Florida National UniversityHAS 3111 Introduction to Health Servi

Florida National University
HAS 3111 Introduction to Health Service Administration
Assignment 1
Read Carefully the Power Point Presentations and answer the
following questions
Chapter 1:
1. Summary the Development of Health Care from 1850-Present
2. Name the Three Perspectives on the American Health Care
System
3. Name the five individual sub-systems in the U.S. health care
system
4. Explain the Employment-related system
5. Explain the Poor and uninsured system
6. Explain the Veterans Administration system
7. Explain the Worker’s compensation system
8. Explain the Active duty military system
9. Explain the Management Strategy Perspective
10. Explain the Clinical Perspective
Chapter 2: Technology in the United States Health Care System
1. Classify the Healthcare Technology by Industrial Group
2. Name the three Stages in Development of Medical
Technologies
3. Explain the role of the Food and Drug Administration
4. Explain the Preclinical Testing
5. Explain Phase I through IV and their purpose
6. Drug Development Process
7. Explain briefly the request for Technology Assessment
8. Name the differential Impacts of Technology on Health Care
9. Explain the Impact on Individual Patients and Insurance
Beneficiaries
10. Explain the Societal and Governmental Policy Impact

Lamar University
Department of History
US History II: 1302
Writing Assignment # 2
Due: Friday September 3rd, by 11:59 PM CST
Overview:
This Writing Assignment is broken down into two parts. Writing
Assignment #1, which is due Friday August 27th and Writing
Assignment #2, which is due Friday, September 3rd by 11:59
PM CST
The assignment now because requires some research into
“strong sources.” Those sources that support your response will
require footnotes and a bibliography to present you evidence, in
CHICAGO MANUAL STYLE
The first part will not require it, but part two should have an
attempt at citing your sources using Chicago Manual style. The
video “HOW TO: Cite in Chicago Manual Style” will
demonstrate is and model the method of citing your references.
It would be the first time trying to cite in any style for many of
you, so that tutorial will be a good starting point for the
beginners and a refresher for others. Also, you may use the
web-site Purdue OwlNet
to assist you in figuring out how to cite various sources that I
do not cover in the video tutorial.
You may earn full credit for answering the questions and
attempting Chicago Manual Style for Writing Assignment #2.
Also, when saving your MS Word document in order to attach

and submit the assignment, label/save each document in the
following order:
Each response should have a cover page, and the rest be no
more than two or perhaps three pages of content. Writing
Assignment #2 will require the use of at least three “strong
sources.” Include footnotes and a Bibliography as the third and
final page.
Finally, do not forget to place [1302.49F Smith, John, Writing
Assignment #2] in the subject line of your e-mail submission of
each of your assignments. The assignments will be sent to
[email protected] by their respective due dates and times.
Writing Assignment #1 (due Friday 08/27/2021):Tell me about
yourself! In two paragraphs. The first paragraph should be
about you and you decide what to talk about. The second
paragraph should be about what your major is and what you
aspire to do with your academic interests. And the portion of
part 1 is a picture of yourself. Nothing fancy or anything, just a
picture of you so that I can put a face to a name.
Writing Assignment # 2 (due 09/03/2021): Describe the
relationship between large industries and the US government
from the mid 1800s to the turn of the century. Give at least two
specific instances of the interaction between big business and
government that supports your description of their interaction.
You may also use a specified group of people within society to
demonstrate your views.
For Writing Assignment #2, remember to footnote at least two
sources over and above your text book, for a total of three
“strong sources”. Also include a bibliography (a list of all of
the sources that you consulted), on the last page, by itself.
There are additional NOTES below for a successful paper, going

forward.
Writing Notes:
Cover Page:
Going forward, let us consider a cover page that includes the
following elements:
Course Name and Title, Name of the Assignment, Title of the
Work (as in the title of a Research paper) Date of Submission,
Your name. These are usually done in writing, so as to
contextualize the information to come that you are presenting.
Think of it as standard as a hand shake upon meeting someone
in the professional setting.
3rd Person, Reported Speech:
While it is acknowledged that the 1st person is a natural way to
handle a biography, I have asked you to write this assignment in
the 3rd Person reported speech.
All assignments, going forward will demand the usage of 3rd
person and past tense. Thus, if you could handle it here, in the
bio assignment, you will handle it in future assignments with no
issues.
Contractions:
Paragraph Structure:
This is done differently in various circles. For our purposes, let
paragraphs be from 5-7 sentences in length. New sets of
facts/topics = a new paragraph.
+++++++++++++++++++++++++++++++++++++++++++++++

+++++++++++
1st: superscript should follow the last punctuation of a sentence
(meaning: put it at the end of the sentence.
2nd: use Footnotes (at the bottom of the page) rather than End
Notes (at the end of the document).
3rd: Use superscript numbers only once- Not multiple times,
even if you are using the same sources over and over again. 1,
2, 3, 4, etc., even if you are citing the same source.
Footnote Formatting: Footnotes are almost formatted for you.
a) In the taskbar above, click the “References” tab.
b) In the third column, where it says “style” click on it and
select “Chicago 15th Edition,” or “Turabian.”
c) Place and click your cursor at the end of the sentence that
you are citing,
d) Then go to “Insert Footnote” in the taskbar and click on it.
e) The superscript will appear automatically where you had your
cursor, along with a corresponding cursor at the bottom of the
page. At the bottom of the page is where you insert your cited
information.
f) When you have finished you simply return to continue
developing your text.
g) When you wish to insert another footnote, simply repeat the
process, and do not worry about the numbering, it is done for
you automatically.
Note: even if you wish to return to an earlier point in your text
and add another footnote, you may do so without having to
worrying about numbering as that is renumbered for you.

Random internet sources are somewhat useful, but could lead
you astray. This issue here is the use of questionable sources, (
random internet sources/fake news and alternative facts) you
should rely more heavily on the assigned text book, lectures and
other sources that are more credible such as refereed journal
article sources.
Bibliography: list all sources used in a bibliography. That
appears on the last page by itself. These appear in alphabetical
order- according to the last name of the first author.
Note: All of the sources that you consult to write your papers
are to be listed in your Bibliography, even if you only use
single page in a massive 800 page book.
Sources are listed once only and are alphabetized.
Sample Bibliography
Brinkley, Alan, Unfinished Nation: A Concise History of the
American People, New York: McGraw- Hill,
2014.
Divine, Robert A., et. al., The American Story: Volume 1 to
1877, New York: Pearson Longman, 2007.
Nelson, William H., “Revolutionary character of the American
Revolution,” The American
Historical Review, vol. 70, no. 4, (Jul., 1964): 998-1014.
Whitney, David C., The American Presidents: Biographies of
the Chief Executives from Washington
through Bush, New York: Guild America Books, 1989.
Notice, all subsequent lines of any source, other than the first
are indented. Also, only the last name of the first author is

(listed) used for the considering what order the source appears.
Furthermore, regardless of the pages actually consulted for
books, no page numbers are given.
For the scholarly journal articles only, the range of pages for
article that you are referencing will include page numbers of the
entire article included.
Looking for Strong Sources?
Follow the Footnotes:
In your text book and provided materials, there are footnotes
and sources relating to the important information that they
author is using. Why not look at those provided sources that
they lay out. There is no reason to reinvent the wheel there.
Start your search there, with what they lay out before you.
Importance of Citing in Turabian and Chicago Manual Style:
Also, this is one of the reasons why learning how to cite in
Chicago Manual Style/Turabian is so important. If you can
construct them, then you can decipher those sources. So always
start there. And that subsequent source will also have further
relevant information that you can again follow up on.
From Weak to Strong:
Lastly, and another tip on finding quality sources: Start with
google and wikipedia etc. The weaker sources inevitably use
key phrases and share key events that start to form a
"vocabulary" of sorts. Note those key phrases, terms, actors and
events gleaned there and use those in your searches on JSTOR
and other scholarly journal searches. You will start to see
quality hits sooner and be able to review them instead of
meandering in only partially relevant material.

� Purdue Online Writing Lab, “Chicago Manual of Style, 17th
edition” � HYPERLINK
"https://owl.purdue.edu/owl/research_and_citation/chicago_man
ual_17th_edition/cmos_formatting_and_style_guide/chicago_ma
nual_of_style_17th_edition.html"
�https://owl.purdue.edu/owl/research_and_citation/chicago_ma
nual_17th_edition/cmos_formatting_and_style_ guide/chicago_m
anual_of_style_17th_edition.html� Accessed: 08/23/2021
� “Web Sources: General Model for Citing Sources in Chicago
Manual Style” Purdue OwlNet Date Accessed 12/11/2019:�
HYPERLINK
"https://owl.purdue.edu/owl/research_and_citation/chicago_ man
ual_17th_edition/cmos_formatting_and_style_guide/web_source
s.html"
�https://owl.purdue.edu/owl/research_and_citation/chicago_ma
nual_17th_edition/cmos_formatting_and_style_guide/web_sourc
es.html�
� See Alan Brinkley, The Unfinished Nation: A Concise
History the American People, Vol. 2: from 1877, (Boston:
McGraw Hill, 2019).
� First name of the Author Second name of the Author, Title of
the Book (City of Publication: Publisher Name, Year of
Publication), page number consulted.
� Follow the steps listed under “Footnote Formatting” to see
how to correctly insert your sources.
� Insert footnote here

� Insert footnote here
� Alan Brinkley, Unfinished Nation: A Concise History of the
American People, (New York: McGraw- Hill, 2014), 77.
� See the following “Bibliography” page. It appears alone on
the page of the document for example of how to list your
sources. Note that there are different types of sources there,
books and journal articles.
Copyright © 2008 Thomson Delmar Learning
Technology in the
United States Health Care System
Chapter 2
2
Health Care Technology
“Technology is credited with the benefits of

American medicine as well as what ails it.
It is the hope for a long, productive life for
millions of people, a primary reason for the
spiraling costs of care, and the source of
many social and ethical dilemmas...”
3
Figure 2.1 Classification of
Healthcare Technology by Industrial Group
• Pharmaceuticals
• Medical Devices
• Medical Equipment
• Medical Processes and Procedures
• Healthcare Information Technology
4

Figure 2.3 Stages in
Development of Medical Technologies
1. Scientific background and development
of the idea for a product
2. Product development, approval, and
distribution
3. Diffusion, adoption, and utilization of the
product
5
Stage 1
• Involves a broad array of basic science
discoveries that provide a fertile
environment from which useful products
may eventually emerge.
• National Institutes of Health (NIH) plays a
critical role in this stage by providing funds

to many organizations.
6
Stage 2
• Product development
– Process of moving from basic research to
implementation
• Three questions are answered during this
phase
7
Stage 2
Is there a need and a viable market for
this product?
Can an appropriate product be developed
that accomplishes what the basic science
research suggests it can?

Can the necessary tests and clinical trials
be carried out to win the regulatory
approval required for public sale and use
of the product?
8
Stage 3
• Mixture of scientific promotion to technical
experts and general marketing to the
health care system.
• Availability of health insurance coverage
for new products is a major factor in the
eventual diffusion and use of new
technology.
9
Policy Issues
1. Priorities determined by government may

take precedence over mandates set forth
by the scientific community.
2. The best way to evaluate returns from a
public investment in basic science
research.
3. Private sector benefits achieved as a
result of significant public investments in
basic science research.
10
Food and Drug Administration
• FDA must approve all drugs and
pharmaceuticals, all medical devices, and
some medical equipment.
• Clinical trials conducted during Stage 2 are
central to FDA regulatory approval.
11
Specific Methods for

Evaluating Medical Technologies
• Review by regulatory agencies
• Technology assessments used by health
insurance carriers
12
Review by Regulatory Agencies
13
Preclinical Testing
• Sponsor must evaluate the product’s
safety and biological activity through in
vitro and in vivo animal testing.
• Sponsor must:
– Develop pharmacologic profile of product’s
effects.

– Determine its acute toxicity in at least two
animal species.
– Conduct short-term toxicity studies.
14
Phase I
• Typically involves less than 100 healthy
volunteers.
• Purpose
– Observe how the drug works in humans, to
determine general safety, and to see if there
are any unexpected side effects.
• Clinical effectiveness is not measured
during this phase.
15

Phase II
• Typically involves 250+ subjects.
• Purpose
– Obtain a first reading about the potential
effectiveness of the drug and to determine
whether it is appropriate for the trial to
progress to the next phase.
• Phase II also provides additional
information on safety and side effects.
16
Phase III
• Typically involves 1000+ subjects.
• Purpose
– Determine drug’s effectiveness and to see if
side effects will need to be considered.
• If the FDA is satisfied with the results, the

sponsor must submit an application to the
FDA for approval as a new drug (NDA).
17
Phase IV
• Sponsor must continue to monitor patient
experiences with the new drug and report
any adverse events.
• Purpose
– Pick up on any previously unexpected adverse
reactions that may only appear with longer
term or widespread use of the medication.
18
Drug Development Process
• Preclinical trials

– 6 years
• Clinical trials
– 7 years
• Final NDA approval
– 1-2 years
19
Technology
Assessment by Insurance Carriers
20
Request for
Technology Assessment
• Health insurance organizations will be
approached by developers and/or
clinicians.

• Insurance organization will then request a
formal assessment of the technology.
21
Request for
Technology Assessment
• Request for assessment focuses on
effectiveness of the technology and usually
does not include any reference to cost or
price.
22
Strengths of the
Technology Assessment Process
• Rigorous review of published scientific
evidence.

• No discussion of economic or financial
details.
• Carried out in an open public forum with all
background information and discussions
available to all interested parties.
23
Differential Impacts of
Technology on Health Care
• Economic
• Clinical
• Organizational
• Industrial
• Patients and insurance beneficiaries
• Societal and governmental policy

24
Economic Impact
• Technology significantly contributes to the
rise of health care costs.
• Short-term analyses may show that the
use of new technologies significantly
increase short-term expenditures.
25
Economic Impact
• Long-term cost effectiveness analyses
may show a much more positive impact on
health status thereby reducing total health
care costs over a lifetime.
• Cost-elevating technologies versus cost-
reducing technologies.

26
Clinical Impact
• Development of new technologies has
vastly improved what physicians can do for
their patients and the outcomes that can be
achieved.
• Physicians are now faced with the
increased need to follow expert clinical
standards and guidelines in practice.
27
Clinical Impact
• Physicians are faced with competitive
pressure to be seen by their peers and
patients as up-to-date on the latest
technologies and pharmaceuticals.

• Physicians may exert pressure on
hospitals and medical groups to acquire
the latest technologies.
28
Organization Impact
• Health care organizations are continuously
pressured to maintain the latest
technologies.
• Hospitals and clinics are also faced with a
growing array of regulatory, compliance,
and legal issues.
– Many of these pressures can only be met by
an increased use of newer technologies.
29

Industrial Impact
• Technology has given rise to new industrial
organizations and has expanded the range
of many existing companies.
• The increasing complexity and expansion
of the health care system has enabled
niche organizations to serve specialized
needs.
30
Industrial Impact
• IT organizations have expanded to
accommodate an increased demand for
accessible health information.
31

Impact on Individual
Patients and Insurance Beneficiaries
• Individuals are more directly informed
about their illnesses and the treatments
available to mitigate them.
• Insurance carriers are able to reduce
overutilization and improve the quality of
their care by educating their beneficiaries
via the Internet.
32
Societal and
Governmental Policy Impact
• Both the increase in the number of
uninsured individuals and the possibility of
reduced access to the latest technology
have raised significant questions regarding

social equity and fairness.
33
Societal and
Governmental Policy Impact
• Federal government prohibition against the
importation of drugs from countries with
lower prices versus the willingness of state
and local governments to encourage such
purchases.
34
Societal and Governmental
Policy Impact: FDA Issues
• Time it takes the FDA to approve
pharmaceuticals, medical devices, and

other treatments
• FDA process may not always uncover
long-term hazards to health.
Chapter 1
Understanding Health Systems:
The Organization of
Health Care in the United States
2
Reference Table 1.1
The Development of Health Care
• 1850-1900:
– Epidemics of acute infections due to unsanitary
living conditions.

• 1900-1941:
– Development of scientific medicine and the
beginning of governmental and societal
intervention.
3
Reference Table 1.1
• 1941-1980:
– Shift from acute illnesses to chronic illnesses
• Classic model of illness
– Development of health insurance, and the
explosion of medical technology.
4
Reference Table 1.1

• 1980-present:
– Chronic diseases now include illnesses related
to environmental hazards and working
conditions, a rapid growth in costs due to
technology, and an increase in governmental
influence.
5
Social Organization
• 1850-1900:
– No formal structure.
• 1900-1941:
– The development of local hospitals and health
insurance plans.
• Mid 1960’s:
– Implementation of Medicare and Medicaid

insurance programs.
6
Three Perspectives on
the American Health Care System
1. Public policy perspective
2. Management strategy perspective
3. Clinical/patient perspective
7
Public Policy Perspective
• U.S. health care system is comprised of five
individual sub-systems:
1. Employment-related system
2. Poor and uninsured system
3. Veterans Administration system

4. Worker’s compensation system
5. Active duty military system
8
The Employment System
• Covers approximately two-thirds to three-
quarters of the total American population.
• Finances one-third of health care
expenditures.
• Collection of private employers providing
health insurance in the private sector.
9
The Poor and Uninsured System
• Local governments supported by taxes and
individual incomes are the sources of

financing.
• Services are provided by safety-net
providers and local hospitals in the public
sector.
10
The Poor and Uninsured System
• Individuals who qualify for state Medicaid
programs may obtain care in the private
sector.
11
The Veterans Administration System
• National system operated by the federal
government.
• Financed by federal tax revenues.

• Coverage is only available to military
veterans based on length of service or
service-connected disability.
12
The Workers’ Compensation System
• Care is provided to individuals who suffer
from injuries or illnesses related to work
environments.
• Insurance benefits include direct financial
support for living expenses and health care.
• Both the employer and the employee share
the cost of the insurance.
13

The Active Duty Military System
• Care is financed and provided entirely by
the military system for active-duty
members.
• Private insurance is provided to cover
dependents.
• Dependents may receive care from
hospitals and physicians in the private
sector or within the military system.
14
Management
Strategy Perspective
• In the 1980s
– Employers began to demand that insurance
companies constrain the rising costs of health
insurance premiums.

• Employers began utilizing managed care
policies to reduce their costs.
15
Management
Strategy Perspective
• This resulted in a major shift from a
“provider-controlled” health care system to
a “payer-controlled” system.
16
The Clinical Perspective
• How patients obtain care
• Basic service components provided to the
patients
• Perceived quality of care and patient

satisfaction
17
Table 1.2
The Basic Service Components
Health Promotion
Emergency Medical Services
Ambulatory Care for Simple/Limited Conditions
Ambulatory Care for Complex/Continuing Conditions
Inpatient Care for Single/Limited Inpatient Conditions
Inpatient Care for Complex/Multiple Inpatient Conditions
Long-term care (either in-home or institutional services)
Services for Social/Psychological Conditions (both inpatient
and outpatient)
Rehabilitation services (both inpatient and ambulatory)
Dental Services
Pharmaceutical Services

18
Table 1.3
Factors Affecting Utilization Rates
Consumer Provider System
Signs and symptoms Access mechanisms Contractual
arrangements
Beliefs Provider incentives Payment mechanisms
Insurance coverage Operational systems Legal considerations
Income and wealth Technology and
medical information
Networks and
providers
Information access and
knowledge
Referral arrangements

Florida National UniversityHAS 3111 Introduction to Health Servi

Florida National UniversityHAS 3111 Introduction to Health Servi

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