1. Journal Topic: What is meant by the phrase “First, do no harm.”
Future Trends in Healthcare 14
Journal Topic: What is meant by the phrase “First, do no harm.”

2. Learning Objectives Define key terms.
Discuss what is meant by the phrase “First, do no harm.”
Discuss the Children’s Health Initiative Program (CHIP).
Describe who is covered under the Patient Protection and Affordable Care Act (PPACA).
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3. Learning Objectives
Explain what health benefits are covered by Medical Exchanges.
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4. Introduction Healthcare is changing
New treatments, medications, and procedures
New laws
Patient Protection and Affordable Care Act (PPACA)
New ethical dilemmas

5. Problems in the Current Healthcare System
First do no harm
Preventable medical errors are killing 100,000 Americans every year
Incorrect diagnosis, drug mix-ups, needle infections, and surgical mishaps
More hospitals are creating educational programs
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6. Problems in the Current Healthcare System
Cost of healthcare
Cost wasn't always deciding factor
Expensive procedures
MRI
Prescriptions
Defensive medicine
Excessive medical screenings
Yearly mammograms
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7. Problems in the Current Healthcare System
Cost of healthcare
Medical bills and illnesses are currently responsible for about one-half of all bankruptcies in the United States.
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8. Problems in the Current Healthcare System
Lack of healthcare providers
Low-income patients use hospitals as primary care provider
Many are sicker than higher-income patients
Generally admitted to hospital from ER
Physicians who provide care to the indigent on the decline
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9. Problems in the Current Healthcare System
"Germ warfare"
Nearly 2 million patients a year develop hospital-based infections
Many of the deadliest bacteria are now drug resistant
MRSA (Methicillin-resistant Staphylococcus Aureus)
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10. Problems in the Current Healthcare System
Fraud
Intentional deception or injury to another person
Credentials
Medical records
Billing
Drug trials
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11. Problems in the Current Healthcare System
Prescription drug abuse
Accidental fatal drug overdoses have risen 500 percent since 1990
Now at epidemic levels
OxyContin
Vicodin
methadone
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12. Problems in the Current Healthcare System
Ethnic disparities in healthcare
African Americans, Latinos, and American Indians do not always receive good health care
Lack of insurance
Language barriers
Subconscious bias

13. New Advances and Improvement in Healthcare
Promoting prevention and health screenings
Too much emphasis on treatment rather than wellness
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14. New Advances and Improvement in Healthcare
Patient rights
Awareness
Hospital charts
Right to be seen by a medical doctor, not just a resident
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15. New Advances and Improvement in Healthcare
Use of robotics
Machines to perform human tasks
Supply delivery
Medications
Meals
Surgery
Surgeon controls robotic arm
Many applications
Smaller incisions
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16. New Advances and Improvement in Healthcare
The ethics of using robots and robotics
Robotics enhances surgeon skills, not replacement
Some healthcare employees fearful of losing jobs to machines

17. Healthcare Trends and Reform
History of healthcare laws and programs
Federal Emergency Treatment and Labor Act of 1986
Children’s Health Initiative Program (CHIP) in 1997
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18. Healthcare Trends and Reform
Accountable Care Organizations (ACOs)
Group of providers accountable for the care of a group of patients
MCOs
HMOs
PPOs
Medicare and Medicaid
COBRA
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19. Healthcare Trends and Reform
Health maintenance
Patient Protection and Affordable Care Act (PPACA) in 2010
Affordable Care Act
Supporters
Opponents
Revenue and cost
Who is covered?
Preventative care
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20. Healthcare Trends and Reform
Patient Protection and Affordable Care Act (PPACA) in 2010
Insurance exchanges
American Health Benefit Exchanges
Health Exchanges
State-based
Allow consumers to review and compare online plans in each state
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21. Healthcare Trends and Reform
Patient Protection and Affordable Care Act (PPACA) in 2010
Preexisting conditions
Can not be denied coverage
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22. Healthcare Trends and Reform
Patient Protection and Affordable Care Act (PPACA) in 2010
Early implementation problems
Initially no deadline
Enrollment double expecations in some states
Fine for those who fail to purchase insurance

23. The Ethics of Care under the Affordable Care Act
"Adverse selection"
Insurers must cover children despite the presence of preexisting conditions
Birth control and abortion
Insurers must offer preventive care
Some organizations are exempt
Some states may prohibit abortion coverage
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24. The Ethics of Care under the Affordable Care Act
Healthcare law scams
Fraudulent claims to acquire personal information
Subsequent Medicare claims paid
Health literacy
How do we teach our patients?
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