HREQ 1930 Study Guide - Final Guide: Biomedicine, Blackberry, Respiratory Disease

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apricotseal471

4 Apr 2013

School

York University

Department

Human Rights and Equity Studies

Course

HREQ 1930

Professor

John Kucharczuk

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Document Summary

Chapter 9: politics, public policy and health inequalities. Policy is a course of action that is anchored in a set of values regarding appropriate public goals, and a set of beliefs about the best way of achieving those goals. Public policy implicitly argues that an issue is no longer a private affair. That issue has consequences for collective well-being and must be regulated. There is always debate as to whether an issue is private affair or a public matter. Equally, there is debate about public goals and how they ought to be achieved. Crucial to remember that public policy is shaped by political, economic and social forces. Examples include the long-gun registry in canada and the gun ownership in the u. s. Yet, policy is inescapable in relation to many aspects of collective life. Since many issues have implications for collective well-being. Recall that health is a function of a variety of social determinants, including health care and services.

Related Questions

PROVIDE A RESPONSE OR STATEMENT TO THIS STUDENTS DISCUSSION:

1 - Please share your experience on selecting a managed care plan. Please discuss the advantages and disadvantages of your MCO plan.

Up until about ten years ago my company offered an HMO MCO plan option managed by Kaiser Permanente. This plan was less expensive in my paycheck deduction and offered $10 co-pays for every office visit and 100% hospitalization. In 1992 as a single young man in my twenties I found this option very attractive. I ended up getting married early that year, had a flu episode and a bout of food poisoning. My wife ended up with a hospitalization as well. What looked good on paper ended up being a very restricted healthcare experience. My office visits were restricted to only one clinic where the health care professional point of contact were physicians assistants under the supervision of an MD which we never saw. All of the prescriptions were for generic medicines and when my wife was hospitalized she was not allowed branded medicines either. We also thought she was discharged too early. The advantages of this type of plan are costs and simplicity. If we had not been sick that year we probably would have signed back up for it. The disadvantages were that our level of care was reduced to a less skilled health care professional and the attending physician who cared for my wife in the hospital discharged my wife early due to a time limit the HMO had placed on the length of stay for her illness code. That was the first and last year I chose an MCO plan for my health coverage.

2 - Many argue that there is no consistent, direct correlation between the cost of care and its quality in a managed care program. Do you agree or disagree?

In my personal experience managed care plans attempt to lower the primary care contact to non MD health care professionals such as Nurse Practioners and Physicians Assistants. While these clinicians are well trained and certainly have their appropriate place in medicine, they do not have the extensive medical training that MDs and DOs spend a minimum of 8 years mastering. These clinicians cost less than MDs and are very attractive way to reduce staffing costs. As a patient however I prefer the highest skilled level clinician caring for me and my family and am willing to pay more for this higher level of care. In my opinion Kaiser Permanente may have saved money but I was not happy with the level of care and medicines provided. They may have saved money that year but they lost me as a customer. Epstein et al, (2014) compared Accountable Care Organization (ACO) patients with non ACO patients and while they found that there were many differences in spending, age, and severity of illness, there was no difference in quality metrics despite non ACO members costing more overall. It would seem that in this example costs can be lowered without affecting quality outcomes. However ACO participants had access to significantly more participating clinicians and hospitals. What is missing from this study is a patient survey comparing the satisfaction of ACO and non-ACO patients.

3 - Do you think patients' choice of provider and access to care will be limited under ACOs?

In my personal experience and through observations of managed care offices and hospitals as a pharmaceutical representative, ACOs not only restrict the choice of provider and access to hospitals they utilize lesser trained medical professionals in Primary Care, Specialty and Hospitals in addition to restricting access to branded medications. This observation is in agreement with Epstein et al, (2014) in which ACO members cost less but had less access and choice of participating access points and clinicians.

4 - In what ways can an ACO succeed in both delivering high-quality care and spending health care dollars more wisely?

ACOs can be very useful in curbing costs. For those with limited health care budgets or those patients who receive public assistance an ACO model whether public or private. However Lewis et al, (2014) found that even though there was an almost even split between ACOs contracting for private and public contracts in the U.S.A., public contracts were less profitable than private ones due to public patients costing more to manage per capita than private ones. Quality was not examined. It would seem that an ACO would be ideal when faced with limited resources but ACOs may be reluctant to engage in contracts that are less profitable.

write six recommendations based on below studies:

write a conclusion about below studies:

1- Sharma (1997) evaluated organizational commitment and its determinants in a private sector manufacturing organization with a sample of 200 respondents from skilled workers, resulted that both situational and personal factors contribute to workersâ commitment to organization. Between the two, situational factors contribute more to commitment than do person-related factors. Organizational characteristics (such as adequacy of resources) and two task characteristics such as task difficulty and task.
2- Reddy, et. al. (2000) in their study of organizational climate and dual commitment in private and public sector enterprise focused on examining the workersâ dual commitment- both organizational and union commitment- in the context of organizational climate. The study was conducted in four public and four private textile organizations of Coimbatore by interviewing 200 respondents. The study revealed that organizational climate has an important role in determining organizational commitment and not union commitment.
3- Ponnu and Chuah (2010) in their study organizational commitment, organizational
justice and employee turnover in Malaysia investigated the relationship among
organizational justice, organizational commitment and turnover intention of Malaysian
employees. The study based on the responses of 172 employees of Malaysia and found
that both procedural and distributive justice perceptions were significant contributors in
explaining organizational commitment and turnover intention. Further, found
significant, strong and positive relationship between organizational justice and
organizational commitment. On other hand, there was a significant, strong and negative
relationship between organizational justice and turnover intention.

4- In a scientific research which was conducted by Syed Azeem(2010, job satisfaction and organizational commitment among employees in Oman), with a sample of 150 employees from government sector and private sector through distributing questionnaires. It was found that the job satisfaction and age variables were the most dominant factors that affect the organizational commitment in Oman.
5- A study was conducted to determine MARA Professional Colleges lecturersâ perception on organizational commitment. The study builds on social exchange theory and organizational model to identify the factors influencing the organizational commitment of these lecturers. The study analyzes whether or not there is a significant relationship between job satisfaction, job involvement, perceived organizational support and organizational commitment among lecturers in MARA Professional Colleges. Data were collected via questionnaires from 132 lecturers of three different MARA Professional Colleges. The findings of the survey show there is a significant relationship between job satisfaction, job involvement and perceived organizational support. Job involvement contributed the most which is 28.8%, followed by perceived organizational support 23.9% and job satisfaction contributed 9.4% towards organizational commitment among MARA Professional College lectures. The results suggest an improvement of social change by increasing job involvement, perceived organizational support and job satisfaction is an efficient way of obtaining highly committed human resource. The results of the study have valuable implications for policy makers in MARA Higher Education Division, college administrators and educators.
6- Elina Anttila (2014, components of organizational commitment under a case study consisting line managers from Finnish industrial company) aims to find factors affecting employeesâ organizational commitment within the case organization as well as point out some strengths and weaknesses the company has in this area. The company studied is Finnish multinational industrial company. The sample of this qualitative study consisted of nine Finnish first level managers from different segments of this company. The data was collected using theme interviews and qualitative attitude approach. Therefore, the analysis was also conducted in two separate ways. The data from theme interviews was analyzed using thematic content analysis while the analysis of the data from qualitative attitude approach followed the principles of that method concentrating on explanations of stance taking. As a result of this study, the factors affecting the organizational commitment in this organization can be divided into three categories. The first one consist matters directly linked to the company itself. The second category has factors linked to the work community. Finally, the third is formed by factors related to the work characteristics. Companyâs strengths lie in itsâ interesting field of business and variety opportunities it can offer for employees globally.

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6. Though political pundits on television and radio inform the public, they also have to be concerned with

a. Entertainment value to increase their ratings.b. All of these.c. Making their audiences feel better about America.d. Being factually correct.

7. Social movements have been important sources of social, political, and economic change in the United States.

a. TRUEb. FALSE

8. A double standard exists on the part of advocacy organizations because issues facing advantaged subgroups get more attention than those facing disadvantaged subgroups.

a. TRUEb. FALSE

9. Contemporary political observers echo the two views of de Tocqueville and Madison in how they view the role of political groups.

a. FALSEb. TRUE

10. A national advocacy organization is an interest group

a. That only represents businesses.b. That informally represents broad groups of Americans who have similar interests.c. That represents all Americans whether they are powerful or not.d. That only represents minorities or people with less power in society.

11. The American people believe that justices on the US Supreme Court

a. None of these.b. Should be appointed for life.c. Should be elected and only for a 10-year term.d. Should be elected for life.

12. Regional, cultural, religious, occupational, and ethnic diversity all tend to increase the formation of political groups and social movements.

a. FALSEb. TRUE

13. In the United States, political parties are

a. Relatively rareb. Are a relatively accidental feature of the American historyc. None of thesed. Mentioned in the Constitution

14. Why are interest groups, political organiztions, and social movements so numerous in the US?

a. All of these.b. Because federalism and the separation of powers have created multiple points of access to political institutions.c. Because of the 1st Amendment, which protects speech. association, and the right to petition the government for redress of grievances.d. Because the way people are elected to Congress does not do a very good job of representing minorities, who have to find other ways of getting their needs met.

15. What is the margin of error for a sample of 1000 voters?

a. Plus or minus 3%.b. Plus or minus 1%c. Plus or minus 5%d. Plus or minus 2%

16. E.E. Schactschneider says about the interest groups that claim to work for poor people

a. That they may be making things worse for these people.b. That they do a good job even without handing out small benefits to attract people to their group.c. None of these.d. That they are able to accomplish a great deal even though the poor do not join those groups.

17. Why do the campaign staffs of presidential candidates pass up large states like California and Texas to concentrate on smaller states like New Mexico or Ohio?

a. The large states are just a few and there are more votes altogether in the small states.b. It is easier to persuade people in the small states.c. The large states are reliably red or blue, so the campaigns go after states where the vote is closer and they can take all of the votes even with a small win.d. The large states are just too expensive for campaigning.

18. Jackson notes that equality is generally defined as

a. Equality of process.b. Equality of opportunity.c. Equality of outcomes.d. Equality of results.

19. In an open primary, the voter can choose which primary election--Democratic or Republican--he or she would like to vote in.

a. TRUEb. FALSE

20. The womenâs movement can be very active on an issue such as affirmative action in higher education, which afffects their more affluent members, but overlook welfare reform, an important issue for their more disadvantaged or marginalized members.

a. TRUEb. FALSE

21. It is sometimes called "first-past-the-post" and sometimes "winner-take-all," but this kind of election means

a. No matter how many votes are cast and how many candidates the one with the most votes wins.b. None of these.c. The candidates have to have run-off elections until one wins two thirds of the votes.d. The top two candidates have to have a run off election.

22. Public opinion matters because in a democratic system we believe that government policy should follow the public will.

a. TRUEb. FALSE

23. With regard to ideology, Americans

a. Tend to identify with a party by their mid 20s.b. Tend to choose a political affiliation early in life.c. Tend to stay identified with a political party consistently the rest of their lives.d. All of these.

24. Alexis de Tocqueville

a. Found few religious associations in America.b. Wrote at the time of the American revolution in the 1780s.c. Wrote his great book Democracy in America at a time when Americans were forming many interest groups and associations in the 1830s.d. Was appalled at the number of commercial and manufacturing associations he found in America.

25. According to Strolovitch, in judging the effectiveness of an advocacy organization which claims to represent the marginalized,what are the guiding questions we should ask?

a. How active for the intersectionally marginalized are they? Because without that the organization is a failure.b. What coalitions do they form? Because coalitions are the key to success.c. What institutions do they target and what coalitions do they form? Because the political activity is the most important barometer.d. How active for the intersectionally marginalizedn are they, what institutions do they target, and what coalitions do they form?

26. How do the two dominant political parties prevent minor parties from emerging?

a. By using their vast funds and media resources to disparage minor party candidates.b. By refusing to give successful third party candidates leadership positions in the legislature.c. By poaching popular third party candidates before they begin to help their party.d. By manipulating election rules in debates and public funding to discriminate against the minor parties.

27. Since 1836, the republic has been dominated by how many political parties at a time?

a. Threeb. Fivec. Oned. Two

28. As sample size increases, the margin of error

a. Is greater than or equal to the margin of error.b. Stays the same.c. Decreases.d. Increases.

29. Affirmative advocacy

a. Looks for over-represented and under-represented issues in setting the agenda for activityb. Actively seeks out coalitions and works with others at the state and local levelc. All of thesed. Has a proactive agenda

30. The cell-phone only population is likely to include more young people, which pollsters have to take into account

a. TRUEb. FALSE

31. One method that schools use to politically socialize young people is

a. Ask students to watch TV news.b. Tell students who to vote for.c. Ask student to participate in mock elections.d. Ask students to read newspapers.

32. In addition to the legislative branch, advocacy groups target the executive and judicial branches.

a. TRUEb. FALSE

33. The problem with opt-in internet panels is that

a. Participants self-select, leaving out significant sections of the public.b. All of these.c. They have a greater margin of error.d. They do not use scientific methods.

34. An example of an organization which claims to represent a large demographic group is

a. The National Association for the Advancement of Colored People (NAACP).b. All of these.c. The Japanese American Citizen's Leagues (JACL).d. The National Organization of Women (NOW).

35. Conservative and liberal ideologies differ mostly on

a. Campaign finance reform.b. Defense policy only.c. Economic and social issues.d. Civil rights.

36. Despite the fears of some that advocates for marginalized groups appeal to the courts too much, evidence shows that they in fact use the courts reluctantly and as a last resort.

a. FALSEb. TRUE

37. Are Americans more likely to vote in presidential elections than other types of elections?

a. No, Americans like to vote for direct democracy issues rather than indirect democracy representation.b. Yes, consistently American participate in presidential elections over other elections.c. Only in years when the presidential election is particularly interesting.d. No, because Americans are more interested in local issues.

38. The key way in which political parties enable democracy is

a. They stimulate interest among members of the mass publicb. All of thesec. They keep elected officials responsived. They allow a broader spectrum of participants to become involved in politics

39. In democracies around the world, multi-party systems are much more common and one sees small parties that advocate for one issue, one religion, or one demographic group.

a. TRUEb. FALSE

40. Poll results vary based on

a. Whether the method used was approved by the Census Bureau.b. Mean, median, and mode.c. Survey mode, sample size, and population definition.d. The statistical application of the Weights and Measures Bureauâs guidelines.

41. Voters who like a third party are nevertheless inclined to vote for a dominant party candidate for fear they will waste their votes.

a. FALSEb. TRUE

42. National organizations that file amicus curiae briefs are targeting

a. The Congress.b. The courts.c. The presidency.d. The Federal Reserve Bank.

43. Small racial, ethnic, or religious groups in the US

a. Don't have quotas for seats in the schools or government as they do in India.b. Do not have a party which is dedicated to their interests.c. Do not have legislative representation as is the cases in other countries with proportional representation.d. All of these.

44. When is the candidate's website NOT a good source of information?

a. To find more information about the candidate's biography.b. To find out more about the candidate's positions on the issues.c. To find an unbiased account of the candidate's voting history.d. To find out which prominent people and organizations support the candidate.

45. According to the "funnel of causality," party identification is more psychological than anything.

a. FALSEb. TRUE

46. The agencies which connect people to government are called "linkage mechanisms."

a. TRUEb. FALSE

47. Some theorists argue against the pluralists with a "rational actor" argument that says

a. That people are rational and want to maximize benefits and minimize effort, so they do not spend their time and resources to organize.b. That rational people always seek public goods.c. That it is rational to organize to acquire more public goods.d. That rational people really do not want the public goods as much as theorists think.

48. According to Jackson, the digital revolution has given us more information about the candidates,

a. And the candidates usually approve of the things written about them.b. And the information is usually quite accurate.c. But the information is not always accurate.d. But it is not very detailed.

49. Red states mean states that usually vote for the Democratic Party, while blue states mean those that are reliable for the Republican Party.

a. FALSEb. TRUE

50. According to Jackson, what is a core political value that nearly all Americans accept?

a. Equalityb. Democracyc. Libertyd. All of these

HREQ 1930 Study Guide - Final Guide: Biomedicine, Blackberry, Respiratory Disease

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