(BOOST YOUR GRADES FOR 2024 EXAMS). WGU C425 Topic 1 - Healthcare Delivery Systems, Regulation, and Compliance. Exam Review Questions and answers, VERIFIED.

WGU C425 Topic 1 - Healthcare Delivery Systems, Regulation, and Compliance. Exam Review Questions and answers, VERIFIED. The current model of U.S. healthcare focuses on identifying symptoms or diseases in patients and eliminating them. The U.S. has a unique system of healthcare delivery, which did not emerge by mere accident, but as a result of market forces and an obligation to treat special populations. Medicaid joint federal-state health insurance program for low-income adults, children, the elderly, and the disabled. Medicare A federal program of health insurance for the elderly, certain disabled individuals, and people with endstage renal disease. Demand-side rationing Prices and ability to pay ration the quantity and type of health care services people consume (consumers are on the demand side) Planned rationing or supply-side rationing Generally carried out by a government to limit the availability of health care services, particularly expensive technology In the U.S., those who support social justice principles seek to find public solutions to provide more equitable access to medical services, whereas market justice drives the privatized, employer-based model of health insurance, which has become the predominant model in the U.S. The current model of health insurance evolved from risk pooling in the lumber industry. Today's healthcare managers must navigate complex administrative territory that requires solid knowledge of: The nuances of private and public health insurance Financing and reimbursement methods Reform initiatives expanding access to healthcare services What is health? a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity Biopsychosocial model of health: WHO definition of health: "A complete state of physical, mental and social well being, not merely the absence of disease." How does WHO define a health care system? all activities with the primary purpose to promote, restore, or maintain health What is holistic health? Treats the whole person Views mental, physical and spiritual aspects of life closely connected and equally important with regard to treatment approaches Incorporates alternative therapies Differentiate between illness and disease Illness -Identified by a person's perception and evaluation of how he or she is feeling Disease Based on a professional evaluation It is possible to have a disease without feeling ill or feel ill without having a disease Acute Disease -Relatively severe -Episodic (of short duration