Week 9 Notes
Week 9 Notes FHS213
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This 5 page Class Notes was uploaded by Ellie Collins on Monday March 2, 2015. The Class Notes belongs to FHS213 at University of Oregon taught by Dr. Alltucker in Fall. Since its upload, it has received 116 views. For similar materials see Issues in Family and Human Services in Education and Teacher Studies at University of Oregon.
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Date Created: 03/02/15
Week 9 notes Monday Healthcare in the United States America s Healthcare System a three minute history pre1700s gt gt gt 1900s gt gt gt 1920s gt gt gt WWII gt gt gt 1960s gt gt gt 2010 1 2 3 4 5 6 1 Virtually no health care Average life expectancy 36 years 2 Medical Quackery people spent about 5 year but practices didn t work 3 Medical practices improve price increased rapidly people willing to pay not the poor 4 Employers not allowed to raise wages so offered health insurance to entice workers 5 Two major government programs Medicare and Medicaid a Medicare Healthcare for Americans 65 b Medicaid Healthcare for lowincome Americans 6 Installment of Obamacare gt expansion of medicare Average life expectancy 85 years Where do people get their health insurance 48 from employer 16 from Medicaid 14 from Medicare 5 other private 1 other public 15 uninsured lt Obama care addresses this Obamacare The Affordable Care Act an overview Expands Medicaid coverage to 30 million Americans Individual Mandate every citizen is required to have health insurance or pay penalty Employer Mandate employers with more than 5 0 full time employees must offer affordable health care insurance Insurance reform 0 Cannot deny coverage because of preexisting conditions diabetes cancer etc 0 No lifetime caps on coverage Insurance provider cannot just stop coverage 0 Young adults can stay on parents plan until age 26 Insurance exchanges online marketplaces where individuals can compare and purchase insurance plans remember Cover Oregon Oregon s failed insurance exchange Tax credits provided for some lowincome Americans and small businesses Want a better comprehensive idea check out httpwwwtopmtobsncomobamacare One big problem The Medicaid Gap 0 The original Obamacare required states to expand their statewide medicaid programs 0 26 states sued the federal government 0 US SC found this mandate unconstitutional 0 Medicaid Gap 0 consider a 20000 income most states require 15000 min to qualify for medicaid 0 Who is in the medicaid gaps I Those who make too much to qualify for medicaid but not enough to purchase affordable health care 8 of income I Workingclass Americans Who is Paying for Obamacare 0 455 billion from Medicaid savings from a reduction in medicare payments to doctors and hospitals 0 Criticism saved in medicaid but paying towards medicaid 0 Some physicians turning away medicaid patients can t afford it 210 billion from increased Medicaid payroll tax 107 billion from fees on insurance drugs devices 32 billion from excise tax on high cost cadillac plans which encourage overuse of medical system 0 1313 billion from 38 tax increase on unearned income investment income 27 billion from tax on tanning So who s paying the most Wealthy individuals and middle class families How is US in comparison to the World 0 The US spends the most but still has a lower life expectancy and higher infant mortality than many developed countries why Criticisms of Obamacare Obamacare is not a health care reform it is an expansion built on an existing system a system that was not great to begin with A true healthcare reform would need to address cost Why does US healthcare cost so much 0 Overuse 0 American feel an entitlement to desired healthcare without needing reason or permission 0 New problem new consumerism leads to selfdiagnosis through intemet Despite what some may believe doctors usually know what they re doing 0 Overtreatment 0 US has a feeforservice system Little incentive for doctors to limit tests and procedures If insurance pays patient has little incentive to limit tests and procedures Defensive medicine physicians overtest and over medicate in order to avoid being sued o Malpractice 0 Insurance rates are very high for doctors O Leads to higher costs for procedures 0 High Wages 0 US healthcare wages are the highest in the world 0 Not necessarily bad but drives up price 0 Additionally there are a lot of people involved in the private insurance industry this leads to higher prices from the insurance companies Is Obamacare Working 0 So far 11 million insured through online marketplace 10 million insured under Medicaid CHIP 3 million have stayed on their parents plan 24 million Americans reached short of the 30 million goal but still a lot 0 Number of Americans who are uninsured is lowest since 2001 Spending in healthcare grew the least since the 1960s In Conclusion The system is awed but it is working and improving Wednesday Counseling Basics for Human Services Most people drawn to the human services are natural born helpers most have learned natural helping skills in the context of friendship or family However professional and therapeutic relationships need to be approached in a different manner than friend or familial relationships Important Skills Emotional Intelligence Patience Positivity Con dentiality Compassion Active Listening Skills Empathy Honesty Aware of Implicit Bias Mentally Healthy SelfCare Culturally Competent Intellectually Curious Ethically Competent Comfortable with Ambiguity The Fixer the righting re ex O Humans have a desire to be right and to make things right 0 Our righting re ex kicks in when we want to help 0 Many people drawn to the human services a naturally inclined to x problems 0 Can be appropriate with friends and family not in a professional setting 0 Professionals must learn to recognize and set aside Why is it important to check righting re ex There is more than one right way of nding a solution What is right in the mind of the helper might not be right for the ones needing help A determination to change and x can actually be detrimental to a situation It is important that the client has selfdetermination Client SelfDetermination is when the helper allows the client decide their outcome Helper guides but does not control The Metamorphosis between xer and helper occurs with professional development Professional development helps enhance inherent skills and teaches new important characteristics for professional helpers The Case of Janelle Janelle grew up in a white middle class neighborhood Her family talked a lot about diversity in many aspects She believed she had a fairly open mind and a broad view of diversity However after coming to UO she realized that she only viewed diversity as race and class but at the university she met people of diverse religions cultures sexual orientations etc As she was lling out a questionnaire in a Psychology class she discovered that she felt uncomfortable thinking about working with certain kinds of people such as a woman who wanted an abortion This frustrated and confused Janelle and she realized she didn t have a broad of an acceptance as she thought Janelle was experiencing ambiguity Ambiguity doubtfulness or uncertainty feeling more than one way about something Why is it important to re ect on ambiguity It usually points out things that we need to work on personally and professionally 0 It helps us to re ect deeply about stereotypes prejudice attitudes or beliefs 0 It helps improve critical thinking skills 0 It is important to know which cases could be affected by you ambiguity or bias Ambiguity can be uncomfortable or frustrating but it leads to development and improvement Client Observation most communication is nonverbal o Facial expressions universal across cultures 0 Important to be aware of client s attitudes or emotions based on nonverbal cues Culturally Competent Issues of Privilege Intelligentsia if you graduate from college you will be seen as a member of intelligentsia whether you want to be or not You will be viewed as privileged by many clients and the general public You become one of them and a part of the system Important to realize others view of you when you are going in as a professional helper Privilege can put you in an outgroup and will affect how you interact with people In the video case example the counselor used a motivational interview technique which encouraged client selfdetermination She remained positive and did not input her own views into the situation In conslusion Righting re ex can be hard to reduce but it is important to allow clients to not be seen as a project to be fixed Counseling requires a combination of inherent and learned skills
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