PUH 5301, Public Health Concepts 1 Course Learning Outcomes for Unit VIII Upon completion of this unit, students should be able to: 1. Assess current public health developments in the community. 2. Analyze key public health concepts and principles. 3. Discuss the different public health disciplines’ impact on population health. 4. Explain the role of government regarding public health practice and policy. 5. Evaluate the impact of social determinants of health on population health. 5.1 Identify ways to reduce medical costs in your community. Course/Unit Learning Outcomes Learning Activity 1 Unit VIII Reflection Paper 2 Unit VIII Reflection Paper 3 Unit VIII Reflection Paper 4 Unit Lesson Chapter 26: Is the Medical Care System a Public Health Issue? Unit VIII Reflection Paper 5.1 Unit Lesson Chapter 27: Why the U.S. Medical System Needs Reform Unit VIII Reflection Paper Reading Assignment Chapter 26: Is the Medical Care System a Public Health Issue? Chapter 27: Why the U.S. Medical System Needs Reform Unit Lesson Balancing Public Health and the Medical System Medicine is a crucial part of public health in that individuals are taken care of as opposed to the community in general. For example, public health officials could educate the community about immunizations and wellness exams to avoid chronic diseases, but it is up to the individual to use that education and visit his or her physician. Medical care is expensive, and the costs have risen over time in the United States. More money is spent every year on medical bills than public health preventive measures. There is always the debate of who is superior in the health sector—medical care or public health measures (Schneider, 2017). The government, in this situation, makes it a point of duty to set boundaries, discipline unethical behavior, and establish standards. While public health is important, the government needs to safeguard individuals’ privacy as well as religious and personal beliefs while healthcare providers are providing good care for their patients without being biased or providing improper diagnoses. UNIT VIII STUDY GUIDE The Healthcare System PUH 5301, Public Health Concepts 2 UNIT x STUDY GUIDE Title Certain types of medical care are necessary for the community’s overall health, including the prevention and treatment of infectious diseases. Public health officials try to contain certain infectious diseases by providing immunization programs and free medical treatments or testing for those without insurance. Another way public health officials try to be responsible for medical care is through emergency services. In the late 1960s, the federal government encouraged communities to provide emergency care through the assistance of public health officials, particularly in the wake of the Highway Safety Act of 1966 where it was necessary to get immediate care (Schneider, ...

1. PUH 5301, Public Health Concepts 1
Course Learning Outcomes for Unit VIII
Upon completion of this unit, students should be able to:
1. Assess current public health developments in the community.
2. Analyze key public health concepts and principles.
3. Discuss the different public health disciplines’ impact on
population health.
4. Explain the role of government regarding public health
practice and policy.
5. Evaluate the impact of social determinants of health on
population health.
5.1 Identify ways to reduce medical costs in your community.
Course/Unit
Learning Outcomes

2. Learning Activity
1 Unit VIII Reflection Paper
2 Unit VIII Reflection Paper
3 Unit VIII Reflection Paper
4
Unit Lesson
Chapter 26: Is the Medical Care System a Public Health Issue?
Unit VIII Reflection Paper
5.1
Unit Lesson
Chapter 27: Why the U.S. Medical System Needs Reform
Unit VIII Reflection Paper
Reading Assignment
Chapter 26: Is the Medical Care System a Public Health Issue?
Chapter 27: Why the U.S. Medical System Needs Reform
Unit Lesson
Balancing Public Health and the Medical System
Medicine is a crucial part of public health in that individuals
are taken care of as opposed to the community in
general. For example, public health officials could educate the

3. community about immunizations and wellness
exams to avoid chronic diseases, but it is up to the individual to
use that education and visit his or her
physician.
Medical care is expensive, and the costs have risen over time in
the United States. More money is spent
every year on medical bills than public health preventive
measures. There is always the debate of who is
superior in the health sector—medical care or public health
measures (Schneider, 2017). The government, in
this situation, makes it a point of duty to set boundaries,
discipline unethical behavior, and establish
standards. While public health is important, the government
needs to safeguard individuals’ privacy as well as
religious and personal beliefs while healthcare providers are
providing good care for their patients without
being biased or providing improper diagnoses.
UNIT VIII STUDY GUIDE
The Healthcare System
PUH 5301, Public Health Concepts 2
UNIT x STUDY GUIDE
Title

4. Certain types of medical care are necessary for the community’s
overall health, including the prevention and
treatment of infectious diseases. Public health officials try to
contain certain infectious diseases by providing
immunization programs and free medical treatments or testing
for those without insurance.
Another way public health officials try to be responsible for
medical care is through emergency services. In
the late 1960s, the federal government encouraged communities
to provide emergency care through the
assistance of public health officials, particularly in the wake of
the Highway Safety Act of 1966 where it was
necessary to get immediate care (Schneider, 2017). Part of the
emergency care was the creation of 911
services, dispatch ambulances, and trained emergency
personnel.
In addition, state and federal laws require that everyone should
be treated and stabilized in the emergency
room before payment is requested. After the patient is
stabilized, any uninsured or poor patient is then
transferred to a charity or public hospital.
Paying for Medical Costs
Employers usually provide health insurance
in the United States, which covers the
employee and his or her family. This has
assisted many families for decades, as they
do need to worry about major medical bills.
Another way people have been covered is
through their car insurance. In the case of
an accident, patients pay their deductibles,
and the car insurance takes care of the rest.
If the person not at fault in the accident goes

5. to the hospital, the insurance of the person
at fault takes care of his or her medical bills.
Health insurance is extremely important
because patients usually pay deductibles at
the beginning of the year and also have
copayments when they go to the hospital as
opposed to paying large sums of money if
they are without insurance.
Community health centers are also good places to pay for care,
especially for the poor and uninsured
because the copayment is decided by annual income and the
family size. The United States hosts over 1000
community health centers, and many of them are located in rural
areas to serve local communities
(Schneider, 2017). These community health centers are also
used by public health officials to educate
communities on certain problems in their communities and how
to tackle them.
School children have been major carriers of communicable
diseases, so communities began to employ
nurses and doctors to examine potentially sick children and send
them home before their diseases spread. In
December 2017, about 150 students were exposed to
tuberculosis at Hanks High School in the Ysleta
Independent School District in El Paso, Texas (Martinez, 2017).
This came as a result of one of the students
who tested positive for the disease.
The problem with immunization is that many people do not
vaccinate their children for personal and religious
reasons. As you may remember from an earlier unit, in Orange
County, California, there was a measles
outbreak in Disneyland, which was not strange considering that

6. only 60% of children had been vaccinated in
that county. As a result, the personal belief exemption was
abolished in Orange County in 2015 (Schneider,
2017). In these situations, it becomes expensive to eradicate the
spread of the disease due to those children
without medical insurance and those who choose not to
vaccinate.
The United States has attempted several times to provide
universal health insurance like in Canada, Hungary,
Netherlands, and other industrial countries. The attempt that
was closest to success was the Affordable Care
Act or Obamacare of 2010. Medicare was initiated in 1965 for
people over 65 years, and Medicaid is for the
poor; both are expenses shared by the federal government and
states (Schneider, 2017). In 1992, President
Health Care and Costs Balance
(Sermulis, 2015)
PUH 5301, Public Health Concepts 3
UNIT x STUDY GUIDE
Title
Bill Clinton also attempted to initiate a universal care system.
While that was unsuccessful, he created a
health program to serve all poor children called the Children's
Health Insurance Program (CHIP). This was to

7. serve people who may not qualify for Medicaid but do not make
enough to afford private insurance.
Ethical and Legal Issues in Providing Medical Care
One of the major legal issues in the United States is abortion.
The country is divided between when, why, and
who might have an abortion and the right to life opinion that
life begins at conception (Schneider, 2017). The
present situation in the United States is characterized by high
division and intense conflicts that is not as
common in other industrialized countries (Beckman, 2017). A
bitter battle between two opposing ideologies
remains at the root of abortion politics in the United States.
Those who are in support of abortion view it as a
right that is necessary for social equality and justice for women,
while those who oppose it see abortion as a
threat to social cohesion, motherhood, spirituality, and morality
(Beckman, 2017).
Another legal issue that has caused controversy is the right to
life when someone is faced with a terminal
disease. The Right to Die or Death with Dignity laws are
another social or religious controversy in the United
States. The first one was passed in Oregon in 1994, followed by
Washington in 2008, and others like Vermont
in 2013, California in 2015, Colorado in 2016, and Hawaii in
2018 followed suit (CNN, 2014). While it still
remains a controversy, several other states are thinking of
enacting the right for patients to choose how and
when they die when faced with a terminal disease.
The right to end life has also been a problem with people who
have suffered brain death or are on life support.
While some families supported the fact that a life on life
support is not a quality life, others argued that it was

8. life as long as the person is breathing (Schneider, 2017). Some
popular cases were those of Nancy Cruzan,
Terri Schiavo, and Karen Ann Quinlan.
Rising Costs of Health Care
It is obvious the United States’ medical system needs reform,
specifically with the issues in the Affordable
Care Act, difficult access to Medicare, and quality of care for
all (Schneider. 2017). Although health
expenditure is high in the United States, more Americans are
unhealthy. In 2011, the United States ranked
27th out of 30 industrialized countries in infant mortality rates,
and life expectancy at 65 years was ranked at
25th out of 34 for woman and 20th out of 34 for men
(Schneider, 2017).
To top it off, access to medical care is difficult. For example, in
2013, over 13% of Americans did not have
insurance for the entire year, while many more did not have
health insurance for part of the year (Schneider,
2017). The access problem is related to the cost—high monthly
premiums, deductibles, and copays. The
United States has the highest number of uninsured people of any
other industrialized country. Medicare and
Medicaid are also hard to access with about 14% of the income
of elderly people being used to pay out-of-
pocket medical costs (Schneider, 2017).
Some reasons for the high or rising healthcare costs are as
follows.
is funded by states and the government.

9. development of medical technology, it is
sometimes not covered by insurance or has copays that are too
expensive.
he medical budget in
the United States was used for
administrative purposes (Schneider, 2017).
chronic diseases like type 2 diabetes,
cancer, and heart disease. While public health encourages
preventive health measures, most
Americans do not participate and have to deal with high bills
that may never be paid after they are
diagnosed with a chronic disease.
Controlling Medical Costs
About 44% of medical care is paid by local, federal, and state
departments and about 21% by private
insurance (Schneider, 2017). Therefore, the local, state, and
federal departments try to work with public
health officials on how to reduce these costs by working on
preventive education for their local communities.
PUH 5301, Public Health Concepts 4

10. UNIT x STUDY GUIDE
Title
Another way of trying to reduce medical costs is limiting
spending on new technology and facilities. Medical
care spending rises steadily in the United States, causing a stir
for health policy makers. Public health officials
generally point to new medical technologies as the main driver
for escalating expenditures (Sorenson,
Drummond, & Bhuiyan Khan, 2013). Therefore, the government
is constantly looking for ways to reduce that
expense. This is particularly noticeable with new treatments for
certain diseases like cancer. People are
constantly going for less invasive surgeries; however, those
surgeries are the most costly because of the
technology involved.
Employers try to keep costs down by bargaining with providers
for discounted services. One of such discount
services is a preferred provider organization (PPO); this is a
health plan that allows for medical providers
(doctors and hospitals) to create a network of participating
providers. It allows for the patients under the plan
to pay less to providers that are within that network (Schneider,
2017). One company that uses this plan is the
University of Texas where members are able to get many health
problems resolved with discounted prices.
Conclusion
The United States has the most expensive healthcare system in
the world, which also has many flaws
including uninsured people, difficult access, and expensive
copays and deductibles. Even though the

11. Affordable Care Act reduced the number of uninsured, it also
created several problems for families including
high deductibles and copays. While public health officials feel
like rationing or controlling the cost of medical
care, the quality of care for all is still a challenge.
References
Beckman, L. J. (2017). Abortion in the United States: The
continuing controversy. Feminism & Psychology,
27(1), 101-113. https://doi.org/10.1177/0959353516685345
CNN. (2014, November 26). Physician-assisted suicide fast
facts. Retrieved from
https://www.cnn.com/2014/11/26/us/physician-assisted-suicide-
fast-facts/index.html
Martinez, J. (2017, December 7). About 150 Hanks High School
students may have been exposed to
tuberculosis. Retrieved from
http://kfoxtv.com/news/local/about-150-yisd-students-may-
have-been-
exposed-to-tuberculosis-health-officials-say-12-07-2017
Schneider, M.-J. (2017). Introduction to public health (5th ed.).
Burlington, MA: Jones & Bartlett Learning.
Sermulis, E. (2015). Health care and costs balance
[Photograph]. Retrieved from

12. https://www.dreamstime.com
Sorenson, C., Drummond, M., & Bhuiyan Khan, B. (2013).
Medical technology as a key driver of rising health
expenditure: Disentangling the relationship. ClinicoEconomics
and Outcomes Research, 2016(5),
223–234. https://doi.org/10.2147/CEOR.S39634