care, access, fairness, efficiency, cost,
    and quality. The World Health Organization (WHO),
    in 2000, ranked the U.S. health care system as
    the highest in cost, first in responsiveness,
    37th in overall performance, and 72nd by overall
    level of health (among 191 member nations
    included in the study). The WHO study has been
    criticized, in an article published in Health
    Affairs, for its failure to include the
    satisfaction ratings of the general public.

  • A 2008 report by the Commonwealth Fund ranked
    the United States last in the quality of health
    care among the 19 compared countries. The U.S.
    has a higher infant mortality rate than all other
    developed countries. According to the Institute
    of Medicine of the National Academy of Sciences,
    the United States is the "only wealthy,
    industrialized nation that does not ensure that
    all citizens have coverage" (i.e. some kind of

2. Health Care Facilities in the U. S.
  • In the United States, ownership of the health
    care system is mainly in private hands, though
    federal, state, county, and city governments also
    own certain facilities.
  • The non-profit hospital's share of total hospital
    capacity has remained relatively stable (about
    70) for decades. There are also privately owned
    for-profit hospitals as well as government
    hospitals in some locations, mainly owned by
    county and city governments.

  • There is no nationwide system of government-owned
    medical facilities open to the general public but
    there are local government-owned medical
    facilities open to the general public. The
    federal Department of Defense operates field
    hospitals as well as permanent hospitals (the
    Military Health System), to provide
    military-funded care to active military
    personnel. The federal Veterans Health
    Administration operates VA hospitals open only to
    veterans, though veterans who seek medical care
    for conditions they did not receive while serving
    in the military are charged for services. The
    Indian Health Service operates facilities open

  • only to Native Americans from recognized tribes.
    These facilities, plus tribal facilities and
    privately contracted services funded by IHS to
    increase system capacity and capabilities,
    provide medical care to tribespeople beyond what
    can be paid for by any private insurance or other
    government programs. Hospitals provide some
    outpatient care in their emergency rooms and
    specialty clinics, but primarily exist to provide
    inpatient care. Hospital emergency departments
    and urgent care centers are sources of sporadic
    problem-focused care"Surgicenters" are examples
    of specialty clinics. Hospice services for the

  • terminally ill who are expected to live six
    months or less are most commonly subsidized by
    charities and government. Prenatal, family
    planning, and "dysplasia" clinics are
    government-funded obstetric and gynecologic
    specialty clinics respectively, and are usually
    staffed by nurse practitioners.

3. Medical products, research and development in
the U.S.
  • The United States is a leader in medical
    innovation. In 2004, the health care industry
    spent three times as much as Europe per capita on
    biomedical research. Companies provide medical
    products such as pharmaceuticals and medical
    devices. In 2006, the United States accounted for
    three quarters of the worlds biotechnology
    revenues and 82 of world RD spending in
    biotechnology. The amount of financing by private
    industry has increased 102 from

  • 1994 to 2003. Most medical research is privately
    funded. As of 2003, the NIH was responsible for
    28about 28 billionof the total biomedical
    research funding spent annually in the U.S., with
    most of the rest coming from industry. The
    National Institutes of Health play a larger role
    in funding basic research.
  • The top five U.S. hospitals carry out more
    clinical trials than all the hospitals in any
    other country. Between 1975 and 2008, the Nobel
    Prize in medicine or physiology has gone to U.S.
    residents more often than recipients from all
    other countries combined.

  • In 29 of the 34 years between 1975 and 2008, a
    scientist living in the U.S. either won or shared
    in the prize. Despite all the foregoing, and
    because of government priorities slighting
    immediate public health in favor of long-term
    research, the US pays twice as much yet lags
    other wealthy nations in such measures as infant
    mortality and life expectancy, which are among
    the most widely collected, hence useful,
    international comparative statistics.

4. Health Diet
  • A healthy diet is one that helps maintain or
    improve health. It is important for the
    prevention of many chronic disease such as
    obesity, heart disease, diabetes, and cancer.
  • A healthy diet involves consuming appropriate
    amounts of all nutrients, and an adequate amount
    of water. Nutrients can be obtained from many
    different foods, so there are a wide variety of
    diets that may be considered healthy diets.

Fresh vegetables are important components of a
healthy diet.
  • The World Health Organisation (WHO) makes the
    following 5 recommendations with respect to both
    populations and individuals
  • Achieve an energy balance and a healthy weight
  • Limit energy intake from total fats and shift
    fat consumption away from saturated fats to
    unsaturated fats and towards the elimination of
    trans-fatty acids
  • Increase consumption of fruits and vegetables,
    legumes (??), whole grains and nuts
  • Limit the intake of simple sugars
  • Limit salt / sodium(?) consumption from all
    sources and ensure that salt is iodized

  • Other recommendations include
  • Sufficient essential amino acids (???)
    ("complete protein") to provide cellular
    replenishment and transport proteins. All
    essential amino acids are present in animals. A
    select few plants (such as soy and hemp) give all
    the essential acids. A combination of other
    plants may also provide all essential amino
    acids. Fruits such as the Avocado(??), and
    Pumpkin Seeds also have all the essential amino
  • Essential micronutrients such as vitamins and
    certain minerals.
  • Avoiding directly poisonous (e.g. heavy metals)
    and carcinogenic(???) (e.g. benzene) substances
  • Avoiding foods contaminated by human
    pathogens(???) (e.g. tapeworm(??) eggs).

5. American Food guide pyramid (1992)
Chinese Food Pyramid
  • The food guide pyramid (historical) known as the
    food pyramid, and formally titled the Improved
    American Food Guide Pyramid, was published by the
    USDA(United States Department of Agriculture) in
    1992 to replace the earlier food groups
    classification system. The food guide pyramid
    suggested optimal nutrition guidelines for each
    food category, per day, using a mnemonic graphic
    of a pyramid with horizontal dividing lines, to
    represent suggested percentages of the daily diet
    for each food group. Currently published every
    five years, an update to the 2005 system is
    expected in 2010.

  • MyPyramid, released by the United States
    Department of Agriculture (USDA) on April 19,
    2005, is an update on the American food guide
    pyramid. The new icon stresses activity and
    moderation along with a proper mix of food groups
    in one's diet. As part of the MyPyramid food
    guidance system, consumers are asked to visit the
    MyPyramid website for personalized nutrition

The six divisions of the pyramid
  • MyPyramid contains eight divisions. From left to
    right on the pyramid are a person and six food
  • Physical activity, represented by a person
    climbing steps on the pyramid, to illustrate
    moderate physical activity every day, in addition
    to usual activity. The key recommendations for
    2005 (other specific recommendations are provided
    for children and adolescents, pregnant and
    breastfeeding women, for older adults and for
    weight maintenance) are

  • 1) Engage in regular physical activity and reduce
    sedentary activities to promote health,
    psychological well-being, and a healthy body
    weight. (At least 30 minutes on most, and if
    possible, every day for adults and at least 60
    minutes each day for children and teenagers, and
    for most people increasing to more
    vigorous-intensity or a longer duration will
    bring greater benefits.)
  • 2) Achieve physical fitness by including
    cardiovascular conditioning, stretching exercises
    for flexibility, and resistance exercises or
    calisthenics for muscle strength and endurance.

  • Grains, recommending that at least half of grains
    consumed be as whole grains
  • Vegetables, emphasizing dark green vegetables,
    orange vegetables, and dry beans and peas
  • Fruits, emphasizing variety and deemphasizing
    fruit juices
  • Oils, recommending fish, nut, and vegetables
  • Milk, a category that includes fluid milk and
    many other milk-based products
  • Meat and beans, emphasizing low-fat and lean
    meats such as fish as well as more beans, peas,
    nuts, and seeds

  • There is one other category
  • Discretionary calories, represented by the narrow
    tip of each colored band, including items such as
    candy, alcohol, or additional food from any other
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