January 17, 2012 1. What do healthcare Administrators do? a. Manage a private practice i.

One person usually a chief business officer b. Manage a Hospital Department i. Clinical Department ii. Support Department c. Manage Facility i. Nursing Home d. Professional School i. Nursing, PT, OT, etc. ii. Academic side HC Admin e. Public Health System i. We are one of the few private health systems ii. However we still have a government and a public health suste, f. Health Insurance Companies 2. What are their responsibilities? a. Financial management i. Accounting, billing b. Budgeting c. Marketing i. Public relations, development, advertising d. Human Resources Management e. Billing and Collecting Money = Collections f. Crisis Intervention i. Adapting ii. Counseling 3. Education of Healthcare Administrators a. AU offers B.A. in Health Care Administration only place in US that offers BA for it all others only MA i. Business related b. 3 Degrees you can go into afterwards i. MBA Masters Business Administration ii. MHA Masters Health Administration iii. MPH Masters in Public Health c. Business aspect i. Accounting, economics, strategic planning, public speaking, law, sometimes real estate & computer skills 4. Theme: American Healthcare System is in trouble Why is it in trouble?

January 19, 2012 Overview of the American Healthcare System 1. Phase 1 - 1850 1900 a. Mostly European Medicine b. 2 hospitals i. Massachusetts called Massachusetts General 1. Larger of both 2. Remnants of it still remain ii. New York called Bellevue 1. Used to be a general hospital 2. Phase 2 - 1900 1945 a. American Method of Medicine (Scientific) b. Men would go to Medical School, the first of which was Johns Hopkins c. Medicine would be practiced as Universal Medicine 3. Phase 3 1945 1980 Most Significant a. Coming out of World War II i. Baby-boom - A time where most babies were born in this country. ii. Many men and women came home from oversees. (New Families) iii. A lot of people had to be taken care. b. Medicine was provided by a cash basis (cash base medicine) i. Doctor with a black bag (and Mercedes Benz) would come to the house when sick House Call $25. Everything needed was in the bag. ii. People at the time were able to pay the doctors iii. Medicine grew by leaps and bounds (1955) 1. Polio vaccine was discovered, penicillin, etc. (Discoveries) New Machines 2. Things became expensive; no one was able to pay for it all. c. Health Insurance was invented i. Blue Cross/ Blue Shield Company that (Originated in Minnesota) 1. Licensed the right to other companies to operate BC/BS programs in other parts of the US. Used Franchise Model. a. A Company that has come up with a business concept and they then sell the right to duplicate that to private people. (McDonalds, D&D) b. Independence BC/BS in Pennsylvania ii. Concept of Health Insurance 1. They sell their product to employers and employers pay them a premium (Insurance policies) 2. By paying the amount to BC/BS the employers are able to cover their employees. 3. Employees 100% covered with Health Insurance by each company. a. No longer today b. Company used to cover the whole family. c. People hated their jobs but stayed for the health insurance. 4. Still number one health insurers in the US. iii. B/C we had all these people to take care of we had to build more hospitals

1. Hill Burton Act A congressional Legislation passed by the US Congress, they gave money to communities throughout the country to build hospitals. Care was exceptional! 2. (1960) basically a hospital on every street corner. Hospitals basically built in neighborhoods. Built through government money. iv. Needed Universal Way of Funding Research (1955) National Institute of Health (NIH) 1. Congress instituted 2. Where most of tax money is disseminated. 3. Funds Research 4. Decides what scientist gets what money. v. 1965 We realized people were getting older but had no money so the government created Medicare 1. To take care of older people to provide Healthcare 2. Closest we have to a National Healthcare System a. Which we do not have but other countries do. 3. Medicare Federal Program 4. Medicaid State Program vi. Women were now going to Medical School. 4. Phase 4 1980 Current a. American Healthcare System is in trouble b. We have amazing machines that are expensive i. We can now go to a doc and get a pill w/ a cam in it and doc could watch the passage of the pill c. We still have trouble financing healthcare d. With all the great stuff in this country theres still people walking around with no access to healthcare. Not even access to doctor. e. Major Factors Affecting Medicine i. Growth in Technology but expensive ii. We have an aging population 1. With science we have people walking around in their hundreds 2. Also living old sick people (How do we take care of them?) 3. 1970 avg age of death 70 iii. Inequality in the Healthcare System iv. Employers stopped providing Healthcare v. Government programs mismanaged 1. We almost came close to bankruptcy many times. 2. Obama wanted to revamp program but didnt happen vi. Despite advances we still have a high incidence of disease (AIDS) vii. Healthcare used to be a non-profit business, meaning whatever they made went back into the hospital. 1. Now many hospitals are for profit institutions, we have investors not in medicine hoping the hospital makes money. a. Issue: Profit or Quality of care? i. Many believe we cant have both. How is Healthcare Measured? Healthcare is a statistically based measure

1. 2. 3. 4.

o Thats how it gets money / thats how it presents its case to people who can give it money. By population By disease treated what kind of diseases are we treating as clinicians? The dollars spent How much money is spent on this disease or research? Quality of care dependent on the minds of different people such as the doctor patient and administrator. Quantitative How many (have cancer or disease)? Qualitative Observation

American Perception of Medicine Up to 1980 having good healthcare was a privilege 1980 onwards I have a right to good healthcare Medical Care was reactive for decades Now we use preventative medicine = concept of wellness o American System we try to keep you healthy Mindset among Americans o Many Americans dont care o Patients dont care to listen to warnings.