Question

Tom worked as a manager for a corner grocery store that employed five people. The grocery store does not provide health insurance for its employees due to the expense. Tom, his wife, Mary and their three kids were uninsured. Tom’s wife did not want to incur any medical bills and ignored a mole on her chest. After many months of delay, Tom insisted that she see a dermatologist. She was diagnosed with malignant melanoma, which had metastasized. She died two years later at the age of 37, leaving Tom to raise their three children.

1. Identify primary, secondary and tertiary interventions and explain how each one might have changed the outcome for Mary.

2. How can access to health care be assured for all patients, regardless of the source of their insurance?

Answer 1

Q1 answer. Prevention includes a wide range of activities — known as “interventions” — aimed at reducing risks or threats to health

Primary Prevention aims at prevent disease or injury before event occurs: Primary prevention is that set of interventions that keeps a cancerous process from ever developing and includes health counseling and education, environmental controls and product safety as examples This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviors that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur.

• Legislation and enforcement to ban or control the use of hazardous products or to mandate safe and healthy practice
• Immunization against infectious diseases

Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. Secondary prevention is that set of interventions leading to the discovery and control of cancerous or precancerous processes while localized, i.e., screening, early detection, and effective treatment

• This is done by detecting and treating disease or injury as soon as possible to halt or slow its progress, encouraging personal strategies to prevent re injury or recurrence, and implementing programs to return people to their original health and function to prevent long-term problems.
• Regular exams and screening tests to detect diseases in its earlier stages

Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects. This is done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic diseases, permanent impairments) in order to improve as much as possible their ability to function, their quality of life and their life expectancy.

• Cancer rehabilitation programs
• Chronic disease management program
• Support groups that allow members to share strategies for living well
• vocational rehabilitation programs to retrain workers for new jobs when they have recovered as much as possible

Q2 answer . Health insurance is insurance that covers the whole or a part of the risk of a person incurring medical expenses, spreading the risk over a large number of persons. By estimating the overall risk of health care and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity. According to the Health Insurance Association of America, health insurance is defined as "coverage that provides for the payments of benefits as a result of sickness or injury. It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment"

Uninsured people are less likely than those with coverage to receive timely preventive care. Silent health problems, such as hypertension and cancer, often go undetected without routine check-ups. Uninsured nonelderly adults, compared to those with coverage, are far less likely to have had regular preventive care, including blood pressure, cholesterol checks, and cancer screenings. Uninsured patients are also less likely to receive necessary follow-up screenings after abnormal cancer tests. Consequently, uninsured patients have increased risk being diagnosed in later stages of diseases, including cancer, and have higher mortality rates than those with insurance.

1. We have an obligation to treat people as equals.
2. Treating people as equals is best achieved by giving people equality of resources (and this idea can in theory be shown to be coherent by devising an appropriate initial auction, combined with appropriate post-auction trades and insurance schemes against disadvantaging outcomes).
3. Suppose we had equality of resources in the U.S., for example, that income and wealth were equally distributed, and that all people had information about health care interventions and their effects as good as what the best doctors have, and that no one has prior information about the specific risks faced by specific individuals.
4. Then each person could act prudently to buy insurance protection against various health needs without government subsidies or otherwise distorted markets.
5. What most people would prudently insure themselves against ought to be included in a universal access health system. (Some kinds of protection would thus be imprudent to include and we should abandon a rule of rescue that included them.)
6. Where there is disagreement about what people count as prudent insurance (some would buy it, others not), then we need to consult with representative people of different views and make decisions about universal coverage that reflect that consultation.
7. Government has to take initiative and make health as a primary right to its citizen by providing 100% coverage.