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Lecture

HLTC05H3 Lecture Notes - Generic Drug, Doha Declaration, Atorvastatin


Department
Health Studies
Course Code
HLTC05H3
Professor
R Song

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10-23-2012
HLTC05H3 F
Lecture 6: Doctors, Drugs, and Global Health
Martin Luther King Jr.= “Of all the forms of inequality, injustice in health care is
the most shocking and inhumane.”
oHealth care is a significant determinant of health
Health care and managed care in the developed nations
What is the future of Medicare in Canada?
oPublic healthcare that is nationalized
Market-based healthcare vs public healthcare
oHealthcare in the US is increasingly market-based and is shaped by the
competition, commercialization, and corporatization of the health industry
oIncreasing growth of profit margins and economic growth and salaries of
CEOs
oServices outsourced to HMOs and MCOs
oRunning of healthcare on prevention and integrative services
Maintaining costs and spending
Sticking to a particular budget
Incentives present in HMOs and MCOs
Lower cost, greater efficiency, better quality care w/market-
based health care which has not occurred in the US
With the growth of TNCs and economic growth has led to more
privatized healthcare
Explicit rationing= cutting services that are considered
unnecessary which is problematic because it reduces access
and quality of care
Make profit

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Evolved in the US around the time of welfare reforms in the
late 1980s and early 1990s
Consequences opposite of the intended goal
Increase in costs and spending
oAdministrative costs
Resulted in poorer quality care
Widespread rationing has increased costs and fees which
leads to unequal access
oImportant issue of noncompliance
oRising number of uninsured people
Worsening health
oMedical profession that is becoming profit-driven
rather than altruistic
oStrain on the healthcare safety net in the US
Healthcare facilities that in a more democratic
setting
Faced with public funding cuts
Process over the last 30-34 years w/the onset
of neoliberal ideology
Marketization
oWidening disparities across different [social]
determinants of health and also different sections of
the population in the US
oMajor mechanism of structural violence on human
bodies
oConsequences for the patients who become clients in
the market-based medicine
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oHMOs generate a lot of profit while not being more
efficient in their own spending vs. nationalized
healthcare
oMarket-based healthcare in the US has driven up
costs
oSpecialized entity= private clinics and facilities
(managed medicine; concierge medicine)
Exclusive sort of clinics; for a fee, ensure
access to a doctor, not including other fees
Walk-in clinics in Canada but is not
exclusive in the US
Operation of private-care in Canada that
follow gov’t guideline for pay for doctors
and fees
Canada Health Act is thought to be very
restrictive and why doctors argue that
private care should be in Canada
Market-based healthcare in the US follows Neoliberal
ideology for the Health Care Sector
oLook @ slide 10
Medical rationing results in how many people can doctors,
nurses, administrative staff see at a given time; labeling
[certain] patients as non-compliant= excluding certain
people as being non-compliant which is problematic and
drop off the radar for those nurses and doctors
oProblem for marginalized groups of people and
impoverished populations
The issue of stigma of certain diseases
Negative public opinion of certain diseases and
could lead to problems in later life if added to
the judgment of non-compliance
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